Physical Therapy Billing and Coding Guidelines You Must Know

Doctors managing the healthcare specialty of actual rehabilitation may be finding it too hectic to balance their personal and professional life due to their active perform plans. Some doctors may be attempting hard to get some spare time to focus more on innovative analytic and treatments and research for improved individual proper care. For active physiotherapists and practices, the best solution is to delegate the healthcare payments and programming try to a trusted healthcare payments organization. You must be confident that the organization is strict about following all the HIPAA approved recommendations as top insurance policy companies such as Medicare give emphasis to the same when it comes to compensation.

Physical treatments are a vast field with diverse determines and treatments, and its programming and payments can be rather complex. You should not only adhere to the rules but also be knowledgeable about programming recommendations related to subspecialties covered in actual rehabilitation such as sports, injure proper care, geriatrics, neurologic, EMG, cardiopulmonary, memory foam and paediatrics medicine.

Medical Billing Guidelines to Follow

Any kind of errors must be avoided when managing the payments cycle including individual registration, insurance policy verification, arranging, insurance policy read write, arranging and re-scheduling, recommendations, programming, payments and fixing of accounts, and AR selections.

The healthcare programming organization you choose to trust your actual rehabilitation payments and programming perform has to adhere to the specified recommendations to make sure privacy of the patients’ Secured Health Information.

Billing task should not be commissioned with home-based workers

Every worker must be checked on entering and leaving the premises

Portable storage space gadgets such as weak disks, CDs, DVDs and electronic products such as laptop computers and PDAs should not be allowed in the task premises

All computer systems must have passwords to start and open Windows

The computer systems in use must have firewall and anti-virus protection that is updated regularly

Backups should be made monthly and kept safely secured within the organization property

All lockers used for storage space must be password protected

A routine technical assessment has to be performed to make sure safety

All moved files must be protected via 128-bit encryption

All offices should have smoke alarms and fire extinguishers

Communication security can be enhanced by providing VPN facility

Non-disclosure worker privacy agreement

Specialised Particular Healthcare Programming Services

Only an established freelancing organization delivers effective coding and medical payments solutions with the assistance of qualified experts who are effective in specialty specific coding and payments. Let it be ICD, HPCS or CPT coding, they would help you get highest possible income through precise coding. According to a latest study, the top ten actual physiotherapy CPT requirements that produced 92.2% of the selections are the following.

97110- Healing exercises
97140- Guide Treatment (ie. STM, JM)
97530- Healing Activities
97112- Neuromuscular Re-education
97001- Physical Treatment Assessment (1st Consultation only)
92507- Treatment of speech
97014- Electrical stimulation
97035- Ultrasound
97032- Application of a method to one or more areas
97113- Healing procedure

An effective medical payments organization remains modified on all improvements in the industry to provide customers with the best solutions.
Make sure that you delegate your actual physiotherapy medical payments and coding work to an effective organization that works it part with the necessary severity, following all specified recommendations described previously.

No Medical Exam Insurance – How to Buy Life Insurance without Undergoing Medical Exams

If you are looking for a good insurance plan that guarantees financial protect to your chosen successor in the event of your loss of lifestyle, but want to avoid the hassles of a standard insurance plan, which requires you to go through a healthcare analyze, opting for the no wellness check insurance plan lifestyle protect is a good idea.

Why Most Organizations Need a Medical Exam

Most insurance plan companies require individuals to go through a healthcare analyze, as this validates the medical condition of the candidates and ensures the company’s interests are safeguarded. Most insurance plan companies require insurance plan candidates to go through routine wellness tests, like a blood analyze, hypertension, weight and height and answer a few concerns about their wellness background, so risky diseases (diabetes, HIV, kidney disorders etc.) that affect mortality rate, can be taken into account for deciding plan premiums.

Life Insurance Options for People Who Don’t Want To Take a Medical Test

If you find the thought of undergoing actual examinations for purchasing insurance plan intrusive or inconvenient, you have the option of purchasing no wellness check insurance plan, instead of the standard plan.

There are many insurance plan companies offering a variety of programs with different amounts of coverage assured to plan buyers, which will not have the applicant to go through an actual examination, though the current wellness of the applicant is taken into account.

