Jeopardy

Making a Referral

100

Which of the following is required for CFC eligibility?
A. Physician Statement of Need annually
B. Nursing Facility Level of Care
C. PCM reassessment every 30 days
D. Prior PCS authorization

B. Nursing Facility Level of Care

200

A member with suspected Intellectual and Developmental Disabilities (IDD) requires which referral as part of the CFC eligibility pathway?
A. LMHA
B. MCO Medical Director
C. LIDDA
D. Provider Network

C. LIDDA

300

After identifying possible CFC eligibility, what follow‑up action is required?
A. Close the referral
B. Submit a PCS authorization
C. Complete a Form 2601 request or LIDDA/LMHA referral
D. Wait for audit review

C. Complete a Form 2601 request or LIDDA/LMHA referral

400

Who can identify a potential need for PCS or CFC?
A. Only the Service Coordinator
B. Only the physician
C. Only the Medical Consenter
D. Any involved party (Member, MC, CW, SC, provider, etc.)

D. Any involved party

500

PCS and CFC services may be authorized in which setting(s)?
A. Foster homes
B. Schools
C. Hospitals
D. A&B

D. A&B

Assessment

100

What should never be done prior to completion of the SAI and authorization decision?
A. Educating the caregiver on PCS/CFC
B. Scheduling the assessment
C. Promising a specific number of service hours
D. Completing a referral

C. Promising a specific number of service hours

200

Which factor most directly impacts PCS or CFC hour determination?
A. Caregiver availability
B. Diagnosis alone
C. Functional assessment findings
D. Prior authorization history

C. Functional assessment findings

300

Which entity coordinates services for members receiving CFC through the CDS option?
A. MCO
B. FMSA
C. LIDDA
D. LMHA

B. FMSA

400

Which entity should be contacted when a member has or is suspected of having Severe and Persistent Mental Illness or Severe Emotional Disorder?
A. LIDDA
B. LMHA
C. FMSA
D. CDS Agency

B. LMHA

500

Which SAI section is completed when a member is requesting CFC habilitation services?
A. Medical Necessity section
B. PCS Core section
C. Section M – Habilitation
D. Authorization summary

C. Section M – Habilitation