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The Amplify OT Podcast

The Amplify OT Podcast

By Clarice Grote

Welcome to the Amplify OT Podcast. I’m Clarice Grote, MS, OTR/L and I’m the host of the Amplify OT Podcast. I’m an occupational therapist by trade and a policy wonk by choice. The Amplify OT Podcast is where we break down healthcare policy and legislation to help you not only survive but thrive in this crazy US healthcare system. So, let's dive in!
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Ep. 16: False Claims Act - It's more than billing for services that weren't provided
Ep. 16: False Claims Act - It's more than billing for services that weren't provided
Now I know compliance is not a word that generally sparks a lot of excitement, however, it is something that is extremely important for both the business owner and us as individual clinicians to protect ourselves and our licenses. That’s why this week on The Amplify OT Podcast, I am talking about the False Claims Act. In this episode I cover: The impacts that failure to follow rules and regulations has on you as a licensed professional. What is the OIG and how some facilities are getting busted by them for filing incorrect claims to get a higher payout. Important things you should know in regards to the false claims act and how to protect yourself from legal implications. The responsibility you as a clinician has to understand the laws yourself instead of relying on your facility. Thanks for listening! If you found this episode helpful, don’t forget to follow, rate and review the show. To learn more about Amplify OT head to https://amplifyot.com/ Need CEUs? Save 40% off on your Medbridge subscription by using code “AmplifyOT” at checkout or by visiting https://www.medbridgeeducation.com/amplify-ot. Medbridge has great CEUs on the OASIS and Medicare Reimbursement. Resources: OIG False Claims Act IG Reel: SNF sued for false claims Pt 1: https://www.instagram.com/reel/CgvUZZ3tjli/ IG Reel: SNF sued for false claims Pt 2: https://www.instagram.com/reel/Cgx3NOyvm-9/ IG Reel: SNF sued for false claims Pt 3: https://www.instagram.com/reel/Cg0QiNKridY/ Looking for more policy info? Check out the Amplify OT Academy at https://amplifyot.com/occupational-therapy-continuing-education/ Curious how you can best avoid filing a false claim? Learning what Medicare covers and how our healthcare system works is the #1 way to understand the law. Take charge of your career and be the change you want to see with Mastering OT Policy & Medicare. Register today! CONNECT WITH AMPLIFY OT: Website Work With Me Free Newsletter Instagram LinkedIn Facebook TikTok
19:21
November 22, 2022
Ep 15: Is CMS changing its policy about if OT can initiate the OASIS in Home Health?
Ep 15: Is CMS changing its policy about if OT can initiate the OASIS in Home Health?
**Note: The COVID-19 PHE has been renewed until January 11, 2023, since this episode was recorded** There may be some confusion between CMS changing policies and the expiration of the COVID-19 public health emergency when it comes to Occupational Therapists starting home health OASIS. That’s why this week on The Amplify OT Podcast, I’m answering a listener question about the policy around who can initiate the OASIS in home health. In this episode, I cover: What to expect when it comes to renewing the COVID-19 public health emergency. Why there might be this misconception that there needs to be another discipline doing an evaluation the same day as the OT. The financial and liability implications that misunderstanding this policy can have on you as a practitioner. Thanks for listening! If you found this episode helpful, don’t forget to follow, rate and review the show. To learn more about Amplify OT head to https://amplifyot.com/ Need CEUs? Save 40% off on your Medbridge subscription by using code “AmplifyOT” at checkout or by visiting https://www.medbridgeeducation.com/amplify-ot. Medbridge has great CEUs on the OASIS and Medicare Reimbursement. Did you miss Amplify OT’s OASIS training? Get access to the recording here: https://amplifyot.com/courses/scoring-the-home-health-oasis CONNECT WITH AMPLIFY OT: Website Work With Me Free Newsletter Instagram LinkedIn Facebook TikTok LINKS MENTIONED IN THIS EPISODE: Home Health OASIS & Value- Based Purchasing [Podcast Episode] Patient-Driven Groupings Model (PDGM) in Home Health [Podcast Episode] Is Occupational Therapy a Qualifying Service in Home Health [Article] What is the Patient-Driven Groupings Model (PDGM) in Home Health [Article] Can Occupational Therapists Initiate the OASIS? [Article]
13:05