If you belong to the category of people with serious wellness issues, you can contact reputed insurance plan businesses that provide lifestyle insurance plan with no healthcare examinations, though you will probably have to buy it at a higher premium cost, since these are typically lifestyle protect programs with graded loss of lifestyle advantages. This means, the no wellness check insurance plan will only need that you respond to some a quick question about well being and the company will provide you with their wide range of loss of lifestyle benefit programs. At this stage, you can discuss various factors, like term protect, add-on guidelines, riders in the guidelines offered to you etc. so you can bargain with your insurance plan broker for the best cost-modified, affordable plan.

Also, keep in mind that most guidelines offering you a no actual examination stipulation may have a typical 24 months patiently waiting period till you can claim any advantages from the plan. However, the advantage of these guidelines is the high payout given to successor during the patiently waiting period (100% loss of lifestyle benefit amount) for accidental / accident loss of lifestyle, even if it occurs in the first 2 years.

Benefits of Buying a No Medical Exam Insurance Policy:

Simple, quick and fast processing of insurance plan documents, since no time-consuming tests are involved
Time-saving option, since no doctor’s visits, awaiting clinical reports or re-organizing your daily timetable is required
Available at lower premiums payable on a monthly basis for adults who can answer simple wellness concerns competently
No patiently waiting period engaged, since full dental coverage programs is ensured from the first day of purchasing policy
Most established insurance plan companies provide this insurance plan with a money-back guarantee so there is no risk involved
Enhances your existing lifestyle protect or that offered by your employer

Medical Intuition to Heal Permanently & Reach Success

Healthcare Intuitive Technology, or Healthcare Instinct, is a science that uses one’s abilities to tap into you natural intellect and knowledge, as well as the capability to listen to- and understand –the simple power alerts, regularly transmitted from the bodies defence mechanisms and survival power.

Traditionally, Healthcare Instinct, can be divided in two parts, the beginning relates to the process of performing a scan of one’s body program & power field (or aura), in order to sense, more on a general stage, prospective power prevents or blockage of power, and to recognize prospective dangerous mobile remembrances, possibly relevant to health challenges.

The 2nd aspect requires a further degree of intuition and medical psychic capability, needed to recognize on a much further stage, the real cause, the root, relevant to a prospective power block and underneath unconscious dangerous styles, with the ultimate goal of clearing them, to promote complete treatment or breakthrough.
I would like to point out the proven reality that everybody, was born with some user-friendly capability, however, not of the same stage though, actually, some may be more sensitive and user-friendly than others, and only few are really conscious on a further stage, of having this gift and how to use it to identify/dissolve/ heal physical/emotional prevents and adverse styles.

Having been a Healthcare Intuitive for, as long as I remember, since I was a child, –(first memory I have got goes back to age 4 and half), and with 18 + years of using this technique successfully on myself and others, I am a firm believer that, since your physique program was developed by your Soul, which is best suited, then also your physique program was developed ideal & whole, and it remained ideal until… the conditioning, either already received during the time you still were in your mother’s uterus, or soon after your birth, infected that radiant perfection & wholeness of our bodies, unfortunately contributing to the creation of injury & dangerous mobile remembrances, resulting later in possible present psychological and actual issues.

I would like to remind you that your own bodies defence mechanisms, which has a natural intellect, is totally still connected to the best Soul that designed you.
So basically, in a few words, what Healthcare Instinct treatment is able to do for you, is reading and decoding the bodies instability on the inner stage, then restoring our bodies and mind to their original wholeness.

As a medical psychic, I also am conscious of,… and have no doubt… that, what we call diseases or just actual issues or symptoms, (either chronic or temporary)- are not adverse results, as we have been programmed by the medical establishment and by our society, to believe to. You will be surprised to find out they are nothing more than just loving messages coming from your physique program, as a way to trying to get your interest, to show you how and when the treatment needs to happen,… they are just a short-term (unpleasant result …) they are not meant to be the ultimate results.

Life Insurance with No Physical, No Medical, No Exam, No Health Check

Looking for lifestyle insurance plan policy with no actual required? Some individuals choose non healthcare lifestyle insurance plan policy because they simply don’t have the time or the inclination to go through the rigors of a full healthcare examination. Others make this decision simply because they don’t like to go to the doctor. Fortunately coverage is distributed in fairly considerable quantities nowadays without the necessity of a health check.

