1. Adult Autism Waiver Service Utilization
Understanding the Utilization Review Process
Amber Bennett

2. Background The Adult Autism Waiver went into effect on July 1, 2008.
Assumptions were made about service utilization for funding purposes based on other waivers serving adults with developmental disabilities.

3. Background
Since then, we have all learned much about serving adults with autism
We have gained experience making educated estimates of which services and how much of each would be needed and used by specific participants.

4. Now our ISPs must reflect what we’ve learned…
Purpose
Now our ISPs must reflect what we’ve learned…

5. Why is this so important?
In the example below, over $14,000 was set aside for Supported Employment services that were never used. That didn’t benefit this participant but it did have a negative impact…
Service Name
Provider Name
Start Date
End Date
Units Billed
Units Remaining
Billed $
Remaining $
% Remaining
Supported Employment
JKL SE Agency
07/01/2011
06/30/2012 50
850
$547.50
$9,307.50
94.44%
Supported Employment
JKL SE Agency
07/01/2012
06/30/2013
500
$0.00
$5,475.00
100%

6. Why is this so important?
When the cost of services (the amount paid) is overstated, BAS has to manage the waiver to that higher amount. When the program spends a lot less than planned, that effects the AAW budget allocation in the following year, which is based on the amount actually spent.

7. Why is this so important?
It also means that we’re leaving “money on the table” that could have gone towards bringing more participants into the waiver.

8. Why is this so important?
If ISPs reflect the actual usage of services, then instead of funds being reserved for services which are never used, they can be used to serve more participants and the capacity of the waiver might even expand without having to increase the overall cost of the program.

9. Why is this so important?
If participants are not using the services in the amount on their ISP, that indicates that either the services are not being delivered, or the ISP does not reflect the needs and goals of the participant. In either case, it means that the ISPs of those participants are flawed and must be addressed.

10. Why is this so important?
To give you an example of just how substantial this problem is:
Fiscal Year
Total number of units authorized on participant plans: 1,097,014
Total number of units utilized: 686,904
The utilization rate for the FY11-12 = 62.62% (686,904 ÷ 1,097,014 = )
The dollar amount associated with this utilization amount (funds held by unused service units) = $4,711,706.06

11. How can we correct this?
This is going to require a change in the way of thinking for all involved:
BAS Representatives
SCs & SC Supervisors
Participants
Participant Representatives

12. How can we correct this?
The Bureau of Autism Services sends out an Annual Review Packet to SCs 90 days prior to an ISP renewal deadline.
The packet includes:
SIB-R Response Booklet
Service Provider Choice Form
Quality of Life Questionnaire
ISP Team Attendance Sheet
Parental Stress Scale
Participant/Representative Sign off sheet
MA-51 form
MA-51 Instructions
Participant File Documents Chart
SC Documents Chart
Service Utilization Packet

13. Service Utilization Packet
The Service Utilization Packet consists of:
A letter addressed to the SC explaining the process for reviewing and evaluating service utilization,
Suggestions of how to explain the process to participants and their representatives,
An explanation of the HCSIS Expense Summary, and
HCSIS Expense Summary for the participant who has the upcoming Annual Review

14. Service Utilization Process
You, as the SC, are responsible for reviewing the service utilization information with the ISP Team.
Discuss with the team how much of each service was actually used in the current Plan year and what is expected to be used next Plan year. Has anything happened that would change the amount used in the coming ISP year?

15. Justification The following are possible justifications for a higher amount of service units:
Change in participant or family circumstances
Past service delivery issues
Provider billing does not accurately reflect utilized units
Other circumstances that suggest a higher level of utilization in the coming ISP year

16. Examples of Justification
Change in participant/family circumstances
Living situation has changed
Change in the family dynamic (i.e. death in family, illness or absence of family member or participant, new job or loss of job)
Participant wants to work towards new goals and/or objectives

17. Examples of Justification
2. Past service delivery issues
Services not delivered as prescribed in the ISP (this could be due to staff availability or turnover or participant resistance to receiving services) are now being delivered
Services did not begin in a timely manner but have now started and will continue

18. Examples of Justification
3. Provider billing does not accurately reflect utilized units
Provider is not billing timely
Billing claim filing errors- claims are being rejected and not reflected on Expense Summary reports

