final review for admin

a federal and state program that provides health coverage to the poor

medicaid

to prepare for a joint commission survey OT practitioners must do which of the following

examine current policy and procedures for conformance with standards

what can ot do if an APPEAL is denied

• request external review

• ask MD to request a peer internal review from ins co

OTs should participate in advocacy because

1. their job depends on it

2. to ensure policies protect consumers access to services

3. policymakers listen to consistuants

a health care system in which physicians agree to a discounted fee for services in which the subscriber can self refer

PPO

the occupational therapist’s role in transition planning after high school is

1. they are involved in the treatment plan

2. they can continue to work with students after HS for life skills

3. they can continue to work with student after grad for employment skills

what would be an intervention for independent living skills

learning how to read and follow a transportation schedule

a template for an organization’s goal and priorities over 3 to 5 years

strategic plan

close supervision is defined as

contact supervisor at least once a day

True or False: Ots must write an encounter note every time they work with a client

True

when an employee who has potential is not performing as expected the manager should

develop an action plan

an alternate method for meeting a supervisor in person for a meeting is

phone call

during transition planning where should the OT document

• on the IEP

• on the transition plan documentation

what best describes CARF accreditation

recognizing meeting levels of performance, integrity, and quality

the key to effective personal management is

effective communication

True or False: Ot’s in NJ need a MD prescription for services

False, rules vary state to state but in NJ anyone can walk in for services

ideas for a new program comes from

1. the marketplace

2. patients/clients and families

3. personnel/staff

when selecting a continuous quality improvement project, a leader should consider

1. alignment of the initiative to the organization mission/vision

2. the priorities of the department

3. whether the project is related to a regulatory requirement/government mandate

an insurance company denied a wheelchair claim, what should the OT so?

• find out why the claim was denied

• call insurance/initiate appeal

• get info from team

a forecast of your revenue and expenditures is called

the budget

performing one intervention and billing for another that reimburses at a higher rate is an example of

fraud

to qualify for reimbursement through medicare part A client must

1. need skilled therapy

2. need skilled nursing

3. admitted to hospital within the last 30 days for qualifying stay

an occupational therapy manager who supervises other OT’s are responsible for

assuring they are properly trained to perform the assigned work

unresolved conflict in the healthcare setting can contribute to

1. adverse effects

2. compromised patient safety

3. patient mortality

effective OT managers demonstrate

a timely resolution to conflict