November 08, 2022
Ep. 14: Does Medicare limit the number of minutes an OT can provide in SNF? - Social Media Q&A
Ep. 14: Does Medicare limit the number of minutes an OT can provide in SNF? - Social Media Q&A
If you’re ever confused about a new rule at your facility, ask to see the policy. Not only will it clear up any misunderstandings or uninformed practices, but it also presents an opportunity for everyone to learn and grow in our field. This week on The Amplify OT Podcast, I am answering a listener question about whether or not Medicare puts a limit on the number of minutes of care that you can provide to a patient in a Skilled Nursing Facility or any other setting.  In this episode, I cover: When you should be cautious of “new” Medicare rules. How asking to see the policy can help clarify if the concern you’re dealing with is a Medicare rule or a facility rule disguised under Medicare. My thoughts on why the facility we address in the listener’s question may have said there is a limit on the number of minutes of care under Medicare. How you, as the practitioner, can be prepared to advocate for yourself and your patients. Thanks for listening! If you found this episode helpful, don’t forget to follow, rate, and review the show. To learn more about Amplify OT, head to https://amplifyot.com/ Need CEUs? Save 40% off on your Medbridge subscription by using code “AmplifyOT” at checkout or by visiting https://www.medbridgeeducation.com/amplify-ot. Medbridge has great CEUs on Medicare Reimbursement. Are you ready to become your own best resource and learn what Medicare ACTUALLY pays for? Then check out Mastering OT Policy & Medicare. This comprehensive course covers everything you need to know about Medicare, billing, health insurance, and advocacy so you can trade "not knowing" for "informed and empowered"! Check it out at amplifyot.com/step/medicare-course Did you miss Amplify OT’s Section GG training? Get access to the recording here: https://amplifyot.com/product/section-gg-webinar/ CONNECT WITH AMPLIFY OT: Website Work With Me Free Newsletter Instagram LinkedIn Facebook TikTok LINKS MENTIONED IN THIS EPISODE: Patient Driven Payment Model (PDPM) in Skilled Nursing Facilities  How Understanding PDPM in Skilled Nursing Facilities Can Make You a Better Clinician
13:46
October 25, 2022
Ep. 13: Medicare's 8-Minute Rule: OT Billing Q&A
Ep. 13: Medicare's 8-Minute Rule: OT Billing Q&A
The 8-minute rule in billing is used in regard to time codes by Medicare to determine how many units of therapy you can bill underneath a timed code based on the amount of treatment time provided. If how to use the 8-minute rule is confusing to you, you’re not alone. That’s why this week on The Amplify OT Podcast, I am answering a listener question on the 8-minute rule of billing! In this episode, I cover: When you will use the 8-minute rule What the 8-minute rule means and how you can apply it in billing. Timed codes vs. untimed codes. Where you might get tripped up in billing and why it can sometimes be referred to as the 15-minute rule. How you can use your time wisely and ensure you are getting paid for the care, you are providing. Billing is such a complex situation, so it is important for you to always go to the source and seek out accurate information. Thanks for listening! If you found this episode helpful, don’t forget to follow, rate and review the show. To learn more about Amplify OT, head to https://amplifyot.com/ Do productivity talks, Medicare lingo, and reimbursement rules make you want to give up on the profession? Sure, you can keep wrestling with the info provided by your company, looking for documentation shortcuts