Insurance providers always have released lifestyle insurance plan policy with no actual needed but mostly at younger age groups and in smaller quantities. You can get bigger quantities of coverage at older age groups, no health check needed. Here are some of the reasons why.

People Take Better Care Of Their Health

People tend nowadays to take better care of their bodies. We live in an age where access to healthcare details is readily accessible. Because of this the public is more aware than ever before of the behavioural and eating habits that are likely to shorten one’s lifestyle. The plan providers know this and therefore are willing to issue guidelines at older age groups to apparently healthy individuals. They do need to answer a few health questions though.

Medical Science Advancements

People that would normally die 30 or 40 years ago from certain ailments are enjoying productive lives with treatment nowadays. Diseases that were considered death sentence diseases are no longer seen in that light.

Easy Access to Information

Life insurance plan providers used to send out an inspector to investigate each person who applied for coverage whether or not a healthcare was done. This was, in some cases, quite a costly undertaking. You will appreciate that they were committing to what can only be quantified as excessive risk. The applicant pays a small premium but the company has to pay a large sum if this person dies. The risk still exists in similar situations but most of the details needed to approve issuance of coverage are accessible by computer.

Because of these things bigger lifestyle insurance plan policy with no actual coverage is being released. Many companies will issue guidelines up to age 65. A few issue guidelines to senior citizens. The quantities are limited to $250,000, $500,000 or even $1,000,000 in some cases. Younger individuals may even get more than that.

The beauty about the whole thing is that lifestyle insurance plan policy with no actual guidelines can even be bought on the internet. You complete the application, get an approval in as little as 15 minutes and print out your plan there and then. You don’t need to even see an agent.

It is important that the applicant be truthful when applying for lifestyle insurance plan policy with no actual examination needed. These insurance plan providers are very thorough and are likely to uncover any hidden details that may prevent the approval of an application.

The guidelines released on the internet are referred to as no actual phrase. The favoured ones are the 5 season phrase lifestyle insurance plan policy, 10 season phrase lifestyle insurance plan policy, the 20 season phrase lifestyle insurance plan policy and the 30 season phrase lifestyle insurance plan policy.

As we look ahead things can only get better. With even greater progressive strides in healthcare science and more quick access to details on the internet it is quite possible that even bigger phrase with no health check needed guidelines will become available on the internet.

Life Insurance No Medical Exams – Do You Qualify?

Life Insurance plan No Healthcare Examination guidelines are now offered to customers over the internet.

We are going to learn about lifestyle insurance policy plan no health check needed policy. As the name suggests, this kind of lifestyle protection will not have you to undergo any sort of health check. The effects being made here is that it is a lot more convenient to make an application for such insurance policy especially as compared to if you were applying for some other lifestyle protection option. All that will be needed of you is to answer a couple of simple and short concerns. These concerns will only need you to give details of your personal lifestyle and condition at the time of application. Once you have done that, you can click so that you get your 100 % free quotation. If the 100 % free quotation is very pleasing to you, then you will be able to fully connect with get living insurance policy plan cover.

Due to technical improvements life insurance organizations can now determine on the internet whether you are eligible for a plan. You just answer some health-related concerns and within minutes you get an answer from the insurance provider, while you’re still on your computer, as to whether you can buy a plan.

Term life insurance with no exam offers you a simple and fast way to buy phrase on the internet without difficulties of picking a actual exam. There are no doctor’s trips, no providers to meet with, no emailing setbacks and same-day protection is available for certified candidates.

Now you can get quality, cost-effective life insurance protection for your family today, without the long setbacks. In the past, it would take weeks, even up to 2 months for you to go through the program, underwriting of your application, picking a actual exam, and then receive your plan through the mail, or have it provided by your agent.
Once you make an application for phrase on the internet and be eligible for a protection, you can pay through secure payment handling on the internet. Usually, if you pay your first month’s top quality on the internet, your insurance plan starts the same day.

Imagine, you can actually be eligible for and get life insurance no medical exam plan on the internet in the time it takes to have your lunchtime.

There are disadvantages to phrase with no exam. First, the amount of protection available is limited to $25,000-$250,000 in most instances. However, if you make an application for protection from two or more of the providers offering this kind of plan, you may be able to be eligible for a up to $400,000 of phrase without using any medical examinations.

