HSM - Outpatient Physical, Occupational and Speech Therapy Provider Manual and Forms

	Outpatient Physical, Occupational, and Speech Therapy Provider Manual & Certification Forms TABLE OF CONTENTS Effective Date: January 19, 2007

To view the following publications, you will need Adobe Acrobat Reader. To download, click here.

The manual is available in its entirety or by section. Click HERE to download the entire manual.
To view each section, click the links before for the section of interest.

TABLE OF CONTENTS

MANUAL COVER

INTRODUCTION

OVERVIEW OF OPERATIONS

CERTIFICATION REVIEW ACTIVITIES

NOTIFICATION OF REVIEW OUTCOME

RECONSIDERATION PROCESS

QUALITY REVIEW ACTIVITIES

GLOSSARY

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

FORMS AND INSTRUCTIONS
Each form is available in two versions: manual or electronic.
To complete a form by hand, click the "Manual" version, then print the form for use.
To complete a form using your word processing software, click the "Electronic" version and save the form to your computer. To save a form to your computer, right click on the link, select the “Save Target As” option, choose a file location on your computer, then click "Save."

Certificate of Medical Necessity Form
Instructions Manual Electronic
Evaluation/Reevaluation Forms	Plan of Care Forms
Instructions	Instructions
Physical Therapy - Manual Physical Therapy - Electronic	Physical Therapy - Manual Physical Therapy - Electronic
Occupational Therapy - Manual Occupational Therapy - Electronic	Occupational Therapy - Manual Occupational Therapy - Electronic
Speech Therapy - Manual Speech Therapy - Electronic	Speech Therapy - Manual Speech Therapy - Electronic
Precertification Review Request Form	Place of Service Codes
Instructions Manual Electronic	List of codes
Reconsideration Review Request Form	Quality Re-review Request Form
Instructions Manual Electronic	Instructions Manual Electronic