Alpine Therapy Services Support Staff
Operations Specialist: Paige Brown - (back office day to day in SOLI for staffing, coordination and agency communication) Contact Information: ana@alpinetherapyservices.com 720-679-0313 (Direct Office number for calls and texts)
Director of Operations: Cathy Marquardt, OTR - (back office day to day operations to include operational projects and questions from agencies, staffing oversight, inputting from SOLI to Kinnser, and oversight of HR approvals in SOLI) Contact Information: cathy@alpinetherapyservices.com 720-679-0313 (Direct Office number for calls and texts)
Chief Management Officer: Ben Gaylord, DPT (QA, new hire orientation, documentation oversight and day to day management of our team) Contact information: ben@alpinetherapyservices.com 720-679-0315 (Direct Office number for calls and texts)
QA Consultant and IC Expert: Cory Molnar, DPT (QA, Auditor, expert for EVV and documentation for home health) Contact information: cory@alpinetherapyservices.com 720-679-0020 ext 5.
Director of Business Development Sheri Mounteer - (building new contracts and new business relationships) sheri@alpinetherapyservices.com
BASIC CMS (Medicare) Rules
Timeline: An ATS Customer (Agency) will accept a patient referral for home health care. The Customer will input the referral into SOLI if they cannot staff internally. The referral is accepted by the ATS team and it is sent out to the SOLI app. The first clinician to say ‘I am interested’ will be assigned the referral; an assistant cannot be assigned without a supervising therapist. The clinician then calls the patient to schedule the Evaluation or SOC ASAP, representing the agency of the patient in SOLI (ex. I am a PT representing Alliant Home Health and I am calling to schedule your initial PT evaluation). Document your attempts to schedule in Communication Notes.
SOCs must be completed within 48hrs of the written doctors order, or will need a delay order before proceeding. SOCs cannot be completed on the same day they were discharged from a hospital or inpatient rehab facility per CMS.
Evaluations must be completed within 5 days of the SOC, or a delay order will be needed before proceeding.
Delay Orders - A clinician (cannot be an assistant) must call the MD in SOLI, requesting a Verbal Order to Delay Care Initiation per patient request, and input the date, time of day and who they spoke with for a true Verbal Order. This is typically done by an MA for the MD via call back. Input the VO for the Delay order on the chart before evaluating or completing the SOC.
Nonadmits: Never non-admit the patient before calling the agency to see if they have been able to get in touch first. If the patient refuses therapy, call the agency first. Once the agency knows and is in agreement, then call the MD for a VO to refuse the discipline evaluation. Document the VO in the Physician Orders.
Scheduling: Try to schedule the patient for at least one evaluation to meet CMS rules, instead of completing a non-admit. We recommend scheduling each patient 1hr - 1.5hrs apart. For example, start at 8:30, with the next appointment at 10.
EVV (Electronic Visit Verification): Look in SOLI for the correct EVV platform and the protocol website for the agency you are representing; EVV is required for a billable/payable visit for all Medicaid patients.
Review Bag Technique: Before going to your first scheduled patients visit, make sure you review the bag technique, have your name tag available (once this is sent to you from ATS) for infection control. See Home Health 101 for video.
Documentation: Check SOLI and determine what agency you are going to see the patient for, documentation type/billing type will be listed in SOLI and details will be on the protocol website for each agency.
Billing/Payroll: If you are documenting in Alpine Kinnser (depending on the agency) you won’t have to bill the agency for your time. However, if you are documenting in an agency Kinnser such as Alliant Kinnser, you must bill for your visits in Alpine Kinnser using (*) timecards. ALL Billing and Documentation is due within 24hrs, and must be completed in full no later than Mondays at 9am.
Once you see the patient: introduce yourself representing the agency the patient is with, follow bag technique for infection control, obtain the signature in SOLI, capture EVV (time in and out) then document your evaluation/SOC, upload SOC consents when applicable, and call the Agency for the frequency approval, then obtain a Verbal Order to continue care. Make sure to input your frequency in SOLI!!!
CALL the Agency for POC Approval First (Auth or PDGM approval)
VERBAL ORDERS: (Only to be done by PT/OT/ST or MSW; cannot be done by a PTA or COTA) call the MD listed in SOLI and state for example ‘My name is Jayme, Home Health PT calling for Verbal Orders to continue care for patient John Doe, DOB 1/1/1955 for frequency of 1w1, 2w2.’ Document the VO on your evaluation or separate Physician Order. Notify the Assistant when applicable. Continue care per the frequency and VO you obtained at evaluation.
Frequency: once your frequency is approved by the agency for authorization, you must follow that frequency per your POC (plan of care). If you change frequency at re-evaluation or any time during the episode of care, you must call the agency first and then obtain a new VO/Physician order. If you sway from the POC, you have to notify the agency and then the MD. (If you put in a resign from a home health position, per CMS you are required to continue the POCs for your current patients, but the ATS staff can assist when possible in restaffing depending on availability. Care coordination is key in this situation)
CMS will NOT allow “0w1” for example, instead they require 1w1 and a note on the Physician Order/VO stating ‘Patient does not want to be seen the week of 7/26/23’ and complete a missed visit, for example if you are going on vacation and the patient does not want an alternative therapist, or if the patient has multiple doctors appointments, etc.
Vacations: plan ahead and write this in your original POC frequency as above.
Missed Visits: ALWAYS notify the MD, then notify the Agency for insurance reasons, when a missed visit has occurred, as it is a deviation from the POC. Even if you are an assistant, you must notify the MD and Agency when there is a missed visit. Please document your communication with who you spoke to for each on your missed visit note.
Noncompliance: If a patient misses 3 consecutive visits, please call the agency first before calling the MD to obtain a VO to discharge due to noncompliance. This has to be a case coordination decision, per CMS.
Re-Evaluations: Must be completed at least once every 30days. This does not have to wait for the 30 day mark! If you miss a 30 day re-eval, you must do a non-billable DC, obtain new orders for a new evaluation and start over, IF the agency is in agreement. Avoid missing a 30 day re-evaluation and plan ahead! Schedule a re-evaluation at the time of the evaluation.
Supervision: A PTA/COTA should be supervised every 30 days. Therefore, if you do a re-evaluation for a COTA or PTA, make sure you also add a supervision note as well. If you supervise a COTA or PTA, make sure you add a supervision note (*) to each of the PTA/COTA visits as well.
Discharges: Always call the agency to see if you are the last discipline in for discharge. If you are the last one to see the patient, you must obtain the NOMNC (specific to each agency) and complete the DC OASIS.
Transfers or Under Observation: If the patient goes to the hospital, you. may be asked to do a Transfer OASIS if the patient is admitted. If the patient was not admitted and only under observation at the hospital, no Transfer OASIS is needed.
Resumptions of Care: If a patient is admitted to the hospital and then discharged back to home health during an active episode, one clinician will need to complete a ROC (Resumption of Care). This must be completed within 48hrs of the patient going home, but cannot be on the same day as discharge from the hospital.
HEP: Home Exercise Programs must be on the chart at the time of DC. You can utilize HEP2go Link
HR Credentials in SOLI: Keep these updated at all times for survey purposes. Agencies/Customers of ATS are surveyed once a year, meaning ATS is surveyed 1-2x a week!!!! This is CRUCIAL!!!
