I Love Neuro

Wonder if your documentation is up to snuff to pass an audit? Tune into this episode where hosts Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS interviewed Phyllis Goldstein, a speech-language pathologist with extensive experience in Medicare audits and appeals! She shares her journey from clinical work to becoming an expert in navigating the complex world of therapy documentation and reimbursement. Phyllis emphasizes the critical importance of detailed, skilled documentation using precise language that explains exactly what makes their intervention unique and necessary. The discussion explores the challenges therapists face, particularly in neurological specialties, when transitioning patients between skilled therapy and maintenance programs. Phyllis stresses the difficulty of determining when therapy becomes repetitive and no longer medically necessary, while acknowledging therapists' genuine desire to help patients maintain their functional abilities. She provides insights into the Medicare audit process, sharing her strategies for successfully appealing denied claims and her impressive 85-90% overturn rate. She also addresses the big question of are there a lot of cases of therapists going to court for charging cash for wellness services that should really be billed to Medicare as therapy? Get in touch with Phyllis here: 410-382-900 Phyllis@pgconsultants.net

Have you ever been curious how a naturopath approaches medicine for a person with Parkinson’s? Turns out it’s super comprehensive. Spoiler alert - we couldn’t cover it all, but what you’ll learn from Dr. Tanya Denne, ND will blow your mind! Hosts Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS learn about Dr. Denne’s journey into naturopathic medicine and her groundbreaking research on Mucuna pruriens, a botanical treatment for Parkinson's disease. Driven by a personal connection to neurological conditions through her grandmother's Alzheimer's, Dr. Denne discovered naturopathic medicine as a holistic approach to healthcare that goes beyond traditional Western medical treatments. Her research focuses on Mucuna pruriens, a subtropical plant with remarkable potential for Parkinson's patients. Unlike traditional medications, Mucuna contains high levels of levodopa and offers multiple beneficial constituents, including amino acids, glutathione, and antioxidants. Dr. Denne emphasizes that the plant isn't a cure, but can potentially slow disease progression when used correctly. The biggest challenge in using Mucuna is ensuring quality and proper dosage. Dr. Denne warns about widespread supplement adulteration, recommending patients work closely with qualified practitioners to source safe, effective products. She suggests using Mucuna as a complementary treatment to standard Parkinson's medications, particularly Sinemet, to optimize patient outcomes. One of her most compelling case studies involves a patient whose Unified Parkinson's Disease Rating Scale (UPDRS) score dramatically improved from 27 to 8 through an integrative approach combining Mucuna, exercise, and foundational health optimization. Patients interested in learning more can visit Dr. Denne's website at Dr Denne.com for consultations and further information about integrative approaches to neurological health. www.doctordenne.com DoctorDenne@gmail.com IG @Dr.TanyaDenne

Ever dream of having a lively clinic space where all of your neuro dreams come true? In this episode Claire McLean, PT, DPT, NCS and Emily Duval Ledger, NeuroBiz coach dive deep into the challenging journey of finding and establishing a brick-and-mortar space for a neurological therapy and fitness business. They share candid insights about their personal experiences, emphasizing that the process is far more complex than traditional real estate hunting. The conversation highlights the importance of starting small by renting space from others, which allows entrepreneurs to test their business model and understand their specific spatial needs without significant financial risk. Both Claire and Emily describe their initial steps of teaching classes in shared spaces like gyms, physical therapy clinics, and even parks before committing to a long-term lease. Their discussion reveals the intricate negotiations involved in commercial leasing, including understanding different lease types, build-out costs, and landlord expectations. They stress the value of creativity in lease negotiations, such as reduced rent periods, longer lease terms with incremental increases, and finding landlords who genuinely want long-term tenants. The podcast also delves into the practical challenges of renovations, with Claire sharing her experience of a $70,000 build-out that transformed a dated gym space into a perfect neurological wellness center. They candidly discuss unexpected costs, the importance of doing renovations comprehensively, and the need for spaces that can accommodate specialized equipment and exercise programs. Tell your clients about Parkinson’s Wellness Fund grants!