Next, phrase with no medical examinations will cost more than a fully underwritten insurance plan. Because the provider uses a short program and boundaries the number of concerns they ask you, they may agree to some individuals who may not be eligible for a protection elsewhere. Also, most of the individuals approved for a plan are placed into less ranking groups, so the rates may be higher than billed by other insurance organizations.

If you want a life insurance no medical exam plan that’s simple, cost-effective and hassle-free – this may be the kind of plan for you. But, it’s good to consider your options first.

Life Insurance No Medical Exam – The Pros and Cons

Are you in search of Lifestyle insurance plan with no health check required? Have you been looking forever insurance plan on the internet, but maybe you’re frustrated with so many choices?

Why spend endless hours searching on the internet when you already know buying life insurance plan is the right thing to do? And term offers you the maximum security at the lowest prices.

Now it’s quick, simple and inexpensive for almost everyone to get term on the internet without taking a health check. Actually, there’s a few insurance providers that offer immediate acceptance life insurance plan if you are eligible. You can apply on the internet in about 5 moments and find out if you are eligible instantly. That’s right. No more documentation. No healthcare examinations. No more tricky providers. Today, you can get life insurance plan on the internet create your plan instantly after you pay your first top quality on the internet. You can actually get insurance plan “In Force” nowadays, if you are eligible. Not everyone is eligible for defence though. You do have to be in great health, generally. But, even if you’re taking medication, or May not is eligible with other life insurance providers – you might be eligible for a no examination life insurance plan.

Okay, you should be aware that life insurance plan with no examination required may cost you a little more than security through other insurance providers. But the benefits outweigh the costs for some folks. Several benefits include: Instant acceptance, security “in force” nowadays, no doctors, no invasive needles, no tests, no mailing setbacks, no tricky providers to deal with… The list goes on. However, there are two drawbacks – the top quality may be a little higher. And, not everyone is eligible for defence.
It’s readily accessible out if you be eligible for a no examination life insurance plan. You just answer a few simple health questions to get your immediate quotations. Then, you decide if you like the prices, and you can apply on the internet in about 5 moments. You usually get a response within 10 moments as to whether you are approved for your insurance plan. Then, you can pay your first month’s top quality on the internet, and create your plan instantly. It’s that simple. No time setbacks, no mountains of documentation and no dreaded healthcare examinations.

Make sure to check the financial rating of your lifestyle insurer. It is usually provided on their web site. Also, paying annual fees are usually less expensive than monthly payment options. Finally, when you buy direct on the internet, you’re cutting out the uncomfortable salesman at your dining table trying to talk you into the plan.
Life insurance plans no health check policies can provide the security you need at cost-effective prices. It’s worth a few moments to get immediate quotations and decide if you want the security. There’s no hassle, and no sales pressure.

Life Insurance – No Medical, Physical Or Doctors Exam

It is really no secret why lifestyle insurance policy no healthcare has become so desired by phrase insurance policy buyers. They basically seek the easiest way to buy their guidelines. There is the casual anxious person who tries to get over on the lifestyle insurance policy company but these people are spending their time.

They don’t want to be poked by a doctor’s hook or have to do pee assessments. They are basically asked a few indicated questions the answers to which give the lifestyle insurance policy providers sufficient details to work with.

20 or 30 years ago it would not be sensible to sell any type of lifestyle coverage in this manner to anyone but younger people. People, however are in better wellness nowadays at older ages. Why? Medical science has advanced to such a level that enables otherwise international airport sufferers alive a longer and quite effective lifestyle.
The details age! Verifying details on a people wellness, profession and avocations used to be quite a long and prolonged procedure and the cost was just too much. Today this detail is at the convenience of the underwriters, with the candidate’s authorization of course.

As we advance who knows what improvements will become a part of every activity. At present here is what lifestyle insurance policy no healthcare is all about.

If you are between age 18 and age 65 you can acquire between $25,000 and $500,000 cover without having to do an actual examination. The guidelines offered are 10 season, 15 season, 20 seasons and thirty season phrase insurance policy. Once approved these guidelines are assured alternative up until age 95 without any proof of insurability.
You may think that getting an Insurance plan, especially a insurance coverage may be very difficult. Filling out the format or enrolment under one of the leading insurance suppliers involves a number of formalities including a healthcare test to decide your “pre-existing condition”. There are quite a few insurance suppliers who will deny you coverage basing on your pre-existing circumstances especially when you suffer from a kidney disease.

