1. (a) Medical treatment.

   1. (1) After the initial diagnostic medical evaluation, payments may be made to a physician (general practitioner or specialist), clinic, dispensary, or hospital for services provided to the individual.
   2. (2) Examples include drugs, biological, or other medical supplies incidental to treatment up to ninety (90) days (three (3) months).
   3. (3) If additional treatment is needed, a new medical evaluation/prescription is required.

2. (b) Psychiatric treatment.

   1. (1) After the initial psychiatric diagnostic evaluation, payments may be made to a specialist in neuropsychiatry, a psychiatric clinic, or hospital for psychiatric treatment.
   2. (2) Treatment is initially approved for up to twelve (12) visits.
   3. (3) If additional is needed, this should be suggested by the specialist.

3. (c) Surgical treatment.

   1. (1) Payments may be made for surgical operations and fees for preoperative care.
   2. (2) Payments will be made according to the established Arkansas Rehabilitation Services fee schedule.
   3. (3) See Appendix I.
4. (d) Anesthesia. Payments may be made to anesthetists and anesthesiologists not included in hospitalization.
5. (e) University of Arkansas for Medical Sciences. Payments for professional services including surgical treatment, anesthesia, pathology, and others provided at the University of Arkansas for Medical Sciences are to be authorized to the “Medical College Physicians Group”.

6. (f) Physical, occupational, or speech therapy (PT/OT/ST).

   1. (1) Arkansas Rehabilitation Services will pay for PT/OT/ST services when prescribed and provided by competent medical personnel and when necessary to a VR program.
   2. (2) If the expected duration of treatment is more than twelve (12) visits a new evaluation/prescription should be done.

7. (g) Podiatrist or chiropractor.

   1. (1) Arkansas Rehabilitation Services will pay for the services of a podiatrist or chiropractor only with medical consultant approval up to twelve (12) visits.
   2. (2) If greater time is needed, a new evaluation and prescription must be obtained.

8. (h) Dental.

   1. (1) Arkansas Rehabilitation Services may purchase dental services, including oral surgery, when necessary for an individual to participate in or complete a VR program.
   2. (2) Available services do not include routine preventive dental care or cosmetic dental procedures.
   3. (3) Provided dental services must be directly connected to disabling conditions documented during eligibility process.
   4. (4) Recommendation by the dental consultant will be required.
   5. (5) A specific treatment plan and estimated cost must be obtained.
   6. (6) An LMC is required, and approval by the Chief of Field Services is needed.
   7. (7) Services will be purchased consistent with the Arkansas Rehabilitation Services fee schedule.
   8. (8) See Appendix I.

9. (i) Exception.

   1. (1) Insurance benefits must be used first in paying for surgical/medical services.
   2. (2) The amount allowed by the Arkansas Rehabilitation Services fee schedule will be authorized followed by the statement “Rehabilitation Services will pay only that part of the authorized amount not covered by the insurance policy up to the maximum amount allowed by the Arkansas Rehabilitation Services Fee Schedule.”
   3. (3) See Appendix I.

10. (j) Procedures — Medical, surgical, psychiatric treatment.

    1. (1) Documentation of the action to be taken will be made in the case note.
    2. (2) Medical reports and recommendations will be obtained from the attending physician and attached to the ECF.

    3. (3)

       1. (A) Medical consultant’s review is required and attached to the ECF if needed.
       2. (B) See Appendix E.
    4. (4) Refer to the Arkansas Rehabilitation Services vendor list or secure W-9 from new vendor.

    5. (5)

       1. (A) Refer to the Arkansas Rehabilitation Services fee schedule.
       2. (B) See Appendix I.
    6. (6) The case management system will generate the status move after required data is keyed for Status 18 if needed.
    7. (7) Key required information into the case management system for Arkansas Rehabilitation Services purchase authorization.

    8. (8)

       1. (A) When billing statement is received, verify the individual received the service.
       2. (B) Document in the ECF.

    9. (9)

       1. (A) Key required information into the case management system for payment.
       2. (B) Support staff will be responsible for making payments.
       3. (C) Payment will not be processed without an attached bill from the vendor.
    10. (10) Refer to out-of-state policy limitations, if necessary.
    11. (11) University of Arkansas for Medical Sciences requires special payment.
    12. (12) Dental services require recommendation by the dental consultant.

Codification Notes: “ECF” means electronic case file. "LMC" means Local Medical Consult. "VR" means vocational rehabilitation.