MMIS SERVICE AGMT - ASA1

The first panel of a waiver service agreement (SA) is the ASA1. The table below is an approved service agreement for the Elderly Waiver program.

The waiver SA queue screens are ASA1, ASA2, ASA3, ADHS, APRV and ARCP.

In this table MMIS fields are populated with sample data to show how MMIS fields appear with valid values entered. Field entries containing Protected Health Information (PHI) appear as zeros in this example.

Table of MMIS SERVICE AGREEMENT - ASA1 panel
NEXT: ASA2                   MMIS SERVICE AGMT - ASA1  
AUTHORIZATION NBR: 0000 000 0 000
AGMT STAT: A APPROVED CURR LOC/DT: 000 MMDDYY
AGMT TYPE: J EW CONVRSN AGMT START/END DT: MMDDYY MMDDYY
PROV NBR/NAME: ASMT DT:
REF PROV NBR: 0000000000 TOT AUTH AMT: 0000.00 CAP AMT: 00000.00
LAST FIRST MI
RECIP NAME: LAST FIRST I RECIP ID: 00000000 SEX: F
DOB(MMDDYYYY): MMDDYYYY AGE: 00 LA: 00 MAJ PROG: MA
CM NBR/NAME: 0000000000 CASE MANAGER
CO OF SVC: 000 CO OF RES: 000 CO OF FIN RESP: 000
COUNTY COUNTY COUNTY
DISC FUND(Y/N): AUTH DATE: AUTH SIG(Y/N): Y
SCH EVAL/TRMT: MSG 1/2/3:
DIAG RANGE 1 FR: DIAG RANGE 1 THRU:
DIAG RANGE 2 FR: DIAG RANGE 2 THRU:
AVG MO AUTH AMT: 000.00 AVG DAILY AUTH AMT:
TOT USED UNITS: 000.000 TOT USED AMT: 0000.00
LI EXC ST USER ID LI EXC ST USER ID LI EXC ST USER ID LI EXC ST USER ID
04 274 F 0000000
274 RECIPIENT IS ELIGIBLE FOR MEDICARE. YOU NEED TO CHECK WHETHER
THESE SERVICES ARE PAID BY MEDICARE.

ENTER---PF1---PF2---PF3---PF4---PF5---PF6---PF7---PF8---PF9---PF10---PF11--PF12
PAGE HELP S/EXT NAVIG SLIST N/EXT PREV NEXT OOPS

The fields on the ASA1 panel

All fields on the SA serve a purpose. The scope of this course does not include defining all fields. However there are a few fields that will be helpful to know when viewing a service agreement.

AGMT STAT field displays the status of the service agreement. A=APPROVED, D=DENIED, S=SUSPENDED, T=PARTIALLY SUSUPENDED, P=PENDED.

AGMT TYPE field displays the code and name of the service agreement type.

AGMT START/END DT fields display the date span for this service agreement.

How to navigate the waiver service agreement

  1. In inquiry mode most MMIS fields are protected and worker is not allowed to enter data. Inquiry is used to view information in MMIS.
    • The NEXT field can be used to navigate to a specific panel by entering the acronym of the panel in the NEXT field.
    • TRANSMIT to advance to the MMIS panel entered in the NEXT field.
  2. In change and add modes some fields are protected and some fields are available for data entry. Some fields will be auto-populated by MMIS based on worker entries.
    • TAB to available field. Any text in green may be updated. TAB will place cursor at available fields for entry. TAB past fields not needing completion.
    • SHIFT-TAB to go back to previous field.
    • Press HOME key to bring cursor to the top of the page.
    • The END key removes entire entry in a field. DELETE key removes entry one character at a time.
    • The ENTER (carriage return) key moves cursor down page one line at a time.
    • The NEXT field can be used to navigate to a specific panel by entering the acronym of the panel in the NEXT field.
    • TRANSMIT to advance to the next MMIS panel.
  3. In all modes function key F4 navigates to another subsystem to view information.
    • Place cursor on a field entry and press function key F4.
    • If F4 navigation function is available MMIS navigates to the subsystem requested.
    • On all panels from Recipient ID field F4 navigates to MMIS RECIP SUMMAR - RSUM panel.
    • From Case Manager and Provider number fields F4 navigates to MMIS PROVIDER SUMMARY - PSUM panel.
    • From Diagnosis code fields F4 navigates to MMIS DIAGNOSIS SCRN - FDI1.
    • From PROC field F4 navigates to MMIS PROCEDURE CODE1 - FPR1.
    • From edit number F4 navigates to MMIS PA/SA EXC RESLT - FPAT.
  4. To return to MMIS location (subsystem and screen) after F4 navigation was requested press F6.
    • F6 exits current screen and returns to previous screen.
    • Press F6 key only once to return to previous screen. MMIS will repeat exit function every time F6 key is pressed.
    • Function key F6 exits service agreement without saving. In change or add mode pressing F6 more than once could result in exiting service agreement without saving and entries will be lost.
  5. To exit and save data entered use function key F3. Use F3 key only when completely finished entering data and are ready to finalize document.

NEXT field on service agreement panels

  1. The NEXT field displays the acronym of the next panel in the waiver SA queue. In this example ASA2 is displayed in the NEXT field.
  2. TRANSMIT to the ASA2 panel
  3. Worker may enter the acronym of another panel in the SA queue and TRANSMIT to that panel.

Now let's look at the remaining panels in the waiver service agreement.

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