while hoping you’re doing things right, OR you could carve out a bit of time to learn, and in return, you’ll be able to understand policy basics, know where to find the correct answers, and successfully advocate for yourself and your patients. Are you ready to trade that feeling of not knowing for being an informed and empowered occupational therapy practitioner? Sign up for the Mastering OT Policy & Medicare Course  Need CEUs? Save 40% off on your Medbridge subscription by using code “AmplifyOT” at checkout or by visiting https://www.medbridgeeducation.com/amplify-ot. Medbridge has great CEUs on the OASIS and Medicare Reimbursement. CONNECT WITH AMPLIFY OT: Website Work With Me Free Newsletter Instagram LinkedIn Facebook TikTok
15:21
October 12, 2022
Perspective on Policy & Advocacy from Crystal, Amplify OT's Capstone Student
Perspective on Policy & Advocacy from Crystal, Amplify OT's Capstone Student
I had known that I wanted to take on a capstone student but was nervous I wasn’t quite ready for it. When I met Crystal, her drive and curiosity were everything I needed to assure me that I was ready and she was the perfect match. That’s why this week on The Amplify OT Podcast, I am talking to Crystal, who has been working with me for the last 14 weeks and joined me today to share what she’s learned and give more insight into her capstone experience. In this episode, Crystal and I cover: What led to Crystal’s curiosity in advocacy and how we came to work together. Crystal’s role in creating the New Grad Reimbursement Guide course. The additional knowledge Crystal gained through doing her capstone with Amplify OT that she wouldn’t have gotten elsewhere. Myths around policy and engaging in advocacy that Crystal once believed were proven untrue during her capstone work. What’s next for Crystal in her career as an OT. Thanks for listening! If you found this episode helpful, don’t forget to follow, rate, and review the show. To learn more about Amplify OT, head to https://amplifyot.com/ Need CEUs? Save 40% off on your Medbridge subscription by using code “AmplifyOT” at checkout or by visiting https://www.medbridgeeducation.com/amplify-ot. Medbridge has great CEUs on the OASIS and Medicare Reimbursement. CONNECT WITH AMPLIFY OT: Website Work With Me Free Newsletter Instagram LinkedIn Facebook TikTok LINKS MENTIONED IN THIS EPISODE: Crystal’s Blog Post: https://amplifyot.com/advocacy-capstone-experience-2022/  Course Sign-up - https://amplifyot.com/new-grad-guide
27:24
August 29, 2022
Q&A: Is OT a Qualifying Discipline in Home Health
Q&A: Is OT a Qualifying Discipline in Home Health
I'm trying something new in this episode! I typically upload 1-2 Q&A videos to my youtube channel each month where I answer commonly asked questions. Some of you expressed you'd like to have the audio of these Q&As shared on the podcast as well!  These episodes will always be short and sweet. I'll mark them with a Q&A at the front so if you aren't a fan you can skip right past them :)  Let me know what you think!! In this episode I cover,  Answering the question: "Is OT a qualifying discipline in Home Health?"  What a qualifying service means Medicare Part A Home Health Benefit When OT can 'stand alone' or be a qualifying service Thanks for listening! If you found this episode helpful, don’t forget to follow, rate, and review the show. To learn more about Amplify OT, head to https://amplifyot.com/. If you want your question answered, send me a voice memo and I'll put it on my list! Need CEUs? Save 40% off on your Medbridge subscription by using code “AmplifyOT” at checkout or by visiting https://www.medbridgeeducation.com/amplify-ot. Medbridge has great CEUs on the OASIS and Medicare Reimbursement. Did you miss Amplify OT’s OASIS training? Get access to the recording here: https://amplifyot.com/courses/scoring-the-home-health-oasis CONNECT WITH AMPLIFY OT: Website Work With Me Free Newsletter Instagram LinkedIn Facebook TikTok
05:16
August 23, 2022
Home Health OASIS & Value-Based Purchasing
Home Health OASIS & Value-Based Purchasing