If you’re anything like us you always want to do everything possible to help your neuro patients recover and improve as much as possible. On today’s show host Erin Gallardo, PT, DPT, NCS interviews Rose Tilton, OTR/L, OTD about an intervention that she took straight from the research to the clinic: spinal cord stimulation with transcutaneous stimulation. After learning about its applicability in the literature Rose was eager to use it with her patients but hit some road blocks. Finally she was in touch with the authors of a study who helped her and her colleagues become trained in using transcutaneous spinal stimulation on people with spinal cord injury. The clinicians found the intervention was not only simple to do but also very effective for maximizing outcomes in upper extremity rehab, lower extremity rehab, trunk control for balance, bowel and bladder and even sexual function. In today’s episode Rose breaks down exactly what you need to know in order to start using this intervention with your patients today using equipment you already have!   Gain clinical insights that will spark your curiosity to learn more in this episode. While you’ll learn exactly what to do, best practice dictates that you do additional research to ensure you have competency and clearance from your clinical state practice act to perform this intervention. Rose encourages therapists to stay curious, reach out to researchers, and be proactive in exploring new interventions that could transform patient outcomes.

In this episode of the I Love Neuro podcast, hosts Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS sat down with Rachel Wiley, MS, OTR/L, CDP, an innovative occupational therapist who is transforming dementia care through her Dementia Collaborative. With over a decade of experience, Rachel has dedicated her career to supporting individuals living with dementia, their families, and healthcare professionals. Rachel's journey began with a personal connection - her practice, originally named Day by Day Home Therapy, was inspired by her grandmother and aunts who lived with dementia. Recognizing the isolation in dementia care, she created the Dementia Collaborative, a membership-based community that brings together occupational therapists, physical therapists, and other healthcare professionals to share knowledge and support. After transitioning from direct clinical care to a consulting model, Rachel now focuses on family coaching, innovative research and education for healthcare professionals. She uses evidence-based approaches like the the Skills2Care framework, CARE checklist and framework, and the Green Activity Program study. The CARE checklist and framework is a tool she helped co-create that uses non-verbal cues to assess consent, protecting residents' dignity and right to human connection. She has a ton of resources for you to check out! Skills2care framework - training for OTs www.dementiacollaborative.com www.daybydaydementiaconsulting.com www.rachelwileyot.com https://www.linkedin.com/in/rachel-wiley-ms-otrl-cdp-80521079/

We know our listeners are lifelong learners and there are different ways to gain clinical excellence. On today’s show Erin Gallardo, PT, DPT, NCS talked to 4 occupational therapists who’ve completed an OT fellowship. Briana Elson, MS, OTR/L, BCPR, CBIS, Lindsey Talcott, MOT, OTR/L, Gianna Neutts, MS, OTR/L, and Jocelynn Aguilar, MSOT, OTR/L are here to discuss their experience and provide insights about OT fellowships and specifically the one they completed. OT fellowships are intensive one-year programs that offer more than just additional training; they provide a comprehensive approach to mastering neurological rehabilitation. Fellows experience concentrated mentorship, rotate through diverse neurological settings, and develop a deep understanding of evidence-based practice that goes far beyond traditional clinical education. The key motivation for pursuing a fellowship is clear: to become an exceptional clinician who can truly make a difference in patients' lives. The panel emphasized the importance of having at least a year of clinical experience before applying, demonstrating a strong work ethic, and showing a genuine passion for neurological occupational therapy. Also discussed are what the application process is like, the factors that would make you a competitive candidate and who is not a good fit for this type of program. The programs are challenging, requiring fellows to balance full-time clinical work with additional educational commitments - do you want that? Graduates emerge with increased confidence, specialized skills, and a commitment to lifelong learning that sets them apart in their field. Listen to the conversation and see which path you prefer to lead you to clinical excellence! 

Wait, you mean you have to charge for your amazing services?! How scary!! The pricing conversation is a BIG one! If you’ve ever felt scared to ask for a dollar amount, to raise your prices or even did what most clinicians do and undercharged, this episode is for you!  Claire McLean, PT, DPT, NCS, Erin Gallardo, PT, DPT, NCS, and Emily Duval Ledger, CPT dive deep into setting and raising prices for professional services. The key takeaway is clear: healthcare professionals often dramatically undervalue their expertise. Many therapists and wellness professionals struggle with pricing, frequently charging far less than their services are truly worth. The hosts shared personal experiences of initially undercharging, revealing common mistakes that plague the industry. These include basing prices on limited insurance reimbursements, feeling guilty about charging fair rates, and failing to account for the true costs of delivering high-quality professional services. Claire McLean introduced her "back and forth math" approach to pricing that considers multiple financial factors. This method involves calculating monthly income needs, factoring in taxes and business expenses, determining realistic client capacity, and carefully considering additional costs like staff, benefits, and overhead. The goal is to create a pricing structure that not only sustains the business but allows practitioners to deliver their best work. The conversation highlighted several key pricing principles that can transform a struggling practice into a thriving business. Practitioners must recognize that their energy and expertise are their most valuable assets. Charging appropriately prevents burnout and allows professionals to maintain the passion that drew them to their field. By creating clear value and communicating pricing transparently, businesses can attract clients who are truly committed to their own transformation. Learn practical strategies and insights so you and your clients will both thrive! 

