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I'm currently in the process of creating documentation macros (inserted into pt reports) for an EMR to decrease the percentage of my procedure authorization requests that are denied (1st request cycle) through Worker's Comp.
I would appreciate any tips on what to include from some of the experienced pain docs.
From my limited experience, I've noticed that those reviewing the requests could care less about reduction in pain score or VAS and ADLs unless it pertains to the patient's usual and customary occupation.
So what are the vital points?
-Functional Status described how? Weight they can push/pull? Objective increase in sitting/standing tolerance? Walking distance?
-Decrease in use of oral medication?
-Alternative to surgery?
Any Others?
Any differences when requesting from commercial insurance? How about Medicare? or do I ever need to "request" anything from Medicare.
Thanks.
I would appreciate any tips on what to include from some of the experienced pain docs.
From my limited experience, I've noticed that those reviewing the requests could care less about reduction in pain score or VAS and ADLs unless it pertains to the patient's usual and customary occupation.
So what are the vital points?
-Functional Status described how? Weight they can push/pull? Objective increase in sitting/standing tolerance? Walking distance?
-Decrease in use of oral medication?
-Alternative to surgery?
Any Others?
Any differences when requesting from commercial insurance? How about Medicare? or do I ever need to "request" anything from Medicare.
Thanks.