The OASIS is part of the initial and comprehensive assessment that you have to complete on all Medicare and Medicaid patients in home health and is a way that CMS is showing their commitment to standardizing the way in which we assess patients in post acute care across all patients. That’s why this week on The Amplify OT Podcast, I am talking all things OASIS and the upcoming home health Value-Based Purchasing program. In this episode I cover: What is the OASIS, new changes, and new measures to be aware of. The importance of accurate scoring and how you can use the free manual to do so. How scoring with OASIS differs from Section GG scoring and why it is vital to understand the differences. Observation vs. interview and examples of when it makes a difference. Everything you need to know about the upcoming Value-Based Purchasing program. Thanks for listening! If you found this episode helpful, don’t forget to follow, rate and review the show. To learn more about Amplify OT head to https://amplifyot.com/ Need CEUs? Save 40% off on your Medbridge subscription by using code “AmplifyOT” at checkout or by visiting https://www.medbridgeeducation.com/amplify-ot. Medbridge has great CEUs on the OASIS and Medicare Reimbursement. Did you miss Amplify OT’s OASIS training? Get access to the recording here: https://amplifyot.com/courses/scoring-the-home-health-oasis CONNECT WITH AMPLIFY OT: Website Work With Me Free Newsletter Instagram LinkedIn Facebook TikTok LINKS MENTIONED IN THIS EPISODE: FREE OASIS D Scoring Guidance Manual  OASIS E Guidance Manual Draft Home Health Value-Based Purchasing (HH VBP) Resources
26:23
August 15, 2022
Patient-Driven Groupings Model (PDGM) in Home Health
Patient-Driven Groupings Model (PDGM) in Home Health
There are a lot of misconceptions out there about PDGM so let's set the record straight! PDGM is the new home health payment system for Medicare which was implemented on January 1, 2020.  Subscribe to my newsletter Get Unlimited CEUs with Medbridge Start your podcast: Anchor.fm
29:50
July 23, 2022
Discharge Plans and Medicare
Discharge Plans and Medicare
Have you ever felt like no one listens to your clinical judgment when it comes to discharge planning? I used to feel like this until I started talking to case managers more and learned more about how much influence insurance coverage has on discharge plans. I had some basic knowledge but really learned a lot from them. Once we were all on the same page, making discharge planning was a lot less painful for everyone involved.  If you want to learn this information and feel confident discussing it with others, sign up for the New Grad Reimbursement Guide Course! Sign-ups close June 30th so head over now and save your spot - https://amplifyot.com/new-grad-guide
31:31
June 18, 2022
OT Licensure Compact with Meghan Pudeler from AOTA
OT Licensure Compact with Meghan Pudeler from AOTA
Support Amplify OT and our FREE content by making a donation! Podcast Resources: Sign up for our free newsletter: https://amplifyot.com/sign-up  Therapy Blogging 101 Course - Use code CLARICE20 for $20 off your course! Start your podcast: Anchor.fm Join AOTA Learn more about the OT Compact AOTA Advocacy Page
43:45
May 25, 2022
How Medicare Law is Made
How Medicare Law is Made
Let's talk about how exactly Medicare law is created! This episode goes with this article on my website https://amplifyot.com/how-medicare-law-is-made-and-what-you-can-do/  Do productivity talks, Medicare lingo, and reimbursement rules make you want to give up on the profession? Sure, you can keep wrestling with the info provided by your company, looking for documentation shortcuts and posting questions in Facebook groups while hoping you’re doing things right OR you could carve out a bit of time to learn and in return you’ll be able to understand policy basics, know where to find the correct answers, and successfully advocate for yourself and your patients. Are you ready to trade that feeling of not knowing for being an informed and empowered occupational therapy practitioner? Sign up for the Mastering OT Policy & Medicare Course before October 14th, 2022! Need CEUs? Save 40% off on your Medbridge subscription by using code “AmplifyOT” at checkout or by visiting https://www.medbridgeeducation.com/amplify-ot. Medbridge has great CEUs on the OASIS and Medicare Reimbursement. CONNECT WITH AMPLIFY OT: Website Work With Me Free Newsletter Instagram LinkedIn Facebook TikTok
