MRO SAYS
to bill or not bill
Which Is It
100

Needs Assessment, Referral and Linkage, Treatment Plan, Monitoring/Followup, Evaluation

What are the 5 Case Management Standards

100
Reviewing a chart of a new case to learn what former provider did with the consumer

WHAT IS NON BILLABLE - assessment

100

Provider prompted Joe on completing housing application at the Section 8 office

What is Skills Training - Completing Housing App
200

The development of a written PCTP based upon the information collected through the assessment phase. The PCTP identifies the rehabilitative activities and assistance needed to accomplish the objectives

What is the treatment plan

200

Based on parents report of progress determined change of frequency of providing an intervention

What is billable - Monitoring/Followup

200

While processing feelings provider developed descrepencies between Jo's beliefs and actions

What is Therapy

300

Focusing on needs identification of the consumer to determine the need for any medical,                 educational, social, or other services.

What is a Needs Assessment

300

Provider got help from team lead with a treatment plan review

What is billable - Treatment Plan Update

300

Provider contacted Family Life Shelter to learn criteria for entry and made intake appointment for Jo.

What is case management - Referrals/Linkage

400

Activities that help link the consumer with medical, social, and educational providers, and/or other programs

What is Referral and Linkage

400

Provider reviewed a former CANSA to get information for the CANSA reassessment that will be done this week.

What is Not billable as case management

400

Provider accompanied Joe to MD appointment and consulted with MD frequency of insulin self injections and benefits of adherance.

What is Case Management - Monitoring/follow up

500

Time devoted to formal supervision of the case between case manager and licensed supervisor 


What is EVALUATION standard

500

When I have a cancellation and I update the FNA based on what I learned in a previous skills/therapy session.

What is not billable - needs Assessment

500

LSS is leaving the organization and Marta will take over as LSS and will update Jo and family

What is case management - continuity of care