The following is a very basic and general example of the Group Physiotherapy process that we used. I believe we had been fulfilling requirements for years and (HF) were not interested in checking my updated systems and patient notes. By (HF) not co-operating they didn't have to re-instate Group Physiotherapy claiming and pay rebates. I believe they abused their power.
I have also shared the information below to give practitioners complimentary resources to utilise, if you feel they are beneficial.
Regular functional assessment modified to the individuals needs. CLICK HERE.
We had normative data to compare patients levels and used them for goal setting.
We had Physiotherapy assessments, Exercise Physiology assessments, were had postural assessments, we did functional assessments, strength assessments, balance assessments plus much more.
Post assessment we wrote to some health funds to see if they would allow claiming for certain conditions and circumstance. Unfortunately many letters did not get a response.
Every patient and client filled out a pre-exercise form as we were a clinical exercise facility.
It was pre-screening, just like when you go to a medical center, before you see the doctor.
People were allocated into medical/physio exercise needs- Group Physiotherapy and healthy fitness needs. Group Physiotherapy, for a condition was a claimable item, fitness clients was not a claimable item under a Physiotherapy category. We were clear on that. As far as I know, both types of categories just mentioned can attend in the same Group together. Detailed notes are recorded and the correct claiming receipts are given to the respective patients/clients.
Up to one hundred questionnaires had been collected for various conditions, disability indexes, pain questionnaires etc. for years. (HF) never discussed this or discussed the decade of Group Physiotherapy information I had collated and organised.
Individualised clinical exercise programs were created and written up considering the patients/ clients condition, assessment finding, experience and safety levels, limiting factors, their discussed goals and there level of functional ability. The individuals motivation to be pro active in their own healthcare was also considered. Active treatment is a completely different context to treat from rather than from a passive treatment perspective. It requires a significant differentiation of skill set and methods to treat the patient.
We used various resources to write up programs including research papers, the American College of Sports Medicine book and many other rehab books. We created a 'Researched based' folder and backed up most of what we did with research documents.
Detailed, one page management plans were created.
Doctors letters were sent to advise of the history, passive, active and functional assessment findings, the basic details of the individualised exercise program and the goals of treatment.
During each session, the patient/client was supervised, a mini-assessment was performed and many extra activities happened in the session including detailed explanation of program/exercise, advice, manual assistance, manual activities- eg general or PNF stretching, modification-progression or regression of exercises, discussion of pain symptoms, confidence in achieving goals, to name a few.
Home exercises were often given to address specific conditions and weaknesses and to supplement their supervised sessions. Home management was often encouraged for pain, rest, progression, referral to another therapist if required.
X-ray referrals were given as clinically indicated.
Discussions with doctors and other therapists would occur whenever it was required.
We had a very strong focus in our facility, for not having the patient being dependent on hands on treatment. This empowered the individual toward becoming independent, encouraged self care and nudged them continuously toward constant improvement. You may have noticed a distinct use of the term 'facility' on this website, as we facilitated people.
When I realised what (HF) and Business X was doing was wrong all these years, patients were then discharged when their medical/Physio condition had plateaued or resolved. They stopped claiming under Group Physiotherapy as they transitioned to maintenance. Many clients stayed on with us to attend for their continued health progression, to manage their condition and for their fitness needs. In these situations they did not claim Group Physiotherapy.
I have strong reasons to believe, Business X in collaboration with (HF) allowed claiming for most of their clients, many for up to 10 years, claiming even with no health condition, when the condition had resolved or for ongoing management.
This was claimed under a 'Group' code P560 even when the service given was a 'Class' P561.
Switching codes allowed up to $1200 worth of claims, rather than $150 a year, per client.
The motive to switch codes is clear.
It is March 2019 and only yesterday, I come across a template example for Group Physiotherapy patient entries. It was released by the APA- Australian Physiotherapy Association in 2018. This is the link:
The APA claims to be "the sole voice and peak professional body representing physiotherapists and their patients in Australia."
I am unhappy on two accounts:
A) I was asking the APA for Group Physiotherapy examples and templates information back in 2013, after my (HF) ambush. They advised none existed and they don't do that kind of thing. It has taken an organisation with access to 24,000 members, which include scholars, lecturers, business people and access to an annual profit of millions of dollars, 5 years to create a template. Yet, I was totally ignored for 8 years prior with multiple letters to (HF) and the APA, a very limited team and a tight cashflow to fix up the mess (HF) had caused, which confused me by switching codes for another business and under a circumstance of extreme administration bullying and bad faith. A lot of pressure on one individual and a small team. I was kept 'blind' and led down the wrong path and expected to perform as a peak professional. What is going on? I deserved better, my patients deserved better.
B) Even though I have been in constant communication with the APA about my matter over the recent years, nobody bothered to inform me that this information had been created. Is this really representing and assisting Physiotherapists?
If you review the APA service delivery template and my patient notes example above, these points plus much more were included.
I have tried to obtain patient notes from business X. Due to confidentiality, it is very difficult, but I say with confidence, they would not even come close to the expected level of patient note taking as described in the link above.
It is simply another case of Advance Australia Unfair-ly.