19. How can we correct this?
If the ISP Team determines that an amount of service units 25% greater than the amount used during the current ISP year is needed, you must justify that decision to BAS and give the reasons for coming to that conclusion.
Service Name
Provider Name
Start Date
End Date
Units Billed
Units Remaining
Billed $
Remaining $
% Remaining
Supported Employment
JKL SE Agency
07/01/2011
06/30/2012 50
850
$547.50
$9,307.50
94.44%
Supported Employment
JKL SE Agency
07/01/2012
06/30/2013
500
$0.00
$5,475.00
100%

20. How can we correct this?
In this example, 50 units of Supported Employment were billed between July 2011 and June 2012 and 850 units remain. If the Team chooses to include more than 63 units ( %) of Supported Employment in the new ISP starting July 2012 through June 2013, then the team must justify the reason for expecting that amount will be used.”
For example, if the previous ISP included Supported Employment but the participant did not start in a job until late in the plan year, and that job is continuing in the new plan year, this justifies a greater amount of that service than was utilized (used) during the previous plan year.

21. How can we correct this?
Keep in mind that all justifications are required to be entered into a Service Note within HCSIS.
BAS will review the justification and will contact the SC if they don’t agree.
The SC must also document the final decision in a Service Note in HCSIS.

22. How can we correct this? An important fact to share with the ISP Team:
If the amount of any service on the plan turns out to be insufficient, the SC can submit a Critical Revision to increase the amount of that service.
BAS can review and approve a Critical Revision within a few days if notified that it has been submitted.

23. How can we correct this?
BAS is confident that through this utilization review process, participants will get the services they need and the AAW will be managed in a more efficient manner.
It is the SC’s responsibility to ensure that the ISPs meet the needs of the participant and that services are rendered as written.
Please contact the Regional Office Program Representative for assistance if needed.

24. Suggestions to help explain this process to the ISP Team
The purpose is NOT to reduce the level of services being used by any participant. The purpose IS to have ISPs reflect what participants are using and intend to use for the next plan year.

25. Suggestions to help explain this process to the ISP Team
When a participant is new to the AAW, the SC and ISP Team make their best guess estimate of how much of which services the participant will need and use. Once there is some experience with the AAW, the team should better know how much service the participant will actually use.

26. Suggestions to help explain this process to the ISP Team
THERE IS NO ADVANTAGE for the participant in “overloading” the ISP with services at a level that will never be used.
When an ISP overstates the amount of services, it overstates the cost of services to those participants which delays expanding the waiver to support more people.

27. Suggestions to help explain this process to the ISP Team
Proper and efficient management of the AAW requires that each ISP reflect the true needs of participants. When a participant has a significant amount of unused services, that suggests that something is wrong, and BAS will look into that to address the issue. If a significant amount of services are not used, that may suggest that they are not needed, and the ISP needs to be revised to reflect the true need.

28. Suggestions to help explain this process to the ISP Team
Appeal Process
If the ISP team and BAS cannot agree on an amount of service, a notice will be sent to the participant and a copy to the SC stating that BAS is reducing the service.
This letter will also include instructions on how to file an appeal.
The appeal isn’t “filed with BAS”, it is filed against BAS and with BHA but the paperwork goes through BAS.

29. Suggestions to help explain this process to the ISP Team
BAS is to work with the SC and the SC is to work with the ISP team
At any time, if the participant or representative continues to have concerns, the SC should contact the Regional Program Representative for assistance. They can discuss the specific case with you and offer more detailed information.
If the participant or representative wishes to contact BAS directly, they may call toll-free (866)

