As of June 1, 2017, CFHP will implement a speech therapy policy.
Initial evaluation requests must be pre-authorized and must be submitted by the PCP and include:
- Signed physician order
- Clinical notes documenting feeding/swallowing problems
- Early Childhood Intervention (ECI) referral (for members under 3 years)
Initial therapy may be approved for a maximum of 90 days with a frequency of 2X/week. Therapy may be approved for 3X/week by the medical director if the severity of the dysphagia warrants. A re-evaluation will be included in this authorization.
Initial therapy requests/re-evaluations must include:
- Signed physician order
- Evaluation and Plan of Care that includes:
- Physician signature
- Referring provider’s diagnosis and reason for referral
- Brief statement of member’s medical history and any prior treatment history
- Current level of functioning or impairment
- Clear diagnosis and reasonable prognosis
- Treatment modalities, frequency and duration
- Short and long term treatment goals
- Home exercise program
- Plan for collaboration with ECI/Head Start/SHARS when applicable
- Clearly established dc plan
- Documentation of a completed medical evaluation
Please contact Donna Glassman at 210-358-6121 for additional information regarding the policy in full.
