Maximizing documentation | Do's and Don'ts | GG codes | Reimbursement | Appeals |
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What is tips for evaluation/POC
Link objective/scores to functional performance
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What is DO
Define distinct value of OT
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What is GG code 2
setup assistance
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What is types of reimbursement
Medicare/Medicaid/3rd party
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What is Medical Necessity
Skilled Rehabilitative services provided by clinicians that are safe and effective
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What is Need for documentation
Documentation must effectively communicate the need and rationale for OT services
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What is DO
Write legibly and timely
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What is GG code 3
Supervsion/touch assist
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What is the bipartisan budget act
Therapy Caps/max medicare will pay for therapy services ie PT/speech and OT ($2,110 for PT/Speech and $2110 for OT)
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What is the beneficiary
this person receives the notice of coverage or denial of services
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What is ABC's
Accuracy, brevity, clarity
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What is DO
specific areas of improvement
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What is GG code 4
partial/moderate assist
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What is Medicare
65 and older/renal failure/other illnesses/ -65 with certain disabillities, government funded "beneficiary" this is title XIX
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What is 120 days
The amount of time a provider or client has to appeal a denial in writing
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What are COTA responsibilities
Intervention Plan
Daily tx notes Progress report (OTR signs off) |
What is DONT
don't kitchen sink it
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What is GG code 5
substantial/max assist
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What is Medicaid
Managed by states and based off income "recipient"
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What is both A and B
Appeals process is the same for these two parts
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What is DONT
don't establish too many goals
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What is GG code 6
Dependent/Total assist
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What is PPS and PDPM
Prospective Payment System
Patient Driven Payment Model |
What is reason for denial
Not properly filling out a form, not submitting in a timely manner, service is seen as experimental
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