In-Processing Federal Patients: Active vs Maintenance

Course overview

Identify caller status and active, PRN, or maintenance care using a front-desk decision matrix to establish Medicare compliance before the visit. Differentiate Part C plan types and provider status, and apply the AT modifier criteria to determine active treatment versus maintenance care. Distinguish mandatory from voluntary ABNs and demonstrate proper completion of the official CMS form for maintenance CMT services. Evaluate episode documentation for mechanism of injury, functional deficits, and treatment plans while applying mandatory submission and QMB billing rules.