30. HCSIS Expense Summary
Now we are going to review how to read the HCSIS Expense Summary Report

31. HCSIS Expense Summary A B C D E F G H I Current Individual
Name: Donald Duck
SSN: xxx-xxx
MCI#:
Residential County: Disney
Info A B C D E F G H I
Service Name
Provider Name
Start Date
End Date
Units Billed
Units Remaining
Billed $
Remaining $
% Remaining
Supports Coordination – Ongoing
ABC SC Agency
07/01/2011
10/15/2011 38 33
$647.90
$562.65
46.00%
Community Inclusion
GHI CI Agency
08/06/2011
424
316
$3,816.00
$2,844.00
43.00%
XYZ CI Agency
06/04/2012
06/30/2012
309
$2,781.00
$0.00
0.00%
LMN CI Agency
10/16/2011
06/03/2012
2228
423
$20,052.00
$3,807.00
16.00%
130 43
$2,216.50
$733.15
25.00%
08/07/2011
658
742
$5,922.00
$6,678.00
53.00%
Supported Employment
JKL SE Agency
900
$9,855.00
100%
A – This is the name of the service covered by the Adult Autism Waiver.
B – This is the name of the provider chosen to provide the waiver service.
C – Service start date, this is the plan start date, the start of the fiscal year or when a service provider is changed.
D – Service end date, is the end of the fiscal year or plan year or when a service provider is changed.
E – Units Billed are the units the service provider has successfully billed for. (Providers have 180 days after the date of service to bill.)
F – The units estimated for the plan year not yet billed for. (This may reflect provider billing issues or a lack of the participant using the service or a combination of both.)
G – The funds associated with column E.
H – The funds associated with column F.
I – The percentage of units remaining compared to the total units for the service line . (Based on the time this document is printed BAS is expecting that if a service in this column has a percentage remaining higher than 50%, the total service units on the plan would be decreased for the next plan year.)

32. HCSIS Expense Summary 1 2 3 4 5 6 7 Current Individual
Name: Donald Duck
SSN: xxx-xxx
MCI#:
Residential County: Disney
Info
Service Name
Provider Name
Start Date
End Date
Units Billed
Units Remaining
Billed $
Remaining $
% Remaining
Supports Coordination – Ongoing
ABC SC Agency
07/01/2011
10/15/2011 38 33
$647.90
$562.65
46.00%
Community Inclusion
GHI CI Agency
08/06/2011
424
316
$3,816.00
$2,844.00
43.00%
XYZ CI Agency
06/04/2012
06/30/2012
309
$2,781.00
$0.00
0.00%
LMN CI Agency
10/16/2011
06/03/2012
2228
423
$20,052.00
$3,807.00
16.00%
130 43
$2,216.50
$733.15
25.00%
08/07/2011
658
742
$5,922.00
$6,678.00
53.00%
Supported Employment
JKL SE Agency
900
$9,855.00
100% 1 2 3
HCSIS Expense Summary Report is not easy to read when it comes to services… they are scattered through the table…
Due to the plans crossing fiscal years you will receive two of these screen shots for each participant, you will only work with the services that fall within the current plan year. 4 5 6 7

33. FY 2011-12 HCSIS Expense Summary 1 2 3 4 5 6 7 Current Individual
Name: Donald Duck
SSN: xxx-xxx
MCI#:
Residential County: Disney
Info
Service Name
Provider Name
Start Date
End Date
Units Billed
Units Remaining
Billed $
Remaining $
% Remaining FY
Supports Coordination – Ongoing
ABC SC Agency
07/01/2011
10/15/2011 38 33
$647.90
$562.65
46.00%
Community Inclusion
GHI CI Agency
08/06/2011
424
316
$3,816.00
$2,844.00
43.00%
XYZ CI Agency
06/04/2012
06/30/2012
309
$2,781.00
$0.00
0.00%
LMN CI Agency
10/16/2011
06/03/2012
2228
423
$20,052.00
$3,807.00
16.00%
130 43
$2,216.50
$733.15
25.00%
08/07/2011
658
742
$5,922.00
$6,678.00
53.00%
Supported Employment
JKL SE Agency
900
$9,855.00
100% 1 2 3 4 5 6 7

34. HCSIS Expense Summary Example: Today’s date: August 2012
This Annual Review is for ISP: 10/16/12 to 10/15/13
Estimate the future units based on current ISP year: 10/16/11 to 10/15/12
The current plan year crosses two fiscal years: July 2011 to June 2012 and July 2012 to June 2013.
In this example, the ISP runs
from 10/16/11 to 6/30/12 (FY 11-12) and from 7/1/12 to 10/15/12 (FY 12-13)

