...Therapy Billing Tips Provider Reference Supplement [pic] HP Enterprise Services, Arkansas Title XIX Document Date: 5/12/2010 HP Enterprise Services Arkansas Title XIX Account 500 President Clinton Avenue, Suite 400 Little Rock, Arkansas 72201 (501) 374-6608 HP Enterprise Services and the HP Enterprise Services logo are registered trademarks of HP Enterprise Services. All other logos, trademarks or service marks used herein are the property of their respective owners. HP Enterprise Services is an equal opportunity employer and values the diversity of its people. © 2010 HP Enterprise Services. All rights reserved. Contents Introduction 3 Eligibility 4 Restricted Aid Categories 4 All Arkansas Medicaid Aid Categories 6 Therapy Benefits 10 Program Coverage 12 Prior Authorization Request Procedures for Augmentative Communication Device (ACD) 15 Evaluation 15 Contact List for Reviews, Managed Care and Authorizations 16 National Place of Service Codes 18 Quick Tips for Submitting Claims 19 Introduction to Billing 19 CMS-1500 Billing Procedures - Occupational, Physical, Speech Therapy Procedure Codes 19 Augmentative Communication Device (ACD) Évaluation 22 Billing Instructions - Paper Only 22 Completion of the CMS-1500 Claim Form 22 Special Billing Procedures 29 Common Billing Errors 30 Brief Overview of Benefits 31 Contact Information 32 Introduction This Billing Tips document serves as a training supplement...
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...relevance in occupational therapy with children. I will discuss some of the current literature surrounding groupwork and the merits of its use in occupational therapy. I will then analyse and discuss some of the factors in groupwork which influence the outcomes and effectiveness of the group including the group composition, the establishment of long-term and short-term goals, and the therapist’s style of leading the group. I will apply these factors to a specific condition for the purpose of demonstration. Finally, I will reflect on my learning of groupwork and how it will influence my future practice. Groupwork theory and use in therapy: Groups are defined by Mosey(1973) as ‘an aggregate of people who share a common purpose which can be attained only by group members interacting and working together’( as cited in Finlay, 2001, p.3). Acording to Blair(1990, as cited in Finlay, 2001) groups are ‘intrinsic to existence’. We are involved in family groups, classroom, peer, sport, work tasks and other groups. Group work is an approach that is widely used across occupational therapy and healthcare settings. ‘Only in more recent times have group practitioners and researchers begun to explore the use of group activities as a therapeutic approach’(Barnes, Howe & Schwartzbeg, 2008). This is in line with the renewed focus on occupation-based, client-based and evidence based practice(Barnes et al., 2008). According to Yalom(1995), there is much support for group therapy in response...
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...Occupational Therapy: Political Engagement and Social Transformation Occupational Therapy: Political Engagement and Social Transformation An international occupational therapy movement that embraces political engagement and social transformation has been forming (Frank & Zemke, 2009). There has been a shift away from the medical model in the last 30 years (Frank et al, 2009). The political factors and societal factors that play a role in this shift strongly stem from the human rights movement (Andrews, 2013). Andrews (2013) categorizes the human rights movement in three categories: 1) proliferations of human rights, 2) growing human rights culture, and 3) human rights violations by nations and private sector. Andrews (2013) outlines defining historical events that contributed to the human rights movement as the aftermath of WWII, the end of the Cold War, the 1993 Vienna Declaration of Human Rights that defined woman’s rights, the terrorist attacks on September 11, 2001, and the recent global economic crisis. The world has developed a growing negative attitude towards those who discriminate against race, gender, religion, sexual orientation, and disability. According to Lang (2001), the social transformation model arouse out of critique of the medical model that focuses on the individuals’ physiological and functional abilities. This is now a shift towards a focus on society’s ability to integrate individuals successfully. Incompatible physical...
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...I developed a special interest in Occupational Therapy primarily because I think the field attracts people who are genuinely interested in investing in other people. As a child I started attending Camp Gizmo and in the evenings got to go to the Sensory Lab and I remember being so excited when I would get to go there. As I got older and seriously started considering career choices, my mind kept going back to my time in the sensory lab at camp so I started going in and observing sessions during the day at camp and knew that Occupational Therapy is where I am meant to be. Since then, I have observed different aspects of Occupational Therapy at camp including the Activities of Daily Living Lab, the Mobility Lab, Sensory Lab, and the Hand Skills...
