(spw) sas help file

Transfers / SPW
SAS Help File
There are several situations that are considered transfers for SPW members,
and the procedures differ for each.
Transfers from CBA services to SPW Services
When a CBA consumer moves into a STAR+PLUS service area, he must
receive services through Managed Care. When this happens, the losing DADS
case manager closes the CBA case using the CBA Wizard and Code 034 –
Transferred to Managed Care and an end date that equals the end of the month
of move.
Once the CBA consumer has transferred to the STAR+PLUS Service Area, the
SPSU staff in the gaining STAR+PLUS service area follows the same procedures
as in the Initial Service Authorization / SPW section, with the following
exceptions:
Even though there is an existing ISP, the Begin Date for the SPW records is
the date the member is enrolled in an MCO.
The End Date for the Service Authorization (SC 12 and 60) records, the Service
Plan record and the Level of Service record remains the same date as the
current CBA ISP period.
The SPSU staff does not need to complete a Level of Service – PR for the
consumer. They only need the Level of Service – CR created.
Example: A CBA consumer with an ISP period of 11/01/11 to 10/31/12
transfers to a STAR+PLUS service area and begins receiving SPW services on
01/01/12. The Begin Date is the date he enrolled with an MCO and the End
Date for these records remains 10/31/12.
Transfers from SPW to CBA Services
When a STAR+PLUS member transfers from a STAR+PLUS service area into a
non-STAR+PLUS service area, the SPSU staff closes all Service Group 19
SPW records, with the exception of Medical Necessity, using the last day of the
month of move as the End Date.
To close the Authorizing Agent record:
1. Open the SPW member’s case in SAS.
2. Move to Authorizing Agent from the Case Worker directory and select
Authorizing Agent record.
3. Select the open record and then choose Modify or double-click on the
Revised: 4/23/2012 21