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Understanding the MNT Assistant
When providing Medical Nutrition Therapy and other outpatient nutrition or lifestyle management services, Registered Dietitians find the MNT Assistant their most valuable patient and office management tool. It enhances the therapeutic experience for their patients and significantly reduces the time required to provide accurate record-keeping, charting, and even submission of claims. The MNT Assistant uses software already on your desktop so you’re up and running in no time at all.
The MNT Assistant draws upon the sophisticated features of the Microsoft Office suite. The data entry, calculations and storage system uses the advanced database management and reporting capabilities of Microsoft Access. Although not required, having Microsoft Access increases the number of features available.
To preview the MNT Assistant, just click here to download and view a PowerPoint presentation. (If you do not have Microsoft PowerPoint , go to www.microsoft.com to download a free viewer)
The MNT Assistant includes the following (click on any one below to learn more):
MNT Patient Profile questionnaires
The MNT Patient Profile questionnaires include an intake form that collects initial intake demographics, insurance, and healthcare provider information (the MNT Patient Intake form) ; a personal and family health history questionnaire (the MNT Patient Profile 100 form); a dietary and lifestyle assessment survey (the MNT Patient Profile 200 form); and a functional status assessment that measures both physical and mental functional health status (the MNT Patient Profile 300FA form). The patient may complete the MNT Patient Profile questionnaires either at home or in the office. You build your patient’s database with the results of these questionnaires which become the content for subsequent charting and reporting documents.
Topics covered by these questionnaires include:
- Reasons seeking MNT
- Date of appointment
- History of MNT
- Years of education
- Occupation
- Weight history
- Personal health history
- Family living environment
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- Family health history
- Physical and mental functional status
- Eating habits, preferences, restrictions
- Use of supplements
- Current medications
- Physical activity status
- Tobacco, drugs and alcohol use
- Readiness to change
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MNT Patient Profile Reports
MNT Patient Profile Reports may be printed after entering the data from the MNT Patient Profile questionnaires. The initial intake report provides the basic information you need to begin a patient’s chart (Basic Patient Intake Information) When the MNT Patient Profile 100 and optional 200 or 300FA survey forms have been entered you can print the MNT Patient Profile reports (see Basic MNT Patient Profile and MNT Patient Profile with comments). These are designed to be shared with the referring physician and submitted to the patient’s chart. These reports document information required by MNT Evidence Based Guides, Medicare and items that may be necessary for other third third-party payers.
The information provided by each of these reports is described below:
Basic Patient Intake Information
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Includes name, date, ID, gender, age, date of birth, address, phone, email, fax, primary and secondary insurance and health insurance company, reason for MNT, referraling physician with contact phone, fax, UPIN, and general comments |
Basic MNT Patient Profile
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Includes name, date, ID, gender, age, date of birth, education, occupation, family living arrangement, personal and family health history, weight history, medications, activity status, smoking status, dietary restrictions, functional health status, and a summary of reported eating habits |
Reported eating habits include:
- Meals (#) eaten per day
- Meals (#) eaten at home
- Meals (#) eaten out
- Medically related restrictions
- Breakfast eating
- Meal skipping
- Dietary preferences
- Fat and fiber intake intentions
- Readiness for dietary change
- Use of caffeinated beverages
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- Night eating
- Hunger awareness
- Binging
- Appetite status
- Food preferences for fat and fiber
- Use of salt and salty foods
- Use of supplements
- Dairy preferences
- Usual water intake
- Typical alcohol intake
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MNT Patient Profile with Comments
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Includes the MNT Patient Profile Report (without eating habits narrative) with session notes, basic diet assessment data and clinical test results
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MNT Session Notes
Most of the data you collect will be linked to the session notes. In other words, they will be linked to the day or session for which they are most closely associated. When a patient brings in their blood test or nutrition assessment results, they are recorded as a part of that session’s data. The MNT session notes include the session time, all your charting notes, client goals, your nutrition prescription, and other information such as a list of the materials distributed or what’s expected for the next session. This is where you also identify the referring physician, their diagnosis and ICD9 code(s), your intervention strategy, and appropriate CPT codes. This information compiled into both the ‘Session Notes’ and ‘Claims’ reports.
