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The QMR Process: Preparation and Documentation Tips for Local Systems and Practitioners


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This webinar will provide local system managers, supervisors, and early intervention practitioners with an overview of the Quality Management Review (QMR) process in preparation for reviews beginning no later than March 2011. Activities occurring before, during, and after the QMR visit will be discussed in detail. The QMR auditing tool will also be reviewed so that local systems can begin to prepare for QMR visits. Based on information learned from the pilot reviews, tips for completing thorough documentation in the early intervention record will be provided.

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The QMR Process: Preparation and Documentation Tips for Local Systems and Practitioners

  1. 1. The QMR Process: Preparation and Documentation Tips for Local Systems and Practitioners<br />QMR Word Scramble<br />For This Webinar<br />Please Call: 866-842-5779Enter Code: 463 661 9330#<br />ntnfai<br />rdorce<br />autid<br />ciedidma<br />lmopecncia<br />adotmcineount<br />yfamil<br />oinvtritnene<br />bnillgi<br />ivsti<br />Have Available <br />The printouts of the files emailed to you along with your login information.<br />Your phone will be muted. You will experience periods of silence until the webinar begins.<br />
  2. 2. Welcome!<br />Mary Anne<br />Jeff<br />Dana<br />WORD SCRAMBLE ANSWERS <br />infant record audit Medicaid compliance<br />documentation family intervention billing visit<br />
  3. 3. Housekeeping<br />Phones Are Muted<br />Chat for Communication<br />
  4. 4. Practice Chat <br />Use Chat to Ask/Respond to Questions<br />Type message in box on (lower right corner) <br />Click into box, type message, press enter<br />Test Chat Now<br />Chat is Seen by EVERYONE!!<br />
  5. 5. Viewing Options<br />View Slides in Full Screen Mode<br />locate this button on bar below slides<br />click to view slides in full screen<br />Esc. Key to Return to Normal View<br />
  6. 6. Your Feedback<br />Complete a Survey<br />
  7. 7. Handouts<br />DMAS EI Services QMR – Audit Tool<br />Contact Note Checklist<br />DMAS EI Services Report & Follow-Up Plan<br />Contact Note #1 – Sally Jones<br />Contact Note #2 – Sally Jones<br />Have Your Practice Manual Handy<br />
  8. 8. Quality Management Review (QMR) Process<br />Preparing for the Process Tips for Local Systems and Practitioners<br />
  9. 9. Purpose<br />Review the QMR process<br />Review general findings from the QMR pilots<br />Share documentation tips<br />
  10. 10. Question<br />Why do you think we have Quality Management Reviews or QMRs?<br />Use Chat to Respond<br />
  11. 11. Why Do We Have QMRs?<br /><ul><li>Regulatory Requirements
  12. 12. 42 C. F. R. Parts 455 and 456
  13. 13. 12 VAC 30-50-131
  14. 14. Virginia State Plan for Medical Assistance Services
  15. 15. System Transformation
  16. 16. DMAS Participation Agreement</li></li></ul><li>When and Where Will QMRsBegin?<br />QMRs May Be<br /><ul><li>Unannounced
  17. 17. On-site Visit
  18. 18. Desk Review</li></li></ul><li>
  19. 19. What Happens Duringthe QMR Process?<br />Post-Site Visit<br />Wrap-Up Activities<br />Pre-Site<br />VisitActivities<br />On-Site Visit<br />Three Components<br />
  20. 20. Pre-Site Visit Activities<br />Purpose of activities is to prepare for on-site visit.<br />
  21. 21. Pre-Site Visit Activities<br />DMAS Will Select<br /><ul><li>Local System
  22. 22. Time Period
  23. 23. Children</li></li></ul><li>Pre-Site Visit Activities<br />Part C Office Will<br /><ul><li>Notify Local System
  24. 24. Obtain and/or Verify List of all Providers</li></li></ul><li>Pre-Site Visit Activities<br />Local System<br /><ul><li>Collect Records
  25. 25. Secure Space</li></li></ul><li>Your Burning Questions<br />Use Chat to Ask Your Question<br />
  26. 26. Locate Documents<br />Please have these documents available for review:<br /><ul><li>DMAS Early Intervention Services, Quality Management Review Form (QMR Audit Tool)
  27. 27. Contact Note Checklist</li></li></ul><li>On-Site Visit<br />Documents<br /><ul><li>DMAS Early Intervention Services, Quality Management Review Form (QMR Audit Tool)
  28. 28. Contact Note Checklist</li></ul>Team Leader<br /><ul><li>Tamara Wilder</li></li></ul><li>On-Site Visit: What Occurs<br />Record Review<br />Observation of Service Delivery<br />Review of Medicaid Billing Records<br />
