Medical Insurance Reimbursement
. Insurance Billing Codes [Billing service]
Affordable Care Act
Non-discrimination in health Care: No health plan or insurer may discriminate against any health provider acting within the scope of that provider’s license or certification under applicable State law. This provision is a federal protection applicable to all groups including E.R.I.S.A and other plans establish or regulated under the bill. Just as H.I.P.P.A protections apply across the board, the non-discrimination provision will be applicable to all health benefits plans both insured and self-insured.
This opens up a myriad of services including physical medicine and rehabilitation, including nutritional and weight loss counseling et al and such when a plan pays for those services to any provider, it must also pay to providers acting within their scope. Example: When a plan has limited Chiropractic, but unlimited physical medicine services, it would be required to continue to pay the doctor of Chiropractic for the physical medicine service even when there is no longer any chiropractic manipulation allowances. This holds true for other health Care professionals.
Nordic Pole Walking along with its stretching and strengthening exercises can now be billed and paid by most insurance companies under Physical Medicine codes either 97110 Therapeutic exercisesor 97112 Neuromuscular Reeducation.
Therapeutic Exercise – 97110
Therapeutic exercises are used for the purpose of restoring strength, aerobic capacity, endurance, range of motion and flexibility where loss or restriction is a result of a specific disease or injury and has resulted in a functional limitation.
Therapeutic exercises may require active, active – assisted or passive participation by the patient. 97110 Code can be billed at $45 for each 15 minutes of exercise up to 4 units or 60 minutes. The therapeutic exercise Nordic Pole Walking can be given to a patient with the assistance of a staff member or C.A.
Neuromuscular Reeducation – 97112
This therapeutic procedure is provided for the purpose of restoring balance, coordination, Kinesthetic sense, posture, and Proprioception. This procedure may be reasonable and necessary for restoring prior function which has been affected by:
· Loss of deep tendon reflexes and vibration sense accompanied by Paresthesia, burning, or diffuse pain of feet, lower legs, and/or fingers;
· Nerve palsy, such as Peroneal nerve injury causing foot drop;
· Muscular weakness or flaccidity as result of a cerebral dysfunction, a nerve injury or disease or having had a spinal cord disease or trauma;
· Poor static or dynamic sitting/standing balance;
· Postural abnormalities;
· Loss of gross and fine motor coordination;
· Hypo/hyper Tonicity.
Evaluation and Management Codes
All Healthcare Professionals use these codes to bill insurance companies on patient services. Due to the additional changes in 2016 all Professionals, that includes M.D,’s will have to verify that their patients are making changes of improvement each month in their health which is Outcome Base Care to be paid. Nordic Pole Walking has over 350 Medical studies showing why it is the fastest growing full body metabolic exercise in the world today. It is easy to document the changes that occurs in such a short time and will continue to show improvement each month no matter want the patients’ condition, as long as they can walk, they can do this exercise. This exercise will easily transition to a daily home exercise program that will help maintain your patients’ health. This is what the Insurance Companies with the new regulations are wanting.
Supportive Documentation Recommendations
Supportive Documentation on Nordic Pole Walking will be available to all Health Care Professionals no matter your specialty, who is certified with our program. This can be done online for your convenience. We also recommend after being certified with us, that you look at the A.N.W.A. schedule on our website that gives hands on instructor training each weekend across the U.S. We are endorsed by the American Nordic Walking Association.