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...extraordinarily passionate about. As I am pursuing a career as a profession of occupational therapy, my project will be centered around terms related to the field. This will not only allow me to discover more about the background of the profession, but will enable me to discover some of the specific terminology used by professionals in the field. After telling others that I want to be in the field of occupational therapy, I have found that many are familiar with the term, but are unclear of the exact definition. Looking at the different components of the word, it means OCCUPAT- a particular action, ION- the act of, AL- pertianing to, THERAP- treat medically,...
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...going to happen to my grandfather’s life, the words cut like daggers. My cousins and I watched our parents bewail with sorrow as we just sat aside our grandfather’s hospital bed feeling helpless and confused. About a month went by while my grandfather was still in John Muir, and his progress was nothing to rave about. We would visit him daily, but he never seemed to be getting much better. He couldn’t eat, talk, or move, but we just reminded him to keep fighting and we knew, with hope, he would be able to make a substantial recovery. When my grandfather was dismissed from the John Muir hospital in Walnut Creek, he moved into the Kaiser Permanente Medical Center in San Leandro. While in San Leandro, he started to receive more intense therapy, his recovery was slow but we started seeing improvements; he was able to eat solid food, without a pump, began to talk again. While visiting my...
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...There are many potential benefits of recommended therapies to an individual’s health and well-being. All of the children and young people that I support within my work role receive a variety of therapy treatments such as occupational therapy and speech and language therapy. By providing these therapies children and young people can be supported within areas of development that they may have difficulties with. For example, SLT offer weekly sessions for residents and pupils to help them gain knowledge and understanding of emotions through using flash cards and multiple choice question and answer system. They also help to support non-verbal speakers through the use of pecs and proxytalker’s so all individuals are able to access the support that they need to meet their needs and levels of understanding. SLT also provide social stories for children and young people to help them understand changes that may be happening to them or going to happen with their life, daily routines and development. Without these therapies the children I work with may struggle to understand the things happening in their life and this may lead to potential behaviours. SLT also supports children and young people’s levels of communication and set up structured ways to communicate with them so they are able to understand what is being asked of them or what is needed of them....
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...looking for a current policy that is affecting occupational therapy, the one that comes to mind is the Affordable Care Act, also known as ObamaCare. Some do not like this policy and think that they should be able to make their own decision about their health insurance. When it comes to occupational therapy, I think that the Affordable Care Act works in our favor. This law impacts many things such as who receives coverage, what coverage is provided to the patient, and how the services are provided. People who were uninsured before the Affordable Care Act were diagnosed at later stages of diseases, were more likely to get hospitalized, less likely to get diagnostic or therapeutic services, more likely to report being in poor health, more chronic medical issues, and die at a younger age. A lack of insurance restricts the services that are available to...
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...A good example for occupational therapy is the American Occupational Therapy Association (AOTA) based in Bethesda, Md. The AOTA represents the professional interests and concerns for their members and has their own Standards of Ethical Conduct in which OTs and OTAs operate. Similar to the Academic Integrity Code at DSC, the AOTA Code of Ethics is intended to provide a structural framework in which OTs practice in an effort to provide safe and effective health care to the...
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...arm and hand functions that interfere with accomplishing goal oriented activities and vocational needs (Richards, Stewart, Woodbury, Senesac, & Cauraugh, 2008a). Knowing the best methods to promote motor recovery in arm and hand functioning is therefore critical in stroke rehabilitation. Lori Gage Richards, (PhD, OTR/L) is an active researcher and educator seeking to uncover which therapies drive neural reorganization after a stroke, and what are the most effective strategies leading to improvements is UE function. Richards is currently Associate Professor and Chair of the Occupational Therapy Department at the University of Utah. She was recently appointed editor-in-chief of the American Journal of Occupational Therapy and serves as Chair of the Nursing and Rehabilitation Committee-Stroke Council, of the American Heart Association. Additionally at the American Heart Association, she is a member of both the Leadership Council - Stroke Council and the Stroke Rehabilitation and Recovery Committee - Stroke Council. Her current professional affiliations include the American Occupational Therapy Association (AOTA), Society for Neuroscience, and the American Congress of Rehabilitation Medicine. Motor rehabilitation is premised on the belief that behavior (e.g., practice and motor-based intervention) forces neuroplastic changes in the central nervous system (CNS) which lead to better motor function. According to Richards, Hanson, Wellborn, & Sethi (2008b) the current evidence...
