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1. It's essential to fill out the msa 115 pdf correctly, so take care when filling out the segments comprising these particular fields:
2. The next step is to complete the following blanks: PROGRESS SUMMARY NOTE SEE, SCHOOL THERAPY PROGRAMS NO, YES, TREATMENT REQUESTED FREQUENCY, LINE NO, PROCEDURE CODE, MODIFIER, TOTAL UNITS PER PA, MDHHS USE ONLY, AUTHORIZATION PERIOD APPROVED, REVIEW ACTION, APPROVED RETURNED DENIED NO ACTION, CONSULTANT REMARKS, See CHAMPS, and recertify.
Be extremely mindful when filling in TOTAL UNITS PER PA and TREATMENT REQUESTED FREQUENCY, because this is the part in which many people make mistakes.
3. This next portion is mostly about See CHAMPS, THERAPIST CERTIFICATION The, CONSULTANT SIGNATURE, DATE, MSA Previous editions are obsolete, and Page of - fill out each one of these blank fields.
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