Get Cdphp Rehabilitation And Snf Continued Stay Review Form

Filling out the CDPHP Rehabilitation And SNF Continued Stay Review Form is an essential step in ensuring the authorization of a member’s continued stay. This guide provides clear, step-by-step instructions on how to complete this form online, making the process easier for you.

Follow the steps to successfully fill out the form.

1. Press the ‘Get Form’ button to retrieve the CDPHP Rehabilitation And SNF Continued Stay Review Form and open it in your online tool.
2. Begin by entering the member's full name in the designated fields for last name and first name. Ensure that all spelling is correct.
3. Input the Member ID number in the appropriate field. This should be a unique identifier associated with the member.
4. In the Facility Name section, write the name of the healthcare facility where the member is currently receiving treatment.
5. Record the member's Date of Admit. Use the date format clearly indicated on the form.
6. Provide the contact details of the Case Worker or Social Worker, including their name and phone number. Add a fax number if applicable.
7. Enter the Date of Review, which indicates when this information is being collected for processing.
8. Fill in the Clinical Continued Stay/Skilled Services Update section, providing necessary information relevant to wound care if applicable.
9. Detail the Physical Therapy information, indicating the frequency, transfers, and minutes as required. Describe the level of assistance needed for ambulation and gait.
10. Next, complete the Occupational Therapy section, specifying frequencies and assistance levels for various activities of daily living (ADLs).
11. Report the Speech Therapy details, including frequency and dietary requirements, as well as progress observed.
12. Describe the Discharge Plan with projected discharge date and any barriers that may affect it.
13. Conclude by summarizing the Goal Update and the Projected Last Therapy Date, noting if a letter has been requested.
14. Once all fields are filled out accurately, save your changes, and download, print, or share the completed form as necessary.

Complete the CDPHP Rehabilitation And SNF Continued Stay Review Form online today to ensure timely processing of your request.