Get Ks Bcbs 37-024 2019-2026

The KS BCBS 37-024 is a Rehabilitation Assessment Form designed to gather essential information for assessment and coverage purposes. This guide will help you navigate the process of filling out this form online with clear, step-by-step instructions.

Follow the steps to complete the KS BCBS 37-024 effectively.

1. Press the ‘Get Form’ button to access the KS BCBS 37-024 and open it in the online editor.
2. In Section 1, select the Assessment Type by checking either 'Initial Assessment' or 'Reassessment.' Also, choose the Plan type: 'Blue Medicare Advantage (PPO)' or 'Blue Medicare Advantage Comprehensive (PPO).' Clear any unnecessary data before you proceed.
3. For Section 2, provide detailed Member and Facility Information. Fill in the Member Name, Age, Contract Number, Authorization Number, and Admitting Facility & NPI. Specify Admission Type and provide the Phone Number and Fax Number for the facility.
4. Complete Section 3 for Admission Information if performing an Initial Assessment. Include the Admission Date, Prior Level of Function, Facility Doctor Name, and more. Input the ICD-10 Code and any relevant medical history and home configuration details.
5. In Section 4, enter the vital signs and clinical basics. This includes temperature, pulse, respiration, blood pressure, cognitive awareness, and any oxygen delivery details. Describe nutrition details and pain management.
6. Fill out Section 5 regarding Mobility Current Functioning. Note details about bed mobility, transfers, gait, and assistive devices used.
7. For Section 6, document any IV medications, vascular access, and significant medications affecting functioning.
8. In Section 7, assess Self-Care Current Functioning across various activities such as feeding, grooming, and bathing. Include any necessary comments.
9. Section 8 requires you to review the skin status. Report if the skin is intact or provide information on any wounds or incisions if applicable.
10. In Section 9, summarize the Speech Therapy Current Status, including any evaluations or recommendations.
11. For Section 10, outline Discharge Plans including supervision needs, tentative discharge date, goals, and destination.
12. Utilize Section 11, the Key for Mobility and Self-Care Functioning, to clarify levels of assistance required.
13. In Section 12, add any additional notes. Ensure all necessary information is provided before closing the form.
14. Once complete, save your changes. You may then download, print, or share the KS BCBS 37-024 as needed.

Complete your KS BCBS 37-024 form online now!