Missouri Family Support Division Reorganization Impact on Authorized Representatives
Learn about the modernization and reorganization efforts of Missouri FSD, how it affects Authorized Representatives, and the centralization of processing through MRT Central. Discover key changes and partnerships enhancing customer service for healthcare facilities.
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Presentation Transcript
Missouri Family Support Division AUTHORIZED REPRESENTATIVES MISSOURI HOSPITAL ASSOCIATION
Welcome! Presenting from Missouri FSD: Julie Gibson, Designated Principal Assistant Glenda Deason, Manager, MHABD Medical Review Team Processing Center, Springfield, MO Linda Simmoneau, Program Development Specialist, Medical Review Team
FSD Modernization and Reorganization Upgrading to new/modern technology MEDES replacing existing legacy system (FAMIS) Web-based, automated system Stronger case management tools Cheaper to operate and maintain Phase I -- MEDES MAGI Medicaid (January, 2015) Phase II will focus on Non-MAGI Medicaid (elderly, disabled) (2016)
FSD Reorganization Key Elements of FSD Reorganization: Centralizing application processing/ specialized customer services Creating Customer Resource Centers throughout the state Employing call center technology and processes Converting paper case files to electronic format
How does this impact Authorized Representatives? WHAT CHANGES WILL YOU SEE?
MHABD MRT Specialization MRT Central MRT Central will enable faster and more efficient processing and will provide a centralized point of contact for Authorized Representatives Consolidates processing of MHABD MRT to one primary location Greene County, Springfield, MO Eligibility staff and Medical Review Team work hand in hand to expedite processing of MHABD MRT applications from start to finish MRT Central staff become a specialized team in processing MHABD MRT applications
Partnership with Authorized Representatives MRT Central values the important partnership with ARs and is committed to providing excellent customer service STL AR is transitioning operations to MRT Central all information sent to the STL AR Group will be forwarded to MRT Central via e-mail Please begin using this new email address that has been established solely for applications from hospitals and facilities: FSD.HospitalApplications@dss.mo.gov
How can Authorized Representatives help expedite processes? MAKE SURE THAT THE APPLICATION AND OTHER REQUIRED FORMS ARE COMPLETED THOROUGHLY
MHABD Forms IM-1MA Application for Benefits IM6-AR Appointment of Authorized Representative MO-650-2616 Authorization for Disclosure of Consumer Medical/Health Information IM-61B Disability Questionnaire IM-61C Work History in the past 10 years IM-61D Hospitals, Medical Facilities and Physicians seen within the Past Year
MHABD Verification Forms IM-9 Insurance and Prepaid Burial Verification Request IM-12 Employment Information Verification Request IM-7 Financial Information Verification Request
Tips for Completing the IM-1MA Application If applicant is homeless be sure and note this on the application and include a mailing address which can be the hospital/authorized representative s mailing address Ensure that the type of application is marked, i.e. disabled, over 65, blind/visually impaired. If client is wishing to pursue Gateway to Better Health, please write that in If married and living together, both spouses must be listed on the application All types of income, earned or unearned, should be listed on the application
IM-1MA (Contd) Make sure all resources are indicated on the application Ensure that the application is signed and dated Please make sure we receive the completed application as soon as possible, especially if it is late in the month For example, if the client fills out the application and it is dated for March 30, but we don t receive it until April 1, then April will be the month of application If the client does not have unpaid medical bills prior to the month of application, it may not be necessary for you to go through the need of obtaining information for the months prior (see next slide)
Prior Quarter Coverage Indicate on the application whether or not prior quarter coverage is needed. MOHealthNet may cover outstanding medical costs incurred by the applicant (or spouse) in the 3 months prior to the month application is received All types of income, earned or unearned, should be listed on the application, including prior quarter Make sure all resources are indicated on the application, including any owned in the prior quarter