MNT Session Notes
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Includes the session date, patient name, ID, gender, age, date of birth, contact time and units, ICD9 codes, diagnosis name, CPT code, Intervention name, MNT provider, session notes and comments |
Claims Information
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Includes most of the information required to complete the HCFA/CMS 1500 form for the session contact indicated |
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MNT Dietary and Nutrient Analysis Results
The MNT Dietary Analysis Report documents food and nutrient intake in addition to the use of supplements. It illustrates estimated energy requirements, the patient’s intake of 16 nutrients and the number of servings reported from each food group. These are compared with goals you select based on the DRIs or your patient’s specific needs.
The MNT Assistant will record nutrient analysis results from any compatible dietary assessment program. If you don’t have one, you can use the convenient nutrition analysis tools that come with the MNT Assistant. They conveniently and automatically estimate REE, total energy requirements, and nutrient composition from a 24 hour recall or diet record. You may use the values recommended in the DRI reports such as the RDAs or AIs. Values are automatically provided based on gender and age. Of course, you can also use any other values your patient requires. For your convenience, percent and gram values of recommended protein, carbohydrate and fat can also be calculated.
MNT Dietary and Nutrient Analysis Results
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Reports 21 nutrients values, 10 food groups, and lists dietary supplement used |
Estimated daily nutrient intake and goal values:
- REE and Total Energy Expenditure (kcal)
- Total energy intake (kcal)
- Fat intake (g)
- % kcal total fat
- % Monounsaturated fat
- % Saturated fat
- Cholesterol intake
- Protein intake (g)
- % kcal protein
- Carbohydrate intake (g)
- % kcal carbohydrate
- B-6 (mg/day)
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- Calcium (mg/day)
- Fiber intake (g)
- Folate (mcg/day)
- Iron (mg/day)
- Phosphorous (mg/day)
- Potassium (mg/day)
- Sodium (mg/day)
- Vitamin E (mg/day)
- Alcohol (drinks per day)
- Caffeine (servings per day)
- water (cups per day)
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Estimated daily food group intake and goal values:
- Bread
- Fruit
- Vegetable
- Milk
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- Meat and protein alternates
- Fats
- High fat and sugar items
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These refer to the Food Guide Pyramid food groups)
Supplement usage:
- Calcium
- Folate
- Vitamin C
- Vitamin E
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- Chromium
- Vitamin B6
- Vitamin D
- Other supplements
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Clinical and Lab Test Reports
The MNT Clinical and Lab Test Reports will list lab and testing results by date with target goal values. Reports are designed around these three major conditions: diabetes, hyperlipidemia, and chronic renal failure. By tracking the results of selected clinical tests you can demonstrate your therapeutic effectiveness and motivate your patient for change. A group report will list all test values entered from each session. This and other group statistical reports can be exported to Excel for convenient data analysis. The MNT clinical testing reports are described below.
Basic MNT Clinical Test Results
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Includes name, ID, date of birth, date of test, body weight, goal weight, percent of goal weight (calculated), waist girth, goal waist girth, BMI (calculated), goal BMI, percent of goal BMI (calculated), systolic and diastolic blood pressure with goal systolic and diastolic blood pressure. |
Basic + MNT Clinical Test Results
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Includes the same information in the basic report plus a lipid panel report including fasting status, date of lab test, total cholesterol, HDL cholesterol, TC/HDL ratio (calculated), LDL cholesterol, triglycerides, with glucose and hemoglobin A1c. |
Basic + + MNT Clinical Test Results
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Includes the same information in the basic report plus a lipid panel plus additional lab values including glucose, hemoglobin A1c, hemoglobin, urine albumin, serum albumin, serum calcium, serum CO2, serum phosphorous, serum potassium, serum creatinine, intact PTH, and GFR. |
SM Basic MNT Clinical Test Results
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Includes the same information in the basic report with some diabetes self management data including glycemic episodes (count), a preprandial and a bedtime glucose. |
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Patient-Tailored Nutrition Recommendations
Studies confirm that tailored education materials are more effective in promoting long-term behavior change. The MNT Nutrition and Dietary Guidelines provide tailored educational tools generated from your assessment results. Along with motivational interviewing or Intrinsic Coaching TM techniques, this is an ideal instrument to steer your MNT sessions. You can also add your own special comments or include your patient’s personal action items.
