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BOULDER - UnitedHealtcare, a major insurance provider serving Colorado, is changing how it pays physical therapists and how much it pays them, causing concern among Boulder County physical therapy providers.
The change is being implemented by ACN Group of California, a subsidiary under UnitedHealth Group's Specialized Care Services division. It provides chiropractic management, physical therapy management, complementary medicine networks, and consumer health and wellness solutions to the health-care market.
Starting March 1, ACN plans to reimburse Colorado physical therapy providers $75 for an initial evaluation and visit and $55 per subsequent visit. Rather than paying based on the service performed and time spent with the patient, known as "fee for service," ACN will pay a "per diem rate," which means providers will receive the same payment regardless of time and treatment.
"The strategic goal of our revised fee schedule is to provide parity and simplicity across all our regions," said Cheryl Randolph, spokeswoman for UnitedHealthcare. "Some therapists were paid per diem, others based on a fee schedule. We decided to change it to streamline the process and make it more consistent with the rest of the industry."
Local physical therapists say the new reimbursement rate is too low. The current rate is slightly below the Medicare fee schedule for physical therapy, and the proposed...