Purpose: To instruct on documenting a Therapy Routine Visit in Pointcare. This is catered to the Therapy Assistant audiences, but will train both Therapy Assistants and Registered Therapists in Routine Visit documentation.
NOTE - Reference table is listed below the video to search for key components of a Routine Visit if a 'refresher' is needed to assist in system navigation or quality of documentation.
REFERENCE TABLE
Subject | Time |
Medical Record Review | 0:45 |
Therapy Reassessment Prompt | 5:45 |
PRN – documenting a fall | 6:20 |
Notes | 8:10 |
Reference/Problem Statements for patient | 8:50 |
Mileage/Drive Time | 9:40 |
Vital Signs & Measures | 10:10 |
Parameters | 11:15 |
Physical Assessment | 11:35 & 15:50 |
Therapy Goals/Status | 14:55 & 19:30 |
Interventions/Goals | 20:50 |
Therapy Assess/Plan | 27:40 |
Claim Codes | 29:15 |
Sign Out (always choose either ‘complete’ or ‘incomplete’ at end of every visit to prompt patient signature) | 29:50 |