The Plan of Care (POC) is completed for each child after the provider and family have collaboratively developed goals on the IFSP. These IFSP goals form the foundation of the POC, and are automatically carried over to reflect those goals. The POC also serves as a communication tool with the child’s Primary Care Provider (PCP) and supports PIC’s ability to bill Medicaid and other insurance providers.
Most insurance payers, including Medicaid, require a POC signed by the child’s PCP in order to authorize reimbursement for services. While PIC strongly encourages families to maintain a relationship with a PCP to support the child’s overall health and care coordination, a signed POC is not required for a child to receive services through PIC.
Alaska is a Direct Access State, meaning that under state licensure regulations, therapy services can be provided without a physician’s referral or a signed POC. However, reimbursement from Medicaid and most commercial insurances typically requires a PCP-signed POC.
PIC providers request an ROI for the PPCP from parents at intake. After the evaluation and IFSP, the provider can generate a POC and assigns themselves and if appropriate, secondary providers to the POC goals.
PIC providers must complete the POC upon completing the IFSP so that subsequent sessions are billable from their signature date, provided the PCP signs withing 14 days. The Health Information Team (HIT)nassures the signatures meet timelines and will inform the PIC providers of concerns.
PIC provider’s timely completion of the POC prevents gaps in PIC’s ability to bill for services that children receive.
Upon completion of the IFSP, providers open a POC from the child’s chart.
Long-term goals are transferred from the IFSP completed with the family.
Each goal will need to identify provider or providers who will be working on each goal:
- In RainTree, open a Plan of Care for the child.
- Complete each tab including Progress, Treatment Plan and Recommendations. Where indicated, use the green cross at the bottom of the box to add set phrases.
- Click on Treatment Plan Tab, and open each Long-term Goal and its Short-term Goals.
On the Treatment Tab, as required by Medicaid provide a prognosis, and a certification period. This should be about 6 months from the date of the POC but no more than.
- In each goal, the Main Tab was completed with the IFSP process. Proceed to the IFSP tab and confirm that the previous entered information from the IFSP process is included in the IFSP:
F10 to return to the POC
Complete all tabs and their boxes, then:
- Save and Sign off
- Notify any secondary providers that the IFSP goals are completed and they can complete their own plan of care.
Note: Once an IFSP is signed by the primary, no new long-term goals can be signed without the Primary Provider creating a revision to the IFSP. Revisions require a new IFSP be created and require parent’s signatures that correspond to the date of the parent signature.
Short-term goals can be added to the POC without a signature from the family.
Secondary POC
All long-term goals need to be entered into the RainTree system through the IFSP process. The primary provider will assign any additional providers to goals. Secondaries, may not start a POC until the primary has added them to the IFSP goals.
Upon opening a new POC, the secondary provider will find the assigned goals automatically appear. Secondary provider number will appear in the boxes indicated above--if not assure that they are the assigned provider number and match.
Then, the Secondary provider may proceed with entering Short-term Goals.
Adding Short-Term Goals
Switch to the Main tab and enter Short-term Goals at bottom of page:
At bottom of page, A to Add New in Short term goals
Click on New and then complete the Short-term Goal boxes (these boxes will accommodate about 250 characters)
F10 to save.
F10 to return to the POC
When you have added all the goals
- Save and Sign off