Service authorization

Most authorizations for services must be entered into MMIS before claims for services provided may be paid. Timely entry of service authorizations allows providers to feel reasonably confident that the services they provide will be reimbursed and prevents pended/denied claims and repeated billings.

If there are costs that will not be covered by Medical Assistance or other funding sources, case managers must make persons aware of the costs they may be responsible for.

County case managers must notify persons of all actions that affect their requested or planned Medical Assistance services and their appeals rights in a timely manner, at least 10 calendar days prior to the effective date of the action.

The Notice of Action Home and Community Based Waiver Services (DHS-2828) is used to identify the action (program and services), effective date of the action and notify persons of their appeal rights.

 

 

 

 

 

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