Consultation/Secondary Provider: One-time
Purpose:
A one-time consultation occurs when a secondary PIC provider joins the primary service provider and family to address a specific question or concern. The consultation may include observation during routines or activities, family interview, and discipline-specific assessment as appropriate. The consulting provider is not added to the IFSP.
Practice:
The primary service provider requests the consultation, either directly or through team discussion, and consults with the secondary provider before the visit to clarify the purpose of the consultation. During the visit, the consulting provider offers recommendations related to the identified concern. Consultation is collaborative and may include observation, family interview, and discipline-specific assessment tools, as appropriate.
Procedure:
Required Forms
- Prior Written Notice (PWN)
- Consent to Evaluate \
- ROI, if consultation results will be shared with outside agencies
Documentation
- Consultant: Consultation note in Raintree from the consulting provider about what occurred.
- Primary service provider: Daily note that indicates FSC/service coordination with consulting provider and the outcome of the consultation-how the recommendation will be utilized.
Billing
- Consulting provider (if appropriate): Billing codes used will be specific to your discipline, for example:
- OT/PT: Physical Performance test with report
- SLP: Speech/Language Evaluation
- SLP/OT for Feeding: Feeding Evaluation
- DS: Non Billable Evaluation
- SW: Social Work
- Primary service provider: Family Service Coordination for the time spent in facilitating the interaction with the family.
If a second consultation occurs and the provider is not added to the IFSP:
- Therapy activities may be billed, when appropriate.
- Family Service Coordination by the consulting provider is not billable because there is no Plan of Care.
- Evaluation activities completed during the second visit may be billed using the appropriate evaluation code.
Consultation/Secondary Provider: On-going Services
Purpose:
When a provider, who is not the Primary Service Provider, is added to the IFSP with the permission of the family, to provide more support around a specific domain, such as motor development to the child, parent, and primary provider.To outline the process for adding a secondary (consulting) provider to the IFSP, with family permission, when additional expertise is needed to support a specific area of the child's development. The secondary provider's role is provide therapy and to explicitly build the capacity of the Primary Service Provider (PSP) and the family by providing consultation, coaching, and strategies within their area of expertise.
Practice:
Following an evaluation and/or interview and observation visit, the team may recommend adding a secondary (consulting) provider to the IFSP when the child would benefit from specialized expertise in a particular developmental domain. The consulting provider collaborates with the Primary Service Provider and family to develop appropriate IFSP outcomes and intervention strategies that support the child's progress.
The Primary Service Provider requests the involvement of a consulting provider, either directly with a team member or during a team meeting. The Primary Service Provider is responsible for ensuring the consulting provider is added to the appropriate IFSP outcomes.
The Primary Service Provider and consulting provider consult before the visit so the consulting provider understands the questions, concerns, and outcomes to be addressed. Except when serving as a substitute for the Primary Service Provider, the consulting provider attends visits jointly with the Primary Service Provider.
The purpose of the consulting provider's participation is to support the child, family, and Primary Service Provider through consultation, coaching, modeling, problem-solving, and specialized intervention within their area of expertise. Depending on the child's needs, the consulting provider may provide direct assessment or intervention during the visit when specialized treatment techniques, handling, or discipline-specific expertise are needed, or to model strategies for the family and Primary Service Provider. These direct interactions are intended to build the capacity of the family and Primary Service Provider so strategies can be incorporated into everyday routines and implemented between consultation visits.
The only routine exception to joint visits occurs when the consulting provider is substituting for the Primary Service Provider due to the Primary Service Provider's absence. In those situations, the consulting provider functions as the substitute provider for that visit and communicates with the Primary Service Provider afterward to ensure continuity of services.
Procedure:
- After the consult or evaluation, the primary service provider will add the new service to the IFSP with appropriate start date and frequency for the quarter. Any new or revised goals need to be added to the IFSP/Plan of Care. All changes to IFSP services require a parent signature & initials, date and PWN.
- The consulting provider completes a Plan of Care and may use the following codes based on what occurs at the consultation visit:
- OT/PT: Physical Performance test with report
- SLP: Speech/Language Evaluation
- SLP/OT for Feeding: Feeding Evaluation
- DS: Non Billable Evaluation
- SW: Social Work
Documentation
- Primary Service: Document the visit that occurs with the consulting provider in a Daily Note and if appropriate bill overlapping service as FSC.
- Consultant/secondary:
- Prior to being added to the IFSP: document your consultation visit in a Consultation Note.
- After being added to the IFSP: complete POC and Daily Notes.