Track Plan of Care and Progress Reports

The following describes how to track when Progress Reports and Plans of Care are needed for Medicare and some other payers.

Medicare has specific requirements for establishing and tracking a Plan of Care for all patients, obtaining physician approval for Plans of Care, and producing interim Progress Reports. The General Billing Data tab now allows individual settings for:

  • Whether or not a Plan of Care is required
  • Plan of care maximum days
  • Whether or not an interim Progress Report is required
  • Alerting of the need for Progress Reports by days, by visits, or by both.

Other insurance plans may have similar requirements for a Progress Report. Regardless of the requirements, any insurance plan may be set up so that the staff is warned before a Progress Report is due by counting the number of calendar days, visits, or both. In cases where Progress Reports are tracked by both visits and days, you will be alerted by the one that is to expire first.

Plan of Care Warning

If a Plan of Care has not been established for a payer that requires one, the therapist will be notified in charting as shown below.

Establishing a Plan of Care

To establish a Plan of Care with typical Medicare settings:

  1. To open the Client Editor dialog, double-click the case name in the Chart tab of InsightEMR.
  2. In the Plan of Care/Progress Report Dates area of the Case Information tab, click Add P.O.C.

A Plan of Care with an effective date of today's date and a duration of 90 days will be automatically created. Progress report tracking will also be automatically added, with Visits set to 10.

It might be necessary to adjust the effective date of the Plan of Care and Progress Report tracking.

After establishing a Plan of Care, the system will update you when the patient needs a new Plan of Care or Progress Report.

Warning at Visit Threshold for Progress Reports

When you have reached the threshold set for warnings on Progress Reports, the Case Information will turn red and the system will warn you how many visits are left before a Progress Report is needed.

Documenting a Progress Report

After documenting a Progress Report, double click the Case Information. Then click Add Prog Rpt. The system automatically adds today's date to the Plan of Care/Progress Report grid and enters 10 visits.

The Case Information will turn blue again when you have added the Progress Report.

Plan of Care Due Warning

Similar to the Progress Report warning, you will be warned about an impending deadline to establish a new Plan of Care based on your system setting threshold. In this example the Plan of Care is due in the near future, but there is no immediate need to produce a Progress Report.

After updating the Plan of Care information, the Case Information will again turn blue to indicate that there are no Plan of Care or Progress Report alerts.

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