SOCIAL WORKER - VISIT FAMILY MEMBER(S)

GENERAL NOTES VAC WILL AUTHORIZE SERVICES UNDER A REGISTERED PROVIDERS SCOPE OF PRACTICE UP TO THE BENEFIT GRID LIMIT EXCEEDING FREQUENCIES - VAC PRE-AUTHORIZES POC 12 SERVICES UP TO AN ANNUAL FREQUENCY LIMIT AS IDENTIFIED ON THE VAC BENEFIT GRIDS. APPROVAL OF SESSIONS BEYOND THE ANNUAL FREQUENCY LIMIT MAY BE APPROVED TO ADDRESS CLIENT NEEDS WHEN A TREATMENT CAN BE SHOWN THAT IT HAS BEEN EFFECTIVE AND IS REASONABLY EXPECTED TO CONTINUE TO BE EFFECTIVE IN REACHING THE DESIRED TREATMENT OUTCOMES. THE VAC FORM «REQUEST FOR EXTENSION OF TREATMENT » AND/OR A TREATMENT PLAN FROM THE PROVIDER ARE TO BE USED IN DETERMINING IF EXCEEDING THE FREQUENCY IS JUSTIFIED. USE OF «OTHER» CODES - THE MAC MAY REQUIRE SUPPORTING DOCUMENTATION FROM THE PROVIDER AND/OR OTHER HEALTH PROFESSIONALS AND/OR MAY NEED TO CONSULT WITH HEALTH PROFESSIONALS AND/OR OTHERS BEFORE AUTHORIZING THE REQUESTED SERVICE UNDER THE «OTHER» CODE. A RATIONALE MUST BE DOCUMENTED WHEN USING THE POC 12 «OTHER» CODE. REHABILITATION - ALL BENEFITS FOR REHABILITATION CLIENTS MUST BE PRE- AUTHORIZED. THE FREQUENCY AND MAXIMUM LIMITS ARE GUIDELINES ONLY. LIMITS MAY BE EXCEEDED BY WAIVING THE RULES FOR FREQUENCY AND MAXIMUM IN THE AUTHORIZATION IF DIRECTED IN THE WORK ITEM BY THE CASE MANAGER. REPORTS - OCCURRENCE WILL EQUAL ONE HOUR UNLESS OTHERWISE NOTED. IF MORE TIME IS REQUIRED TO COMPLETE A REPORT, ADDITIONAL OCCURRENCE(S) CAN BE AUTHORIZED. RATIONALE MUST BE DOCUMENTED. SPECIAL NOTES