Know the Benefit
True or False: Housing-Related Deposit (H0044) can be paid directly to the Member.
False.
H0044 requires an approved payee, and payment must not be directed to the Member.
What document tells Review that the provider is requesting Housing-Related Deposit?
The PAR Request Form.
The PAR is the source document that initiates the service request.
Can H0044 be issued directly to the Member?
No.
Payment must be directed to the approved payee, not the Member.
Where is the official record of H0044 review activity maintained?
TruCare.
TruCare is the system of record for HSS authorization activity.
The security deposit amount is missing from the file. What is the next step?
Issue an RFI.
Missing information needed to support a determination requires an RFI when the information could affect the outcome.
Can an H0044 request be approved if there is no active concurrent HTS authorization?
No.
H0044 requires active concurrent HTS unless current guidance specifically allows otherwise. This is a dependency requirement that must be validated before approval.
What document demonstrates a verified housing opportunity?
A. Housing Crisis Plan
B. Lease or Rental Agreement
C. Member Alert
D. Claims Information
B. Lease or Rental Agreement.
Review must verify that an actual housing opportunity exists before approving H0044.
A request includes a landlord deposit and utility deposit. How should they appear in Review?
As separate itemized costs supported by documentation.
H0044 amounts must be itemized and supported before approval.
What HSS service dependency must generally exist before approving H0044?
Active concurrent Housing Transition Supports (HTS).
Dependency requirements must be validated before approval.
The lease is present but unsigned and does not show landlord commitment. Ready, RFI, or Stop?
RFI.
Review cannot verify the housing opportunity without sufficient supporting documentation.
True or False: Approval of H0044 automatically means the Member has used the benefit.
False.
Approval, payment support, and utilization are separate events. Utilization must be verified and documented separately.
Which document helps support affordability and sustainability of the proposed housing?
Housing Budget.
Reviewers should assess whether the housing is financially sustainable and supported by the documentation.
The PAR requests $1,400, but the landlord documentation supports only $1,200. Can $1,400 be approved?
No.
The PAR, authorization shell, and supporting documentation must reconcile before approval.
Before approving H0044, what must be reviewed to determine whether the Member previously used the benefit?
Prior utilization history and Member Alerts.
Deposit history must be reviewed and reconciled before approval.
A Review RFI remains active. Can a final approval or denial be entered?
No.
Determinations cannot be entered while an applicable RFI remains active.
What HCPCS code is used for Housing-Related Deposit?
H0044.
Each HSS service has its own authorization and HCPCS code. H0044 is used for Housing-Related Deposit.
What must utility documentation identify when utility deposits are requested?
The utility provider and the requested deposit amount.
All requested amounts must be itemized and supported.
The lease identifies one landlord, but the requested payee is a completely different company with no supporting explanation. Is the request ready for approval?
A. Yes
B. No, stop and investigate
C. Approve and document later
D. Ignore because the amount matches
B. No, stop and investigate.
Payee information must be supported and reconciled before approval. Unsupported payment direction is a hard stop.
True or False: The initial deposit screening alert replaces final utilization review.
False.
Deposit screening, approval tracking, and utilization verification are separate activities.
The provider responds to the RFI but one requested item remains missing. Is the review complete?
No.
Partial responses do not satisfy an RFI. Decision Logic must be reapplied once the response is evaluated.
A provider requests HTS and H0044 on the same PAR. What should Intake do?
A. Build one authorization with both services
B. Build separate authorizations for each service
C. Deny the request
D. Escalate immediately
B. Build separate authorizations for each service.
The SOP requires one HSS service per authorization unless approved workflow directs otherwise.
Can Review rely on a document that was uploaded but never linked to the authorization?
No.
Uploaded but unlinked documents are treated as not reviewed and cannot support an authorization decision.
May a reviewer estimate a missing deposit amount and enter it into the authorization shell?
No.
Staff must never force fields or create unsupported values. Missing amounts require correction, RFI, or escalation.
The requested amount exceeds the applicable FMR benchmark. What should Review do?
A. Automatically deny
B. Automatically approve
C. Complete cost reasonableness review and determine next steps
D. Ignore FMR
C. Complete cost reasonableness review and determine next steps.
FMR is a benchmark. Exceeding FMR alone does not require denial.
Final review confirms prior HRD utilization and no exception applies. What pathway is generally supported?
A. Approval
B. Review RFI
C. Administrative Denial
D. Claims Information
C. Administrative Denial.
If prior H0044 utilization is confirmed and no exception applies, approval is not supported.