There is no need to be apprehensive on this account. No healthcare lifestyle programs are now available. The benefits provided under such a plan is quite appreciable and are exactly the same as in case of insurance where full healthcare evaluation were carried out by the company organization.

A few restrictions in your acquiring insurance are that you cannot have even at phrase no healthcare evaluation when you suffer from kidney illnesses like AIDS, HIV, ARS, cancer and a few other complicated illnesses relating to heart, lung, diabetes and mental anxieties. Moreover, the circumstances laid down by the company vary from organization to organization and you have to meet their eligibility criteria to be qualified for no insurance.

Therefore, the best course of action for you is to requisition insurance policy quotations on insurance coverage or phrase. Once the quotations arrive, you will know exactly what they provide for you and whether you are qualified for a no healthcare insurance policy. There may also be a few suppliers who even allow such facilities in favour of their customer despite a little loss for them.

For other types, getting a no healthcare insurance policy will be comparatively easier. It will be a savings in conditions of visit of the doctor and such programs are also available at a low cost. A few popular such coverage is programs for funeral or for hospitals or travel. Most of the agencies do not require you to go through healthcare exams for the word lifestyle insurance programs.

How to Get the Most Out of Your Annual Medical Physical

As we become adults it’s especially essential to have an annually healthcare actual just for making sure everything is working the way it should be and to pre-screen ourselves for certain circumstances or illnesses that have a higher chance of arriving as we age. Today I’d like to discuss over some guidelines that you can use for making sure you’re getting the most out of your actual. Nobody really loves to go to a healthcare expert for an annually check-up but as long as you’re there you might as well get the most out of it.

The very first factor you should do is discussing every one of your significant healthcare circumstances if you have any. Ask a healthcare expert whether or not there have been any type of developments in treatment during the past season. Ask them if there’s anything else you could be doing to deal with the problem.

The next factor you should do is evaluation and discusses any medicines you may be on. Bring a list of everything you take to your check-up. This contains prescriptions but also prescriptions and any health products you may be getting as well. Ask whether or not there are any solutions to any of the medication you may be getting and be sure to ask about any risky possible communications between the different medications.

You should also evaluation any immunizations you may need. This may be more designed for young grownups and especially children but grownups need certain immunizations as well such as the flu taken and others like that.

There are nearly an unlimited amount of testing assessments that a healthcare expert could give you, however there are a few that have really been which can work well over the years and you should definitely have them done during your check-up. For example, you should always get your hypertension examined once a season. It’s also a very wise decision to get your cholesterol levels examined as well.

Everybody is active and nobody wants to take a longer period at the physician’s office than is absolutely necessary but it is significant for you to dedicate as a lot of time as possible to your annually check-up so that a healthcare expert can really do it right. If you’re pretty healthier and young, your check-up should last at least 30 minutes. If you’re a little mature and not quite as healthier you can anticipate a excellent strong a chance to really get in there and do factors the way they should be done. Don’t short change this or hurry through it.

So there you have several very simple guidelines and techniques that anybody can use to get the most out of your annually healthcare check-up. We live in such a fast-paced community that many people don’t take a chance to get their annually actual but it can be done the most considerations that you do so be sure not to miss it.

Choosing the Life Insurance without Medical Policy That Suits You

When selecting insurance policy that is right for you, you need to clarify your needs and goals. Take a realistic look at the benefits and risks so that you determine what is best for you. Talking to an experienced insurance policy provider can help you to understand how to choose the best plan and he or she will highlight your exposure to threat. You can get insurance policy coverage without medical exams that will work for you.

Insurance is a great investment and it is an effective way to protect your members of the family against prospective loss of income when you die. Different people have different insurance policy needs as they are exposed to different types and levels of threat. There are several things to keep in mind when you are shopping for a insurance policy coverage.

Most of the guidelines provide for loss of life advantages, which relates to the amount of cash paid out to the specific recipients (people the customers selects to take advantage of the plan money) when the insurance policy holder passes away. If you are planning to purchase insurance policy, you need to know the person(s) who should take advantage of the plan advantages. Your recipients will need cash when you pass away for the following reasons: they need to take care of your memorial costs; they need to negotiate your estate & bequest taxes; they rely on your wage to take care of daily expenses; they rely on your opportunity to earn money for the business; and you owe some cash to some lenders.

