1. Conversion of CCW programs from contracts to FFS
ABCD Alliance
November 9, 2017

2. Electronic Health Records
Recommend having a comprehensive EHR system that maintains billing and service data
Review and ensure information is accurate prior to billing
EHR system has the capability to bill on a weekly basis to ensure proper cash flow

3. Medicaid Eligibility Mechanism in place to check client eligibility
Maintain individual’s entitlement

4. Policies Needed
Contribution to Care Policy
Absentee Policy

5. Residential
Ensure Individual/Families/Guardians are aware of the SC agencies and educated on the process
They need to have a first choose and a second one
Recommend SCA meet and greets

7. SC Meeting Preparations
Copy of Current IHP to refer to
Current Medication List
Current Physician List
Family Information
Day Program Name
Policies signed by the person/family/guardian/payee

8. What SC’s Need to enroll Individual
***samples of each on next slides****
Participant Enrollment Form
Mental health Form
Worksheet Completed
Supported Employment Form if applicable
Clinical Needs form if applicable (acuity)
SC will also need to identify if the person is retired

14. Important!!! The plan approval date is different then the start date
An SCA will want to approve the plan ASAP but you can put in a reasonable start date for services

15. Worksheet MUST BE Correct

16. Long Plan: completed prior to meeting date
ABS Assessment
Unsupervised Time Assessment
Community Care Waiver- Self-Care Assessment
Self Medication Assessment
Individual Fire Assessment
Fire Evacuation Plan
Have prepared goals and objectives to present at ISP meeting
***These may change with Licensing Reg. Updates***

17. Short Plan: completed prior to meeting date
Ensure goals and objectives match outcomes
Ensure all information is correct on ISP

18. After ISP meeting
Ensure you have one point person for the agency that ALL SCA send draft so you can review and send back
Ensure Goal Tracking Form is finalized and in your EHR System
Ensure that the units are correct for each outcome
If you have exceptions for Day Program make sure they are captured

19. Billing Ensure all Licensed location have unique NPI numbers
Must register with NPPIS and maintain its registration in order to obtain new NPI or modify current ones
Make sure you connect your NPPIS to your provider number
Ensure Taxonomy codes are correct before submitting billing to Molina
Delay first billing till you get the authorizations from Molina

20. Billing Ensure the plan received from SCA is accurate
Ensure address is correct under outcome for residential service
Ensure Correct billing NPI number is on service billing report
Main NPI number NOT the doorknob number
Address must be correct for doorknob on the SDR
SDR pulls from the address on the outcome