MNT Nutrition Guidelines
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Includes nutrition recommendations for total calories consumed, total fat intake, monounsaturated fat intake, saturated fat intake, cholesterol intake, protein intake, carbohydrate intake, dietary vitamin B6, dietary calcium, fiber intake, dietary folic acid, dietary iron, phosphorous, potassium, sodium, dietary vitamin E, alcohol, caffeine, water and your special comments. |
MNT Dietary Guidelines
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Includes dietary recommendations in terms of the food groups commonly associated with the Food Guide Pyramid. These include the breads, fruit, vegetables, meat/protein, milk/dairy, added fats, and the high fat and sugary foods. Your special comments will also appear in this report. |
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Behavioral Intervention and Status Reports
Fundamental to successful MNT is documented behavior change. Nationally recognized practice guidelines identify certain behaviors that must be addressed during MNT. The MNT Assistant tracks these behaviors by documenting your discussion of the relevant objectives and your evaluation of the patient’s response. You can evaluate the patient’s adherence, comprehension, and receptivity or readiness to change for each behavior. Overall comprehension, receptivity, and adherence potential may also be recorded.
The MNT Assistant provides you with a set of commonly used interventions and objectives including those found in the ADA evidence based guides for practice. You can also edit or create your own objectives and intervention strategies. This feature will be very useful as new evidence based guides are published.
MNT Behavioral Status Report 1
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Includes patient’s name, date, ID, MNT provider’s name, title of the intervention and a list of the objectives associated with the intervention and corresponding status and adherence ratings. |
MNT Behavioral Status Report 2
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Includes the same information provided in report 1 but replaces adherence with the comments associated with each objective
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HCFA/CMS 1500 Form
After you have completed entering the results of your MNT session you will be ready to preview your Health Insurance Claim information for billing. Yes, the MNT Assistant will automatically compile the claim information you need to complete the Health Insurance Claim Form 1500 – it’s a great time saver. Now, for a limited time only, the MNT Assistant is shipped with a Word document that automatically merges the claims data into a form document. You’ll be able to print a black and white copy of the HCFA/CMS 1500 or print the claims information onto a preprinted government HCFA/CMS 1500 form (minor adjustments may be required to accommodate the printer you are using).
Please note, you are responsible for completing the HCFA/CMS 1500 form accurately. Always double check it for errors. The software is only as accurate as the information you provide.
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Outcomes Studies
The MNT Assistant has an outstanding ability to produce attractive reports and documentation, but the magic starts when you want to evaluate outcomes. Over time you will be able to evaluate the quality and effectiveness of your MNT services. Microsoft Access conveniently sorts and manipulates data. Simple statistical reports can be generated directly from Access. You can export data to other programs for more detailed analysis. This will certainly be a major advantage to demonstrate your effectiveness as more healthcare payers support MNT.
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Updates and Improvements
Medical Nutrition Therapy Northwest is dedicated to high-quality development. New reports and data gathering tools will be developed as new practice guidelines are published. When MNT Assistant users make suggestions that could benefit all users, we will make those available in our MNT Assistant updates. Visit the support forum to gain additional ideas and strategies for providing outstanding Medical Nutrition Therapy.
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Useful Tools
In addition to the MNT Assistant, Dr. Gobble has developed a number of documents and software tools he uses when providing Medical Nutrition Therapy. When you become an MNT Assistant user you receive copies of these tools and the right to modify them for your particular situation. These MNT tools will included a sample Notice of Privacy Practices, authorization for Medicare and Medigap, a diet record worksheet and summary, a diet record and eating plan worksheet, a clinical testing assessment worksheet, MNT Profile questionnaires, Physician referral form with instructions, an MNT service log, a patient notes worksheet, and an Excel workbook with useful calculations for nutrition assessment and diet planning.
To get up and running quickly we have also included a PowerPoint tutorial that walks you through the MNT Assistant and allows you to easily jump from one section to another. It’s a great tool for answering your ‘How to’ questions.
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