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TABLE OF CONTENTS

MANUAL COVER

1. INTRODUCTION
    

2. OVERVIEW OF OPERATIONS
    

3. CERTIFICATION REVIEW ACTIVITIES
    

4. NOTIFICATION OF REVIEW OUTCOME
    

5. RECONSIDERATION PROCESS
    

6. QUALITY REVIEW ACTIVITIES
             Quality Review Process Flow Chart
             Quality Screens (Indicators)
    

7. GLOSSARY
    

8. PRECERTIFICATION CODE LIST (Update Effective: 1/1/06)
    

9. FORMS AND INSTRUCTIONS
   
   Certificate of Medical Necessity Form
   
   Evaluation/Reevaluation
     Physical Therapy
     Occupational Therapy
     Speech Therapy
   
   Plan of Care
     Physical Therapy
     Occupational Therapy
     Speech Therapy   
   
    Precertification Review Request Form
    Instructions for Precertification Review Request Form
   
    Place of Service Codes
   
    Reconsideration Review Request Form
    Instructions for Reconsideration Review Request Form
   
    Quality Re-review Request Form
    Instructions for Reconsideration Review Request Form