CCC+
Services must begin within how many days of authorization?
30 days
To qualify for EPSDT, the client must be under or over 21 years of age?
Under 21 years of age
What form is used for admin-caused errors resulting in decreases, denials, lapses, voids, etc?
Admin Appeal Letterhead
What does LRI stand for?
Legally Responsible Individuals (LRIs)
If an authorization is pended, where will you find this information in WAMS?
The notes section of that SA line
What documents are required for an intake?
UAI, DMAS-96, & DMAS-97
18 years or older
How often should you enter your daily time into APS if you're a non-salary employee?
Daily
LRIs on all waivers need what document?
LRI Fillable 97 (This does not apply to EPSDT clients, as EPSDT is not a waiver)
When processing a discharge, what document do you print and re-upload to the profile page?
DMAS Services 225
For an increase request, what document must be updated to match the new schedule?
The most recent DMAS-99
What form is required to be completed annually by the PCP?
DMAS-7 Form
When a client issue is presented to you during a DB call how many hours do you need to follow-up within?
Address all assigned follow-ups within 24 hours
Where can you find the extraordinary care guide?
Guru
Applicants approved for CL/FIS must accept services within how many days?
30 days
Reauths are ready for submission starting at how many days out?
-45 days before authorization end date
The DMAS-7 requires how many ADLs marked as needing assistance to qualify?
3 ADLs
What must admin follow when dealing with email escalations (Ex: Communication between Admin & SF/CM.)
Chain Of Command
True or False: A member may have two plans of care when there is a paid LRI and another attendant/aide.
True
In order for an applicant to be eligible for CL/FIS, the client must have a developmental or intellectual disability that originated before what age?
Age 22
For MCO changes, when would a FARF be required?
A FARF is only required if: The client is changing FA or the EOR is changing
What is required for PCA services under EPSDT?
The DMAS-7 & DMAS-99 forms are required
What should NEVER be in the subject line even when secure emailing?
Client names
No, Respite is not available when there is a paid LRI, as respite is for the relief of the unpaid primary care giver.
For one ISP year how many reviews/reports will there be?
Four