• Please be sure documentation submitted is legible.
• Please submit records for all dates of service on the claim.
• Please ensure that the medical records submitted provide proof that the service(s) was ordered and rendered. Also, ensure the medical records provide justification supporting medical necessity for the service by submission of the following documentation:
o Physician’s order for IRF admission/placement.
o IRF Patient Assessment Instrument (PAI)/initial assessment.
o Preadmission screening records.
o Inpatient hospital (acute stay records) including discharge summary.
o History and physical.
o Consultation reports.
o All physician’s orders.
o All physician certifications.
o All physicians’, nurses’ and therapists’ progress notes and team conference notes.
o Therapy initial evaluations and any re-evaluations (if applicable).
o All plans of treatment from all disciplines.
o All occupational/physical therapy and/or speech-language pathology and social services notes and minutes of service.
o All/any documentation to support the three-hour rule.
o Discharge summaries from all disciplines.
o Any other documentation to support appropriateness of admission.
o Signatures/credentials of professionals providing services.
o Any other documentation a provider deems necessary to support medical necessity of services billed, as well as documentation specifically requested in the Additional Documentation Request (ADR) letter.
• Please submit records for all dates of service on the claim.
• Please ensure that the medical records submitted provide proof that the service(s) was ordered and rendered. Also, ensure the medical records provide justification supporting medical necessity for the service by submission of the following documentation:
o Physician’s order for IRF admission/placement.
o IRF Patient Assessment Instrument (PAI)/initial assessment.
o Preadmission screening records.
o Inpatient hospital (acute stay records) including discharge summary.
o History and physical.
o Consultation reports.
o All physician’s orders.
o All physician certifications.
o All physicians’, nurses’ and therapists’ progress notes and team conference notes.
o Therapy initial evaluations and any re-evaluations (if applicable).
o All plans of treatment from all disciplines.
o All occupational/physical therapy and/or speech-language pathology and social services notes and minutes of service.
o All/any documentation to support the three-hour rule.
o Discharge summaries from all disciplines.
o Any other documentation to support appropriateness of admission.
o Signatures/credentials of professionals providing services.
o Any other documentation a provider deems necessary to support medical necessity of services billed, as well as documentation specifically requested in the Additional Documentation Request (ADR) letter.
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