Service Unit Validation What is it and how does it work.

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Presentation transcript:

Service Unit Validation What is it and how does it work

Unit Validation is a process that confirms (Validates) if a Consumer is eligible to receive services based upon their assessment results and Care/Service Plan.

Service eligibility is determined by the Nutritional, ADL, and IADL screening scores, along with any additional needs or conditions as identified in the Consumer notes. Currently this is being done by the Regional Office assigned to perform your data entry.

Once the needed services have been identified a Care Plan is set up in the Consumer Record in SAMS.

Once a Care Plan is set up then a Service Plan is established.

Within the Service Plan the service received is identified.

The organization providing the service

The date the service began

The date the services are to end

The end date is set to coincide with the date of the next Assessment

The Status Date, which is the date of the last assessment

And a Service Schedule

The Service Schedule identifies number of units to be received each month and the subservice if applicable.

In order for services to be considered “Valid” they must have a Care Plan and the services must have been delivered prior to the End Date of the Service Plan.

In the process of entering Units of Service into a Roster in SAMS you may get an error message,

This means that a consumers Service Plan has expired or the consumer does not have a Service Plan set up for that service. Units of Service entered for the Consumer were not saved to the consumers service delivery record.

When this occurs, single left click “OK”

The Message will disappear and you will see the Consumer(s) that did not pass validation highlighted in Red.

Once you have identified the Consumer(s) in question provide the Regional Office assigned to enter your data a list of the Consumer(s) who did not pass Validation, along with their ID number.

If the Consumer has been recently reassessed you will be asked to either provide the date the reassessment was sent to the office or to resubmit the reassessment. At that point a Consumer Coordinator will extend the Service Plan End Date appropriately.

If the Consumer has not been reassessed you will be requested to provide a current reassessment.

A Consumer Coordinator will extend the Service Plan End Date to allow for Units of Service to be entered for the Month that Validation failed. However, you will not be able to enter Units of service to that Consumer beyond that period until a current reassessment has been received by your Regional Office.

Once the Service Plan End Date has been extended you can then go back in the Roster Delete and re-enter Units of Service for the Consumer(s) in question.

Currently only In-Home Services are being Validated. It is the goal of the AAA to Validate all Contracted Services in the future. We will update Validation Training at that time to show added benefits to this process.