Quick Facts & Tips

STANDARDIZED ASSESSMENTS are preferred, as it provides statistical data that shows objectivity. 

If unable to use one that is appropriate for the client or the patient, CLINICAL OBSERVATIONS are best suited to describe the functional abilities and limitations of the client. It is best to provide a combination of both. 

 

Assessments are completed at the initial evaluation, then a progress report to update the baseline, and discharge report when OT is completed, or if the client has reached goals, or has plateaued. Initial Evaluation (IE) reports are typically submitted to the insurance provider within 48-72 hours, an authorization will be received, and treatment can be initiated or continued as long as the medical necessity is determined.

 

Progress report (PR) is expected within 30 days from initial treatment or within 2 weeks after initial treatment, whichever is set forth by the payor. For pediatrics, progress report is typically due within 30 days, 60 days, 120 days, or 6 months after initial evaluation, whichever is set forth by the payor. The expectation is that there will be change towards the goals that were established; and improvement in the objective findings or measures presented at IE.  Re-evaluation is expected annually. 

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In SCHOOL SETTING, initial evaluation is determined by the IEP team. If student is qualified, an OT evaluation must be completed within 30 days of receipt. Standardized assessment is preferred. Goals and intervention will be established, determined by OT and agreed upon by the team. Progress reporting is every quarter or dependent on school reporting practices. Re-evaluation occurs every three (3) years.