Referrals

Referrals (18)

%AM, %333 %10 %2015 %00:%Sep

Rehab: Speech/Language Therapy

Written by
Basic Requirements:

1. Complete referral form if not submitted via e-Referral
2. Doctors Progress Notes/Medical Records, including problem list (History and Physical, last 3
visits’ notes) if not in Cerner
3. Medication List if not in Cerner
4. Recent Labs (all labs done within last six months) if not in Cerner
5. PCP within Ventura County
6. At any time the PCP may call and consult with the Specialist to amend or waive the work-up
7. Any other medical services not defined by criteria

 

Scheduling Criteria

Please note: Video fluoroscopic studies MUST be scheduled through Radiology, not Rehab &
requires an IUR

Acute Patients:
  1. Post-Operative Neurological Surgical patients
  2. Discharge from Acute Rehabilitation facility within past 2 weeks
  3. Episode of documented dysphagia/aspiration in previous 30 days
  4. Recent surgery to Neck, throat, tongue, pharynx (Previous 30 – 45 days)
  5. Recent cleft palate surgery (Previous 45 days)
  6. Recent TBI/Concussion with loss of consciousness (previous 30 days)
  7. CVA with new onset Aphasia/Dysphagia (Previous 30 – 45 days)
Subacute 
Most patients with Speech Therapy referral are considered Subacute.
  1. All Pediatric referrals not classified as Acute
  2. Problems with Speech articulation (Not seen in past 6 months)
  3. Problems with progressive decline of cognitive functioning (Not seen in past 6-12 months)
  4. CVA/TBI (Not seen in past 6-12 months)
 
%AM, %333 %10 %2015 %00:%Sep

Rehab: Physical Therapy

Written by
Basic Requirements:

1. Complete referral form if not submitted via e-Referral
2. Doctors Progress Notes/Medical Records, including problem list (History and Physical, last 3
visits’ notes) if not in Cerner
3. Medication List if not in Cerner
4. Recent Labs (all labs done within last six months) if not in Cerner
5. PCP within Ventura County
6. At any time the PCP may call and consult with the Specialist to amend or waive the work-up
7. Any other medical services not defined by criteria

 

Scheduling Criteria

Acute Patients:

1. Post-Operative Orthopedic Surgical patients
2. Post-Operative Neurological Surgical patients
3. Discharges from Trauma Services at VCMC/SPH
4. New Onset Acute Back/Neck Pain with radicular symptoms (Within past three weeks)
5. CVA within past 2 weeks
6. Discharge from Acute Rehabilitation facility within past 2 weeks
7. New onset orthopedic condition (within past two weeks) such as rotator cuff tear, muscle
sprain/strain; joint injury/derangement
8. New onset balance impairment/recent history of falls/Acute vestibular dysfunction
9. Recent onset pelvic floor issues (surgical, new onset incontinence, hernia repair)
10. Recent gait disturbance (foot drop, antalgic gait, other) within 2 months
11. Amputation and prosthetic fit within 3 months

Subacute:

1. Acute exacerbation of chronic low back pain with radicular symptoms
2. Muscle Strain/Sprain: Sports injuries; activities of daily living, occupational injuries
3. Mild to moderate joint derangement from injury in past 2-4 months
4. CVA/TBI: within past 2 – 6 months
5. Pelvic floor issues (progressive weakness, progressive disability, progressive pain)
6. Post-Operative Orthopedic/Neurological/General Surgery 2 – 4 months
7. New diagnoses repetitive movement syndromes

Chronic:

1. Chronic Low back Pain (> 3 months)
2. Chronic Pain Syndrome (Fibromyalgia, Postural dysfunction, Lupus, Migraine)
3. CVA/TIA/TBI with functional decline > 6 months or greater
4. Deconditioning/Muscle Weakness
5. Pelvic floor weakness (pain, incontinence > 6 months)
6. Progressive Functional decline secondary to chronic diseases (e.g. Cerebral Palsy, Rheumatoid Arthritis, Parkinson’s Disease, Obesity, Degenerative Joint Disease, Diabetic Neuropathy)
7. Ongoing history of falls/long term balance deficits

 
%AM, %333 %10 %2015 %00:%Sep

Rehab: Occupational Therapy

Written by
Basic Requirements:
  1. 1. Complete referral form, if not submitted via e-Referral
  2. 2. Doctors Progress Notes/Medical Records, including problem list (History and Physical, last 3
  3. visits’ notes) if not in Cerner
  4. 3. Medication List if not in Cerner
  5. 4. Recent Labs (all labs done within last six months) if not in Cerner
  6. 5. PCP within Ventura County
  7. 6. At any time the PCP may call and consult with the Specialist to amend or waive the work-up
  8. 7. Any other medical services not defined by criteria

Scheduling Criteria

Acute Patients:
  1. 1. Post-Operative: Hand/Wrist Tendon Repair (plastic/general/orthopedic Surgery) – Often seen
  2. same day as surgery/within 48 hours
  3. 2. Post-Operative Orthopedic Surgical patients – Carpal tunnel, hand/writs/elbow fracture
  4. 3. Post-Operative Neurological Surgical patients – Hand/wrist/elbow
  5. 4. Discharges from Trauma Services at VCMC/SPH - Hand/wrist/elbow/TBI
  6. 5. CVA within past 4 weeks
  7. 6. Discharge from Acute Rehabilitation facility within past 2 weeks
  8. 7. Finger/Hand/Wrist/Elbow Amputation: within 3 months
Subacute:
  1. 1. Muscle Strain/Sprain: Sports injuries; activities of daily living, occupational injuries
  2. 2. Mild to moderate joint derangement from injury in past 2-4 months
  3. 3. CVA/TBI: within past 1 – 6 months
  4. 4. Progressive neurological conditions (Parkinson’s, ALS, MS) that have not been treated in over 11 months.
  5. 5. Contracture/Moderate to severe loss of ROM/Function within past 6 months (Hand/Wrist/Elbow)
Chronic: Patients with long standing conditions that may benefit from Therapy or have been seen for same diagnoses in past.
  1. 1. Rheumatoid Arthritis (Hand/Wrist/Elbow)
  2. 2. Degenerative Joint Disease (Hand/Wrist/Elbow)
  3. 3. Late Effect CVA/TBI > 6 months
  4. 4. Stable or Progressive neurological conditions (Parkinson’s, ALS, MS) that have been treated in
  5. past 12 months (Hand/Wrist/Elbow)
Please note:
  • • Occupational Therapy/Hand Therapy - adults ONLY
  • • Tendon Repair/Complex Hand surgery follow up is ONLY available at Eastman Campus
%AM, %375 %02 %2015 %00:%Feb

Retinal Scan - Diabetes

Written by

PDF file is loading ...

Above are the referral requirements for this specialty. 

Also see the powerplans in cerner, beginning with 'REF', that include all the required studies for referrals. 

Referrals via Gold Coast are processed by Patricia Alamillo. Reverrals via other insurance payors are processed via the MOA in your suite.

Page 1 of 2