  29. 29. Document Review<br />Pages 1-6 DMAS EI Services, QMR Document<br />Share one thing you did not realize would be reviewed during the QMR process.<br />Use Chat to Share<br />
  30. 30. QMR Audit Tool<br />
  31. 31. QMR Audit Tool: Page 3<br />
  32. 32. QMR Audit Tool: Page 4<br />
  33. 33. QMR Audit Tool: Page 5<br />Locate Contact Note Checklist<br />
  34. 34. QMR Audit Tool: Page 5<br />
  35. 35. Question<br />Based on the information you just heard and saw regarding documentation, what areas do you feel you might need to improve on?<br />Use Chat to Respond<br />
  36. 36. QMR Audit Tool: Page 6<br />
  37. 37. QMR Audit Tool: Pages 7/8<br />
  38. 38. QMR Audit Tool: Pages 9/10<br />
  39. 39. On-Site Visit<br />Exit Interview<br /><ul><li>General summary of strengths and issues
  40. 40. Preliminary report to be sent for review
  41. 41. Final report</li></li></ul><li>Post Site Visit Wrap Up<br />QMR Team Reconvenes<br />Team Leader Responsibilities<br />
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  45. 45. What Did We Find During the Pilot QMRs?<br />Strengths<br />75/76 providers were EI certified<br />Services provided in the natural environment<br />Documentation of medical necessity<br />Documentation of provider choice<br />Documentation was present for most services provided<br />Parents were satisfied with services received<br />
  46. 46. What Did We Find During the Pilot QMRs?<br />Issues<br />Billing<br />Documentation<br />Provision of services in accordance with the IFSP<br />Not all services provided were billed to DMAS<br />
  47. 47. So What Can You Do?<br />
  48. 48. Question<br />In addition to the QMR process, what are some other reasons why thorough documentation is so important?<br />Use Chat to Respond<br />
  49. 49. Purpose of Documentation<br />Clearly capture what happened during an interaction with or on behalf of a family.<br />
  50. 50.
  51. 51. Ask Yourself<br />Would someone else be able to read my contact note and understand what occurred during my visit/communication with the family?<br />
  52. 52. Locate Contact Note 1<br />Questions to Consider<br />What questions do you have about this intervention visit? <br />What information is missing?<br />
  53. 53. Contact Note 1<br />What questions do you have about this intervention visit? <br />What information is missing?<br />Use Chat to Respond<br />
  54. 54. Locate Contact Note 2<br />Questions to Consider<br />What differences do you see between Contact Notes 1 and 2?<br />Do you know what happened on this visit?<br />
  55. 55. Contact Note 2<br />What differences do you see between Contact Notes 1 and 2?<br />Do you know what happened on this visit?<br />Use Chat to Respond<br />
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  63. 63. Documentation Tips <br />Contact Notes<br />Notes must be descriptive<br />Be objective and positive<br />Indicate what outcomes & goals were addressed<br />
  64. 64. Documentation Tips <br />Be Specific<br />Provide information about how the parent/caregiver participated during visit<br />Include the child’s activities and responses in specific terms<br />Avoid general statements such as “progressing”<br />
  65. 65. Documentation Tips <br />Describe<br />How family activities & routines were incorporated<br />How you coached the family<br />Strategies parent will try between visits<br />
  66. 66. Documentation Tips <br />EI Record<br />Include clear documentation of<br />Provider Choice<br />Medical Necessity<br />Payor of Last Resort<br />
  67. 67. Documentation Tips <br />EI Record<br />File email exchanges<br />Document Individual Right to Appeal when applicable<br />
  68. 68. A Few More Strategies<br />Practice Manual – Ch 9<br />Seek out critiques<br />Put your own monitoring processes in place<br />When in doubt, more detail is always better!<br />
  69. 69. We’re In This Together!<br />
  70. 70. ?<br />Use Chat to Ask<br />
  71. 71. Thank You QMR Pilot Sites<br />Infant & Toddler Connection of Fairfax - Falls Church<br />LSM: Allan Phillips<br />(703) 246-7307<br /><br /> <br />Infant & Toddler Connection of Hanover<br />LSM: Karen Walker<br />(804) 723-7020<br /><br /> <br />Infant & Toddler Connection of Virginia Beach<br />LSM: Jennifer McElwee<br />(757) 385-4425<br /><br />
  72. 72. Thank You<br />a recording will be available on our website in approximately 10 days<br />Virginia Early Intervention Professional Development Center<br /><br />