Members
Who can speak on mbr's behalf?
Legal guardian, parent
Agencies can submit a change of provider WITHOUT mbr consent (yes/no)
No
What type of auth do you submit when this is the first time mbr is being assessed for services?
Initial Auth
Can mbrs refuse the interRAI assessment? (yes/no)
Yes
Where do you go to verify mbr's eligibilty?
NC Tracks
What 2 documents are needed to submit a COP?
DHB 3051 and PCS Auth request form
What type of auth do you submit when you have exhausted all mbr attempts?
UTR auth
Which population does not require a TNT to be completed?
Children
How after do mbrs need reassessment?
Every 6 mos
or When there is change of condition
Name 2 people/entities that can submit a COP?
Mbr, Legal Guardian, facility mbr has transitioned to
What type of auth do you submit when mbr is currently receiving services and does not want to change providers?
Continuation Auth
What letter section is the functionally part of the assessment?
Section "G"
Mbrs must be enrolled in TCM in order to receive PCS services (true/false)
False
On the auth form, what "Purpose of Request" does this fall under?
What modifier would you use for a mbr that is an adult living in the community receiving services?
HB
What must be completed same day of F2F assessment?
Mbr visit note.
Mbrs can receive both ACT and PCS services? (true/false)
True, just not at the same time.
What are 3 points of data you need to collect when outreaching the new accepting agency?
Start date of service, NPI, TIN, phone number, fax number
What modifier would you use for a mbr that is under the age of 21 living in the community receiving services?
HA
What is the timeline for F2F assessment for new referrals?
14days