Have you ever put weights on a walker? We’re guessing you have! Likely ankle weights…Did you find those ankle weights slide around and didn’t stay where you wanted? Well there is an actual product designed by a PT/OT duo that makes weighting ANY assistive device easier and more precise. Physical therapist Nicole Fellows, MS, PT, DPT and occupational therapist Sarah Ali, MS, OTR/L, CSRS, AIB-VRT/CON share their story of developing FALI Rehab, a company that offers adjustable weighted attachments that can be easily added to walkers, canes, and other assistive devices. Sarah and Nicole share how the idea came to fruition, what the process has been like, who benefits from the weights, why you might want to try them and where to learn more info. The weights range from 1-3 pounds and can be customized to individual needs, designed to improve proprioception and stability for users with conditions like Parkinson's, stroke, and ataxia. The product helps users feel more confident and stable while walking and can be used in clinical settings and at home. Their product addresses multiple challenges by providing immediate feedback to the nervous system, allowing users to continue using their preferred assistive device, and offering an affordable alternative to purchasing multiple specialized walkers. Currently, FALI Rehab is working on an improved design that will make attachment even easier, with plans to launch that version in late July/early August. Therapists and individuals interested in improving mobility can learn more at www.falirehab.com. IG is @falirehab  Linked in: FALI Rehab Equipment, LLC

Dr. Katie Wadland, PT, DPT, GCS's entrepreneurial journey is a testament to adaptability and patient-centered care. What began as a pandemic-era pivot while homeschooling her children transformed into Healthy Aging Physical Therapy, a robust 20-person mobile practice specializing in geriatric and neurological rehabilitation. Her practice emerged from a critical healthcare need, offering innovative at-home therapy services that prioritize patient accessibility. Unlike traditional clinical models, Wadland created a flexible business approach that allows therapists to manage their own schedules while maintaining high-quality care standards. Financial sustainability came through a strategic blend of insurance-based and wellness services, with approximately 70% of revenue from Medicare and 30% from wellness programs. By maintaining transparent financial practices and implementing a profit-sharing model, Wadland cultivated a collaborative team culture that values both professional growth and work-life balance. A key differentiator in her practice is the emphasis on continuous learning and interdisciplinary collaboration. Therapists are encouraged to co-treat, leveraging individual specialties to provide comprehensive patient care. This approach not only enhances clinical outcomes but also creates a supportive professional environment. Wadland's success underscores an important healthcare entrepreneurship principle: innovative practices can thrive by remaining patient-focused, adaptable, and committed to both clinical excellence and team development. Her model offers a compelling blueprint for healthcare professionals seeking to reimagine traditional service delivery. FB: @HealthyAging PT  IG: @HealthyAgingPT  Web: www.HealthyAgingPT.com

Ever consider specializing deeper into an aspect of neuro? Wonder what it’s like to dive deep into a subset of the neuro population and sharpen your practice? In today’s show, host Erin Gallardo, PT, DPT, NCS interviews Andrew Doubek, PT, DPT, GCS, NMD about his recent experience going through an accredited movement disorders fellowship program at the Ohio State. In the show we talk about the details of what the fellowship was like from the schedule, mix of experiences, requirements and types of patients. Andrew shares his insights and words of wisdom to anyone considering a fellowship.   Plus, with documentation efficiency being top of mind for so many clinicians, Andrew generously shares his handout of smart phrases crafted from the Clinical Practice Guidelines that you can plug into your assessments and progress notes to ensure you’re targeting the key aspects needed in your notes in less time. Download the smart phrase guides here! PD CPG smartphrase.docx FND smartphrase.docx Core outcomes smart phrases.docx