Consider the inevitable

Death is unavoidable and universal and insurance policy coverage is something that everyone should think about. A lifestyle cover will help to assure you that your recipients will be adequately provided for in the event of your loss of life. When you opting for insurance policy, think about the total well being that you would like the ones you love to have after your loss of life. You should also keep in mind that funerals have a price and there are many related expenses to consider when you are gone.
Potential economical burden
Insurance policy coverage can pay a significant sum of money to your members of the family or recipients, helping to alleviate the prospective economical pressure. If you are your members of the family member’s breadwinner, you have to find the best way to take care for yourself even in your absence. The loss of life of a family member is a painful experience and it is even worse when those left behind have to deal with mounting monetary pressure. Selecting the best insurance policy coverage without medical plan will depend on the amount and number of recipients.
Buying versatile insurance
It is a good idea to choose a versatile plan that gives you a variety of choices. This will help you to get the best conditions for your specific needs. Look at the plan choices available and talk to experts so that you can get the best products. Keep in mind your needs differ from the next person and you should look for a plan that works for you.
Choosing the right insurance policy coverage involves selecting insurers who have the appropriate products. Research the company and make sure that you understand the plan conditions prior to purchasing. This will help you to avoid purchasing a product that does not offer the benefits you require.

A Better Understanding of a Physical Therapy Career

Actual rehabilitation profession is one of the most popular professions in healthcare industry. A physiotherapist is a team who allows sufferers living with problems, limitations and problems resulting from accidents to restore. Furthermore, a specialist allows sufferers who have undergone surgery to restore through therapy applications. This is based on evaluation, diagnosis, diagnosis and treatments that will aid in offering the best possible results for the individual.

No one can calculate the future. Accidents, surprising heart attack or any such frustrating incident could cause your frustrating reduction of way of life. As the mature in near family members affiliates associates you have a veritable responsibility to take care for you and protected them. A Lifestyle Insurance strategy technique strategy Plan can provide you’re near family member’s affiliates associates with the essential cost-effective protection in such exigencies.

This does not mean that yourself insurance technique only provides cost-effective assistance to your near family member’s affiliates associates at real-time. Even when no such frustrating event happens, you will have the tax advantages and several other schematic advantages secured by your technique. However, the main benefits always are the cost-effective advantages that acquire on the lawful individuals and successors in interest in situation of frustrating reduction of use of the secured person.

Insurance could be a durable insurance or a phrase. While the former contains your whole way of life until the time frame of maturity of the system, the later provides to protect a particular period only. In any situation, insurance program’s a very important factor of your cost-effective preparing.

A person seeking an actual physical therapy profession is expected to offer services that increase a individual’s strength. This means one has to get top quality coaching. Note that the area involves different aspects of path physiology, impairment and functional restriction. These conditions can be greatly improved through different applications. Therefore, when choosing an organization to engage in the profession, look for an organization that is:

• Approved
• Well well-known
• Has a proven record of producing the best therapists and
• An organization that offers the best hands on experience/training

As a specialist, you will be required to examine an individual’s health background, carry out tests on muscle performance, balance and synchronisation. With top quality coaching, there is no doubt to deliver the best health care for your sufferers.

Additionally, when seeking an actual physical therapy profession, it is imperative to be trained efficiently on how to device therapy plans for sufferers. When sufferers sustain accidents, a personalized therapy technique must be employed to increase quick recovery. It is therefore the role of a specialist to develop and implement an approach that works best for the individual. Treatments that a specialist may use include workouts to increase flexibility and build strength in sufferers who may have been incapacitated. Exercises also help sufferers to increase on their office and home functions in a less stressful way.

Electrical stimulations, cold squeezes, ultra sounds and hot packs can also be used in physical therapy depending on an injury that the individual continual. These choices relieve pain and swelling on the involved area.

Actual physiotherapy profession choices

There are three popular profession choices in physical therapy:

• Actual therapist- this is a team who analyse a sufferers overall condition and produces a course of action that details a PT need.
• Physiotherapist assistant- this is a expert who works directly with sufferers and watches how one is giving answers to therapy.
• Physiotherapist assistance on the other hand is a expert who ensures that a individual stays in a clean and organized therapy area. He or she can also prepare an individual for therapy.