(spw) sas help file

More documents

Recommendations

Info

Initial Service Authorization / SPW SAS Help File These records must be completed to create an initial service authorization for SPW: Authorizing Agent Enrollment Service Plan Service Authorization Level of Service Medical Necessity Diagnosis Authorizing Agent - SPW There will normally be one authorizing agent registered for an initial SPW member. The STAR+PLUS Support Unit (SPSU) or Health and Human Services Commission Managed Care Operations (HMCO) staff is registered as the authorizing agent when the initial authorization is authorized. To register an authorizing agent for an SPW applicant: 1. Select Authorizing Agent in the Case Worker directory. 2. Select Add and a blank Authorizing Agent record will appear. 3. Move to the Type field and select CM-Case Manager from the drop down list. 4. Move to the Group field and select 19-STAR+PLUS from the drop down list. 5. Leave the Send to TMHP field at the default selection N-NO. 6. Move to the Begin Date field and enter the date the record is being created. Leave the End Date field at the default 00/00/0000. 7. Move to the Auth Agent field and enter STAR+PLUS. 8. Leave the Agency field at the default selection 324-DHS. 9. Move to the Name field and enter the SPSU/HMCO staff’s name. 10. Move to the Phone field and enter the telephone number of the authorizing agent. Enter the area code, phone number and extension. 11. Move to the Mail Code field and enter the appropriate Managed Care Organization (MCO) Plan Code from the table below. Revised: 4/23/2012 2
12. Save the record. SERVICE MCO PLAN NAME MCO PLAN AREA CODE Bexar Amerigroup 45 Molina 46 Superior 47 Dallas Molina 9F Superior Health Plan 9H El Paso Amerigroup 34 Molina 33 Harris Amerigroup 7P United Healthcare 7R Molina 7S Hidalgo HealthSpring (Bravo) H7 Molina H6 Superior H5 Jefferson Amerigroup 8R United Healthcare 8S Molina 8T Lubbock Amerigroup 5A Superior 5B Nueces United Healthcare 85 Superior Health Plan 86 Tarrant Amerigroup 69 Bravo Health 6C Travis Amerigroup 19 United Healthcare 18 SAS Help File Revised: 4/23/2012 3
Page 1: STAR+PLUS WAIVER (SPW) SAS HELP FIL
Page 6 and 7: Enrollment - SPW To register enroll
Page 8 and 9: 8. Move to the Units field and ente
Page 10 and 11: 14. Save the record. 15. Select Sub
Page 12 and 13: 2. Select Add and a blank Medical N
Page 14 and 15: 8. Save the record. Reassessment Se
Page 16 and 17: 1. Select Service Authorization in
Page 18 and 19: 4. Move to the Service Code field a
Page 20 and 21: To register a Service Authorization
Page 22 and 23: SAS Help File 3. Move to the Servic
Page 24 and 25: Transfers / SPW SAS Help File There
Page 26 and 27: 5. Move to the Termination Code fie
Page 28 and 29: SAS Help File outlined in Initial S
Page 30 and 31: United Healthcare Nueces 1014437 Un
Page 32 and 33: 2. Select Add and a blank Authorizi
Page 34 and 35: Enrollment - SPW To register enroll
Page 36 and 37: 10. Move to the Begin Date field an
Page 38 and 39: Level of Service - SPW SAS Help Fil
Page 40 and 41: 3. Move to the MN field and select
Page 42 and 43: United Healthcare Jefferson 1019600
Page 44: 1. Search for the member’s SPW ca

(spw) sas help file

Create successful ePaper yourself

Delete template?

Save as template?