26:11
April 20, 2022
Patient Driven Payment Model (PDPM) in Skilled Nursing Facilities
Patient Driven Payment Model (PDPM) in Skilled Nursing Facilities
Today's episode is all about PDPM in Skilled Nursing Facilities (SNF). We talk about the fundamentals of the old payment system or RUG levels and how it is different from the payment model we have today. We also take a good look at Section GG, its impact on reimbursement and quality outcomes, how therapy specifically is paid for, group and concurrent therapy, and more!  Do productivity talks, Medicare lingo, and reimbursement rules make you want to give up on the profession? Sure, you can keep wrestling with the info provided by your company, looking for documentation shortcuts and posting questions in Facebook groups while hoping you’re doing things right OR you could carve out a bit of time to learn and in return you’ll be able to understand policy basics, know where to find the correct answers, and successfully advocate for yourself and your patients. Are you ready to trade that feeling of not knowing for being an informed and empowered occupational therapy practitioner? Sign up for the Mastering OT Policy & Medicare Course before October 14th, 2022! Need CEUs? Save 40% off on your Medbridge subscription by using code “AmplifyOT” at checkout or by visiting https://www.medbridgeeducation.com/amplify-ot. Medbridge has great CEUs on the OASIS and Medicare Reimbursement. CONNECT WITH AMPLIFY OT: Website Work With Me Free Newsletter Instagram LinkedIn Facebook TikTok
24:23
February 25, 2022
Insurance and How It Impacts Our Plan of Care
Insurance and How It Impacts Our Plan of Care
This episode covers the main insurance types you will see as a therapy provider including private insurance, Medicare, Medicaid, and others. We review the common insurance terms and how visit limits and therapy coverage can impact how and when we provide care.  Amplify OT Article on this topic: https://amplifyot.com/health-insurance-in-occupational-therapy-plan-of-care/  Sign up on Patreon for Ad-Free Content: https://www.patreon.com/amplifyot Sign up for our free newsletter at www.amplifyot.com Head to amplifyot.com/occupational-therapy-mentoring to see how I can help you achieve your goals!
23:27
January 20, 2022
2022 Medicare Updates: Home Health, Medicare Sequester, and more
2022 Medicare Updates: Home Health, Medicare Sequester, and more
Here is the link to the article on 2022 Medicare changes we are seeing in 2022 https://amplifyot.com/2022-medicare-regulation-changes/ 
11:50
January 06, 2022
Take Action: Stop the Medicare Cuts for 2022
Take Action: Stop the Medicare Cuts for 2022
Up to 10% reimbursement cuts may be coming for Medicare Part B for occupational and physical therapy service on January 1, 2022. This is in addition to the OTA Modifier. Up to 6% cuts may be coming for Medicare Part A. Write your legislators today at www.aota.org/takeaction Here is my article on last years Medicare cuts that talk a bit more about the Medicare Physician Fee Schedule https://amplifyot.com/medicaretherapycut/
08:48
December 07, 2021
The Occupational Therapy Assistant Modifier
The Occupational Therapy Assistant Modifier
This episode looks at the occupational therapy assistant (OTA) and physical therapy assistant (PTA) payment modifier reduction. This reduction takes effect January 1, 2022. The information in this episode was accurate at the time it was published. As with all things in policy, things may change by the time you listen to it. AOTA Take Action Link: www.aota.org/takeaction Amplify OT Articles How to Apply the OTA/PTA Modifier article- https://amplifyot.com/applying-the-ota-and-pta-modifier-co-cq-for-outpatient-therapy/  Sign up for my free newsletter to get it delivered to your inbox as soon as it is finished  Take Action Now to Delay the OTA Payment Modifier Reduction
23:41
December 04, 2021