35. HCSIS Expense Summary 1 2 3 4 5 6 7 Current Individual
Name: Donald Duck
SSN: xxx-xxx
MCI#:
Residential County: Disney
Info
Service Name
Provider Name
Start Date
End Date
Units Billed
Units Remaining
Billed $
Remaining $
% Remaining
Supports Coordination – Ongoing
ABC SC Agency
07/01/2011
10/15/2011 38 33
$647.90
$562.65
46.00%
Community Inclusion
GHI CI Agency
08/06/2011
424
316
$3,816.00
$2,844.00
43.00%
XYZ CI Agency
06/04/2012
06/30/2012
309
$2,781.00
$0.00
0.00%
LMN CI Agency
10/16/2011
06/03/2012
2228
423
$20,052.00
$3,807.00
16.00%
130 43
$2,216.50
$733.15
25.00%
08/07/2011
658
742
$5,922.00
$6,678.00
53.00%
Supported Employment
JKL SE Agency
900
$9,855.00
100% 1 2 3
On the Screen Shot for FY there are two lines of SC services
Lines 1 and 5
Line 1 does not apply since it was for a older plan year
So line 5 – is during the current plan year 10/16/2011 to 06/30/12 where 130 units were billed and 43 units were left remaining. 4 5 6 7

36. FY 2012-13 HCSIS Expense Summary 1 2 3 4 5 6 7 Current Individual
Name: Donald Duck
SSN: xxx-xxx
MCI#:
Residential County: Disney
Info
Service Name
Provider Name
Start Date
End Date
Units Billed
Units Remaining
Billed $
Remaining $
% Remaining FY
Supports Coordination – Ongoing
ABC SC Agency
07/01/2012
10/15/2012 53 35
$647.90
$562.65
46.00%
Community Inclusion
GHI CI Agency
07/01/2011
08/06/2011
424
316
$3,816.00
$2,844.00
43.00%
XYZ CI Agency
06/04/2012
06/30/2012
309
$2,781.00
$0.00
0.00%
LMN CI Agency
10/16/2011
06/03/2012
2228
423
$20,052.00
$3,807.00
16.00%
142 34
$2,216.50
$733.15
25.00%
08/07/2011
10/15/2011
658
742
$5,922.00
$6,678.00
53.00%
Supported Employment
JKL SE Agency
900
$9,855.00
100% 1 2 3 4 5 6 7

37. HCSIS Expense Summary 1 2 3 4 5 6 7 Current Individual
Name: Donald Duck
SSN: xxx-xxx
MCI#:
Residential County: Disney
Info
Service Name
Provider Name
Start Date
End Date
Units Billed
Units Remaining
Billed $
Remaining $
% Remaining
Supports Coordination – Ongoing
ABC SC Agency
07/01/2012
10/15/2012 53 35
$647.90
$562.65
46.00%
Community Inclusion
GHI CI Agency
07/01/2011
08/06/2011
424
316
$3,816.00
$2,844.00
43.00%
XYZ CI Agency
06/04/2012
06/30/2012
309
$2,781.00
$0.00
0.00%
LMN CI Agency
10/16/2011
06/03/2012
2228
423
$20,052.00
$3,807.00
16.00%
142 34
$2,216.50
$733.15
25.00%
08/07/2011
10/15/2011
658
742
$5,922.00
$6,678.00
53.00%
Supported Employment
JKL SE Agency
900
$9,855.00
100% 1 2 3
The Screen Shot for fiscal year shows services from the beginning of the FY to the end of the plan year.
Line 1 – shows the SC information we need.
Here we see that between 07/01/2012 and 10/15/ units were billed and 35 are remaining. 4 5 6 7

38. Here is how to do the math:
Looking at FY screen shot
Looking at FY screen shot
10/16/2011 to 06/30/12
where 130 units were billed and 43 units were left remaining.
07/01/2012 to 10/15/2012
53 units were billed and 35 are remaining
= 183
For the plan year running 10/16/ /15/2013
if the number of units requested is under 183, no justification is required
If the number of units is between 183 and 229 (183+25%), no justification is required
If the number of units is over 229 justification IS required
Read slide
Now that was easy right? Now lets look at a service where the participant changes providers within the plan year!

