If you’ve treated Veterans with VA benefits, either through Zeel or elsewhere, you’ve probably heard of an RFS, which is short for “request for service”—the term used to request approval for additional covered treatments from the VA.
As a therapist in the Zeel provider network, you may need to submit an RFS for a Veteran who would benefit from additional treatments. Fortunately, the Zeel Provider App makes it easy and seamless! Here’s everything you need to know about submitting an RFS for massage.
What is an RFS?
Veterans with a referral for massage therapy are prescribed a specific number of sessions in a fixed window of time. If a Veteran has completed all allowed treatments in a referral and the provider believes he or she would continue to improve with further sessions (or if the original referral has expired), the provider can submit a Request for Service, or RFS.
Zeel does not make the final determination as to whether or not an RFS is approved, and approval is not guaranteed. We pass the request to the Veteran’s VA care team, who makes the final decision. However, we can provide guidance to ensure that there is enough clinical information provided.
Why Submit an RFS?
A request for additional services may be indicated for any of the following reasons:
- You believe based on your clinical judgment that the Veteran is making significant progress towards their recovery goals, and more time is required to meet them
- Regular massage therapy is supporting the Veteran’s quality of life and allowing them to complete daily activities, self-care, and recreational and work activities
- Regular massage is helping to reduce the intake of pain medications
Clinical Rationale
When submitting an RFS, it is your responsibility to document all relevant clinical information in order to demonstrate how your treatment has improved the Veteran’s pain level, objective deficits, mobility and function. It is vital to demonstrate functional outcomes that have been achieved since initiating treatment. Lack of clinical information is more likely to result in a denial of the RFS.
It is not enough to just state “I am requesting an RFS in order to reduce pain and improve mobility.” The information provided should be:
- Measurable
- Explicit in its demonstration of functional improvement and/or reduction in use of pain medication
- Unique to the patient
Completing an RFS: What You’ll Need to Know
Section 1: Progress Made to Date
In this section, you should describe the progress the Veteran has made towards the goals set during his or her initial evaluation. Again, the information should be measurable and demonstrate how their function is being improved.
Here are some examples:
- Pain scales and functional outcome scores: Patient’s lower back pain has improved from 8/10 to 4/10 on the pain scale.
- Objective limitations/improvements: Patient’s lumbar soft tissue tension has improved from severe to moderate on the left side and from severe to mild on the right side.
- Functional limitations/improvements: Pain reduction and decreased soft tissue tension has helped allow the patient to sleep for 5 consecutive hours since initiating massage therapy.
- Pain medications: Patient reports a reduction in pain medication and only requires it on heavy work days.
Section 2: Reasons for Additional Sessions
Describe why and how the patient would benefit from additional sessions, citing the specific goals and functional improvements the patient is working towards.
Here are some examples:
- Pain scales and functional outcome scores: Believe patient’s lower back pain can improve to 2/10 on the pain scale with 6 additional massage treatments
- Objective limitations/improvements: Patient’s lumbar soft tissue tension can be reduced to mild on both sides with additional treatments focusing on the left side
- Functional limitations/improvements: Decrease lower back pain and improve lumbar mobility to allow the patient to walk 10 blocks pain free
- Pain medications: The patient has reported a reduction in pain medication, taking it only on work days. Goal is to reduce pain medications to only PRN or when needed.
You Are Your Patient’s Advocate
If you observe a Veteran making measurable progress with medical massage, you should feel confident submitting an RFS so they can continue to improve. Keep in mind, however, that RFS approval is not guaranteed, and you should not give a Veteran in your care the impression that it is.
RFS approval practices, such as the number of RFS’s approved for a single referral, differ from VAMC to VAMC, so you should always make sure to help the Veteran get the absolute most benefit they can from the 12 sessions included in the initial referral.