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...headphones, this was the closest I could get to relaxing him. Why did this happen, and how could we dampen it? Since sensory input and pain has an effect on all our daily activities, it is a crucial treatment focus in occupational therapy. My first exposure to occupational therapy was a required class for direct support professionals at Bridges. To introduce us to sensory...
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...Professional Regulation’s for Occupational Therapy In Mississippi Occupational therapists provide skilled care to clients of all ages with dysphasia. Occupational therapists are trained professional that help individuals achieve independence in all aspects of their lives. A few of the health conditions that benefit from occupational therapy include: work-related injuries including lower back problems, limitations following a stroke or heart attack, arthritis, multiple sclerosis, or other serious chronic conditions, birth injuries, learning problems, or developmental disabilities, mental health or behavioral problems including Alzheimer's, schizophrenia, and post-traumatic stress, problems with substance use or eating disorders, burns, spinal cord injuries, or amputations, broken bones or other injuries from falls, sports injuries, or accidents and vision or cognitive problems that threaten the ability to drive. For you to be a licensed Occupational Therapist, you have to submit an application for licensure at least thirty days prior to any admissions to work in any facility. Various educational requirements serve as a qualification to a career as a physical therapist. A person must earn a minimum of two degrees from accredited universities, perform volunteer service and comply with certification requirements to complete the educational requirements toward a career in physical therapy. First, the interested person must complete an undergraduate degree with either a...
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...Collaboration as an occupational therapy (OT) practitioner is very important, it benefits the patients/clients that services are provided for and promotes effective teamwork. Some of the principles that support advocacy, fairness, respect and truthfulness are: Justice, veracity, fidelity and nonmaleficence (AOTA, 2015). According to the American Occupational Therapy Association (AOTA), justice is defined as to, “promote fairness and objectivity in the provision of occupational therapy (OT) services” (AOTA, 2015, p. 5). My clients receiving (OT) services on the weekend will be in compliance with this principle and that of the rehabilitation center, which states that, if patients could benefit from daily services, they should be treated. The OT Code of Ethics (COE) veracity states that, an OT practitioner shall “refrain from using or participating in the use of any form of communication that contains false, fraudulent, deceptive, misleading, or unfair statements or claims” (AOTA, 2015, p. 6)....
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...Facility Planning Part II HCS 446 Laura Norred October 15, 2012 In part one of facility planning the need for a rehabilitation center focuses on physical and occupational therapies was discussed. The need for the center is based on the community not possessing a large enough space they could go to and receive their therapies. The space in the hospital is used for both inpatient and outpatient services and no longer accommodated the large group of people needing help. In part two of facility planning, the regulatory requirements needed for opening a rehabilitation center will be explored. In addition the impact they have on design and equipment will be evaluated as well. Color choices for the facility will be determined as well as a way to combat the noise so that everyone can keep clear focus on the goal. The budget for the project, including planning and cost estimates will be examined to determine if any changes should be made. This paper will also examine at the equipment or electronic items needed to run the facility. Finally the role of stakeholders in the planning and development of the rehabilitation center will be described , in addition to the detailed Gantt chart that will show the implantation plan created for the rehab center. Planning for a facility is not an easy job. It...
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...variety of orthopedic injuries, spinal cord injuries, stroke or other traumatic brain injuries. Patients can be treated in either an inpatient or outpatient setting. This normally depends on the severity of their injury or illness. A patient who has suffered a stroke, for example will be treated within the hospital by therapists before being discharged and prescribed outpatient therapy. Stroke patients are also treated under more than one rehabilitation discipline. This means that they will see not only a licensed physical therapist but in many cases, an occupational and speech therapist as well. There are two main distinctions between physical therapists, orthopedic, neurological and pediatric. Orthopedic therapists work with a number of different diagnoses but the majority of their patients suffer from a muscle, joint or spinal injury. Advancements in medicine have allowed surgeons to perform joint replacement surgeries. Patients who have had a total knee, hip or shoulder replacement will more often than not end up in the hands of a physical therapist. According to the American Physical Therapy Association (APTA) those therapists who decide to become a neurological physical therapist will specialize “in the evaluation and treatment of individuals with movement problems due to disease or injury of the nervous system” (2012). These conditions include traumatic brain injuries, stroke patients, multiple sclerosis, Parkinson’s disease and vestibular disorders that can cause...
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