Client Billing Dashbord

Client Name & DOB

Elfalan David
Date of Birth: June 21, 1959

Address & Contact Info

15150 140th way SE
unit K102
Renton WA
98058 United States
Phone: 2065120079 Email: davidelfalan@gmail.com

Insurance Information

Insurance Provider:

MOLINA
Policy Number: 5678w90-289 Group Number: 5467834

Consent

Has client given consent for healthcare services : Yes Does client have a support system: Yes, I have a strong support system

Service Encounter
Date: August 24, 2024
Client ID: drx2062024


Goals
Goal 1: Assist client in getting transportation to the hospital
Goal 2: Provide the client with resources and tools to support their dietary needs
Progress Toward Goals:

completed getting client to hospital


Peer Support Services Provided
Educating Clients About Chronic Health Conditions,Helping Clients Understand the Impact of Chronic Health Conditions on Daily Life
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Helping Clients Manage Medication Schedules and Recognize Side Effects
[display_values field=”1464″ entry=”9575″]
Educating Clients on Diets That Support Health and Manage Conditions,Helping Clients Incorporate Culturally Appropriate Foods and Recipes
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Helping Clients Understand the Benefits of Physical Activity
[display_values field=”1467″ entry=”9575″]
Teaching Clients Culturally Sensitive Stress Reduction Techniques
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Facilitating Mutual Support and Experience Sharing Among Clients
[display_values field=”1469″ entry=”9575″]
B CPT Code 99490 – Application: Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional_per calendar month,SERI Code T2022 – Application: Case management_per month,ICD-10 Code Z71.9 – Application: Counseling or unspecified,DSM-5-TR Code N/A
[display_values field=”1494″ entry=”9575″]
B CPT Code 97535 – Application: Self-care/home management training (e.g., activities of daily living (ADL) and compensatory training, meal preparation, safety procedures, and instructions in the use of assistive technology devices/adaptive equipment) direct one-on-one contact, each 15 minutes,SERI Code T1016 – Application: Case management, each 15 minutes,ICD-10 Code Z74.8 – Application: Other problems related to care provider dependency,DSM-5-TR Code N/A
[display_values field=”1495″ entry=”9575″]
Providing Culturally Sensitive Mental Health Counseling to Clients,Teaching Clients Coping Strategies for Chronic Pain and Fatigue
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Teaching Clients Techniques to Enhance Emotional Well-Being
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Guiding Clients on Managing Healthcare Costs and Insurance
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Helping Clients Balance Healthcare Routines and Daily Activities
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Helping Clients Make Their Home Safe and Accessible for Their Health Needs
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Date of Discharge: August 23, 2024


Provider Signature: Dave Date: August 21, 2024
Supervisor Signature: JC Date: August 23, 2024

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