39. FY 2011-12 HCSIS Expense Summary 1 2 3 4 5 6 7 Current Individual
Name: Donald Duck
SSN: xxx-xxx
MCI#:
Residential County: Disney
Info
Service Name
Provider Name
Start Date
End Date
Units Billed
Units Remaining
Billed $
Remaining $
% Remaining FY
Supports Coordination – Ongoing
ABC SC Agency
07/01/2011
10/15/2011 38 33
$647.90
$562.65
46.00%
Community Inclusion
GHI CI Agency
07/01/2012
08/06/2012
424
316
$3,816.00
$2,844.00
43.00%
XYZ CI Agency
06/04/2012
06/30/2012
309
$2,781.00
$0.00
0.00%
LMN CI Agency
10/16/2011
06/03/2012
2228
423
$20,052.00
$3,807.00
16.00%
130 43
$2,216.50
$733.15
25.00%
658
742
$5,922.00
$6,678.00
53.00%
Supported Employment
JKL SE Agency
900
$9,855.00
100% 1 2 3 4 5 6 7

40. HCSIS Expense Summary 1 2 3 4 5 6 7 Current Individual
Name: Donald Duck
SSN: xxx-xxx
MCI#:
Residential County: Disney
Info
Service Name
Provider Name
Start Date
End Date
Units Billed
Units Remaining
Billed $
Remaining $
% Remaining
Supports Coordination – Ongoing
ABC SC Agency
07/01/2011
10/15/2011 38 33
$647.90
$562.65
46.00%
Community Inclusion
GHI CI Agency
08/06/2011
424
316
$3,816.00
$2,844.00
43.00%
XYZ CI Agency
06/04/2012
06/30/2012
309
$2,781.00
$0.00
0.00%
LMN CI Agency
10/16/2011
06/03/2012
2228
423
$20,052.00
$3,807.00
16.00%
130 43
$2,216.50
$733.15
25.00%
658
742
$5,922.00
$6,678.00
53.00%
Supported Employment
JKL SE Agency
900
$9,855.00
100% 1 2 3
To read the Community Inclusion service:
For the CI service we are going to look at line 3 and 4… line 6 is from an older plan year.
So for services that started the plan year with (line 4) LMN CI Agency, the participant used 2,228 units and had 423 left.
On June 4, 2012 until the end of the FY the participant switched to XYZ CI Agency and used 309 units with none left unbilled. 4 5 6 7

41. FY 2012-13 HCSIS Expense Summary 1 2 3 4 5 6 7 Current Individual
Name: Donald Duck
SSN: xxx-xxx
MCI#:
Residential County: Disney
Info
Service Name
Provider Name
Start Date
End Date
Units Billed
Units Remaining
Billed $
Remaining $
% Remaining FY
Supports Coordination – Ongoing
ABC SC Agency
07/01/2011
10/15/2011 38 33
$647.90
$562.65
46.00%
Community Inclusion
GHI CI Agency
07/01/2012
08/06/2012
424
316
$3,816.00
$2,844.00
43.00%
XYZ CI Agency
06/04/2012
06/30/2012
309
$2,781.00
$0.00
0.00%
LMN CI Agency
10/16/2011
06/03/2012
2228
423
$20,052.00
$3,807.00
16.00%
130 43
$2,216.50
$733.15
25.00%
658
742
$5,922.00
$6,678.00
53.00%
Supported Employment
JKL SE Agency
900
$9,855.00
100% 1 2 3 4 5 6 7

42. HCSIS Expense Summary 1 2 3 4 5 6 7 Current Individual
Name: Donald Duck
SSN: xxx-xxx
MCI#:
Residential County: Disney
Info
Service Name
Provider Name
Start Date
End Date
Units Billed
Units Remaining
Billed $
Remaining $
% Remaining
Supports Coordination – Ongoing
ABC SC Agency
07/01/2011
10/15/2011 38 33
$647.90
$562.65
46.00%
Community Inclusion
GHI CI Agency
07/01/2012
10/15/2012
424
316
$3,816.00
$2,844.00
43.00%
XYZ CI Agency
06/04/2012
06/30/2012
309
$2,781.00
$0.00
0.00%
LMN CI Agency
10/16/2011
06/03/2012
2228
423
$20,052.00
$3,807.00
16.00%
130 43
$2,216.50
$733.15
25.00%
658
742
$5,922.00
$6,678.00
53.00%
Supported Employment
JKL SE Agency
900
$9,855.00
100% 1 2 3
Now looking at the FY screen shot for the participant switched to a third CI provider to finish out the plan year.
This service line shows GHI CI Agency used 424 units leaving 316 unused. 4 5 6 7

43. Here is how to do the math:
Looking at FY screen shot
Looking at FY screen shot
LMN CI Agency: the participant used 2,228 units
XYZ CI Agency: used 309 units
GHI CI Agency: used 424 units
2, = 2,961
For the plan year from 10/16/2012 to 10/15/2013:
if the number of units requested is less than 2,961, no justification is required
If the number of units requested is between 2,961 and 3,701 (2,961+25%), no justification is required
If the number of units requested is over 3,701, justification IS required
Read slide
Anyone need me to show this again?

