A prescription is considered valid if it contains the following information: the child's name, Medicaid ID number, a valid diagnosis that clearly establishes and supports that the prescribed therapy is medically necessary, minutes and duration of therapy and is signed and dated by the PCP or attending physician.
Rubber-stamped signatures, those signed by the physician's nurse or a nurse practitioner and those without a signature date are not considered valid. Changes made to the prescription that alter the type and quantity of services prescribed are invalid unless changes are initialed and dated by the physician.
Section 214.220 Arkansas Medicaid Provider Manual
*For the purpose of retrospective review, failure to meet the above criteria could lead to a denial of services.
Question:I recently received a denial on one of my patients that stated "goals must be functional, measurable, and specific to each individual child". I work in a facility that requires the use of the SEAS program for my IFSP/IEPs. How can I meet both requirements?
It is possible to list measurable objectives with the overall goals in the SEAS program. For example, one goal commonly utilized states that "the student will demonstrate effective listening skills in formal and informal settings to facilitate communication". The difficulty with the goals is with its measurement. To meet both Medicaid and IEP, this goal could be revised to include measurable objectives. "The student will demonstrate effective listening skills in formal and informal settings to facilitate communication by
Completing the following tasks over 3 sessions with 90% accuracy: follow three step commands, answer questions after listening to a 5 paragraph story, identify sentences containing correct and incorrect syntax structure."
>> Power Point Presentation with more examples of establishing goals that meet Medicaid requirements.
