The following is a list of definitions frequently used for the Cost Recovery Project:
Assessment - The definition of assessment is to the process of determining the need, nature, frequency, and duration of treatment; deciding the needed coordination with others involved, and documenting these activities.
Case Note - The definition of a case note is a descriptive summary of service provided with identification of any isolated or recurring problems
Children's Services Cost Recovery Project (CSCRP pronounced Sea Serp ) - In the public education system, CSCRP seeks to obtain reimbursement for the cost of providing various school-based health and related services to Medicaid recipients.
Early and Periodic Screening, Diagnostic and Treatment (EPSDT) - EPSDT refers to a mandatory Medicaid program service which consists of screening and diagnostic services to determine physical or mental illness, treatment, and other measures to correct or ameliorate any defects or conditions discovered in clients under the age of 21.
Evaluation - The definition of evaluation is:
- Mental Health - Evaluation includes a "Psycho-educational Assessment". This assessment includes psychological and/or educational testing, typically for intellectual, personality, and/or educational evaluation of referred student, for diagnostic purposes resulting in the generation of a report. The psychological component of the assessment evaluates the intellectual, academic, perceptual motor skills, social and emotional adjustment, and readiness for learning.
- Speech - The speech, language, and hearing evaluation includes the assessment of articulation and language (receptive, expressive; form, content, and use) as measured by a standardized/norm-based instrument (i.e., criterion-referenced measures including clinical observations). The evaluation may also include an assessment of oral motor functioning (oro-pharyngeal function), voice quality and speech fluency.
- Physical Therapy - Evaluation refers to the process of obtaining and interpreting data necessary for service delivery. The nature of evaluation will be determined by the student's handicapping condition and how it impacts the educational program. The physical therapist should be a member of the multi-disciplinary team and the IEP team, where appropriate, in order to.
- Occupational Therapy - Evaluation refers to the process of determining the need, nature, frequency, and duration of treatment; deciding the needed coordination with others involved, and documenting these activities. This evaluation addresses the varying degrees of developmental delay, neurological deficits, and/or neuromuscular disorders.
Individualized Education Plan (IEP) - IEP refers to a formal, written plan which is developed to meet the needs of a child identified to be handicapped and requiring special education and health services pursuant to Delaware Department of Education regulation. (Non-handicapped children may also receive school-based services and require a treatment plan, but not an IEP).
Medical Necessity - a service which is reasonably calculated to prevent, diagnose, correct, cure, alleviate or prevent the worsening of conditions that endanger life, or cause suffering or pain, or result in illness or infirmity, or threaten to cause or aggravate a handicap, or cause deformity or malfunction, and there is no other equally effective more conservative or substantially less costly course of treatment available or suitable for the eligible client requesting the services.
Provider Agency (also Provider ) - refers to a person or organization of practitioners who have been certified and enrolled by DHSS to provide services to eligible clients and to be reimbursed by Medicaid for those services.
School-Based Health Services Providers - refers to eligible providers who meet the certification and enrollment requirements for providing EPSDT related school-based services provided in a public education environment.
Six-Month Progress Note - indicates where the student is in relation to the treatment plan goals: indicated if the treatment plan requires changes in the goals and/or objectives; and indicates if the type or frequency of the treatment requires modification.