Options for Authorized Representatives Consider the level of involvement you want/need to have on behalf of a client FSD allows for several options that will enable a provider to assist the client: 1) Become a legal Authorized Representative by completing IM-6-AR 2) Client can give FSD permission to discuss his/her specific case with you (without making you an official AR) by notating on the MO-650-2616 (HIPAA form) 3) Client can give FSD the same permissions as # 2 by completing the newly created IM-6-NF
IM6-AR Appointment of Authorized Representative As an Authorized Representative, you become FSD s primary contact for the client: Represent the client in Hearings Receive all correspondence on behalf of client Access to client case information Speak to FSD on behalf of the client In completing the IM-6-AR: Ensure that this form is completed in its entirety Must be signed by the Authorized Rep, or it cannot be accepted Make sure that the form is legible Please print your name behind your signature
MO-650-2616 Authorization for Disclosure of Consumer Medical/Health Information
MO-650-2616 Authorization for Disclosure of Consumer Medical/Health Information This is often the most confusing form for the client to complete Please have the client sign this form in black ink. MRT Processing must have signatures that are visible in order to obtain the appropriate medical records needed /schedule necessary evaluations Ensure that both signature lines are signed on the back of the form Make sure that the individual has NOT signed the revocation area
IM-6-NF AUTHORIZATION FOR RELEASE OF MEDICAL/HEALTH INORMATION TO THE NURSING FACILITY
IM-6-NF AUTHORIZATION FOR RELEASE OF MEDICAL/HEALTH INORMATION TO THE NURSING FACILITY A user-friendly form that gives FSD permission to discuss a person's case with the provider Alternative to the IM-6-AR Does not make the provider the Authorized Representative
Other MRT Forms IMPORTANT TO ENSURE THAT THEY ARE COMPLETED AND SUBMITTED
IM-61B Disability Questionnaire This form is the voice of the individual when MRT is making a determination. Must be completed thoroughly MRT Processing must know ALL medical conditions of the individual This form also helps to determine if any other evaluations need to be scheduled for the client
IM-61C Work History in the past 10 years FSD must obtain employment information for the past 10 years The individual must make every attempt to provide accurate and complete information
IM-61D Hospitals, Medical Facilities and Physicians seen within the Past Year
IM-61D Hospitals, Medical Facilities and Physicians seen within the Past Year Provide information for all medical services the individual has received in the most current year FSD will not be requesting records older than one year The dates of service are critical to obtaining the relevant medical records be sure to include them
IM-9 Insurance and Prepaid Burial Letter This form is required if the individual has any life insurance or burial policies, and must be completed and signed by the client The name of the company is required The company address is requested, if available
IM-12 Employment Information Request This form can be supplied if paystubs are unobtainable by the individual Ensure that the form is signed Ensure that the employer name and address is provided: It is very important that we know the location of the employer where the client works/worked, especially since many are franchised or have multiple locations
IM-7 Financial Information Request This form is completed by a bank/financial institution, and is necessary if the client does not have access to, or does not provide their financial institution/bank account verification If the individual has access to their information, please have them attempt to obtain the information themselves, as some banks charge a fee for filling out the IM-7
MHABD Authorized Representative Case Status Report Starting April 1, 2015: AR will receive Vendor Case Status Report Semi- Monthly Two Vendor Case Status Reports E-mailed to AR On 1steach month status for prior month from 16thto last day On 16theach month status for current month 1stto 15th Will develop a customized report for ARs in the near future
MHABD AR Case Status Report (Contd) Current Vendor Case Status Report contains the following fields: Participant Name (AR) Case Number (for AR zeroes) Application Date Referral Received Date Application Status Pending Approved Not Eligible Effective Date of Status
Final Notes FSD.HOSPITALAPPLICATIONS@DSS.MO.GOV This email address is monitored 100% of every business day MRT Central will follow-up on any pending AR applications If you do have an urgent matter, you may call Glenda Deason at 417-895-6062 Also, check out our updated website at dss.mo.gov/fsd/
