Sinclair’s Review Questions

<%@LANGUAGE="JAVASCRIPT" CODEPAGE="65001"%> Sinclair’s Review Questions

Training Caseload - Page 7a

Sinclair’s Review Questions

Answer the following questions based on reviewing Sinclair’s request for MA-LTC.

1. Has Sinclair completed the appropriate MA-LTC request form?

Yes, Sinclair has completed the appropriate MA-LTC form. Because he is requesting both MA and MA payment of LTC services, the DHS-3531 is the most appropriate form for him to use.

2. What is the date of Sinclair’s request for MA-LTC?

Sinclair requested MA-LTC on the 1st of this month (CM/01/YY) based on the “Date Received” field of the DHS-3531.

3. Has Sinclair requested retroactive coverage?

Yes, based on the DHS-3531, Sinclair is requesting retroactive coverage for last month.

4. What waiver program has Sinclair been approved for?

The CADI waiver.

5. On what date was Sinclair screened?

The first of this month (CM/01/CY).

6. When does Zach anticipate Sinclair’s services to begin?

The first of this month (CM/01/CY).

7. What other information has Zach provided?

The cost of Sinclair’s CADI services will be $1,500 each month.

8. On what date was the DHS-5181 sent?

The first of this month (CM/01/CY). You must return a copy of this form to Zach with the 2nd page completed with information about why eligibility is pending if Sinclair’s eligibility has not been approved by the 10th of this month.

9. What is the begin date of Sinclair’s MA-LTC?

The begin date will be the first of this month (CM/01/CY), as this is anticipated begin date indicated on the DHS-5181, and there is a request for MA-LTC for this month. You will determine basic MA eligibility for Sinclair for the retro month.

10. Did Sinclair meet the institutional level of care requirement?

Yes, based on Sinclair’s DHS-5181, Sinclair meets the case management requirements for CADI services, and an institutional level of care is a component of those case management requirements.

To Do: Update the corresponding fields found in the first section of page one of Sinclair’s DHS-5590, found at the back of his case packet, based on the answers you just provided.

Updated October 22, 2012.
Copyright © 2011 Health Care Eligibility and Access (HCEA).