Using the case information you gathered in clinical IV or V, prepare a packet of information to send to a third party payer justifying your therapy or equipment recommendation. If you are using something denied, make sure you understand the reason for the denial and address it thoroughly. Make sure your logic is so clear that you lead them to agree with your decision. Remember that points like increased patient function and having the potential to decrease or prevent future costs are very persuasive. In addition, you will need to research the procedure for denial for that particular 3 rd party payer. If you are not using something already denied- research that 3 rd party payers typical coverage and limitations for such an item. The packet should include but is not limited to: denial, PT examination, proposed equipment description & cost/ proposed therapy plan & cost, & justification letter.

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