44. Justifications Some reasons why services may not be fully used:
Services have not been rendered as written
Response: SC should work on resolving this with the participant, the ISP Team or the provider
Services were rendered but not billed
Response: Notify BAS if you suspect this is the case; BAS will work with the provider on resolving
The participant doesn’t want the service or the amount but others on the team insist on including it
Response: The SC should work on resolving this with the ISP Team or provider, in a manner consistent with person-centered planning. The SC may also contact BAS for assistance.

45. HCSIS Expense Summary 1 2 3 4 5 6 7 Current Individual
Name: Donald Duck
SSN: xxx-xxx
MCI#:
Residential County: Disney
Info
Service Name
Provider Name
Start Date
End Date
Units Billed
Units Remaining
Billed $
Remaining $
% Remaining
Supports Coordination – Ongoing
ABC SC Agency
07/01/2011
10/15/2011 38 33
$647.90
$562.65
46.00%
Community Inclusion
GHI CI Agency
08/06/2011
424
316
$3,816.00
$2,844.00
43.00%
XYZ CI Agency
06/04/2012
06/30/2012
309
$2,781.00
$0.00
0.00%
LMN CI Agency
10/16/2011
06/03/2012
2228
423
$20,052.00
$3,807.00
16.00%
130 43
$2,216.50
$733.15
25.00%
08/07/2011
658
742
$5,922.00
$6,678.00
53.00%
Supported Employment
JKL SE Agency
900
$9,855.00
100% 1 2 3
Supported Employment service
This service was never used through the year as the participant didn’t have a job.
BAS’ recommendation for this type of situation.
A. wait until the participant has a job and add the service through a critical revision OR
B. only put a week’s worth of service units on the plan for when the job starts and then submit a Critical Revision to increase the service units to what the participant actually needs 4 5 6 7

46. HCSIS Expense Summary
Using Recommendation “A” (Don’t add service until participant has a job):
the service start date would be the date the service actually starts…
i.e. 10/23/2012 and an end date of 07/13/2013 with an estimated 16 units per visit 3 days a week (totaling 1810 units)
So compared to the previous screen where 900 units are on hold totaling $9, for a service that will never be billed against this participant now has a job, the number of authorized units for Supported Employment on the Plan are greater then what was on hold, but they will be used and will actually be billed against.
Sam works at PetSmart three days a week helping with inventory.

47. HCSIS Expense Summary
If you were to go with Recommendation “B” (Put a small number of units on the plan before a job is found):
You would be able to enter the service start date as the beginning of the plan year and the end date as the end of the plan year. You (the SC) would enter the units manually since you are only entering in enough for 1 weeks of service.
The duration is 12 units per visit and frequency is 5 times per week and enter 60 total units manually instead of the system doing the calculating.
In the notes section you would add the reasoning that the units are set up to equal one week’s worth of service units since this is a service you are working on but has yet to actually start.
Service units only total one week since Alex does not currently have a job. This will be updated once a job is found.

48. Tools that will help In this training, BAS has:
Provided you with background information on why there needs to be a change in the way we think about waiver services.
Provided you with ways to explain the need to the ISP team.
Provided you with examples of justification for a service request beyond a 25% increase from the utilized amount from the current plan year

49. Tools that will help In this training, BAS has: And now:
Explained how to use and read the HCSIS Expense Summary Report.
Provided examples of common service requests and how BAS would like to see them handled for ISP approval
And now:
We will cover the Service Utilization Calculator for SCs

50. Service Utilization Calculator
Where to find it:
This went out as a Provider Need to Know on 04/19/2013
It is posted to the VTC:
Log in to the VTC
Scroll down to the Supports Coordinator Section
(2nd topic down) Service Utilization Calculator for SCs

51. Service Utilization Calculator
How to use it:
This can be opened each time you need it, or you can save it to your computer and access it off your desktop!

52. Questions
We covered a great deal of information today, do you have any questions?
We will take the questions asked here and add them to the FAQ you already get in the Service Utilization Packet.