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Table of Contents |
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04/01/2020 |
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Abbreviations* |
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04/2017 |
100 |
Reserved |
|
200 |
Reserved |
|
300 |
Reserved |
|
400 |
Eligibility for Services |
|
401 |
Medicaid Eligibility Requirements |
|
04/2015 |
|
402 |
Program Eligibility |
|
01/2016 |
|
403 |
General Provisions and Services |
|
04/01/2018 |
|
404 |
Service Limitations and Exclusions |
|
10/01/2018 |
|
405 |
Reserved |
|
|
|
406 |
Reserved |
|
|
|
407 |
Denial of Services |
|
04/2015 |
|
408 |
Reserved |
|
|
|
409 |
Reserved |
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|
|
410 |
Reserved |
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|
|
411 |
New Admissions |
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10/2017 |
|
412 |
Request to Change Agencies |
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07/01/2018 |
|
413 |
Switch in Options |
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07/2017 |
|
414 |
High Risk Intake |
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04/01/2018 |
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415 |
Annual MPQH Reviews |
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04/2015 |
|
416 |
Reserved |
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|
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417 |
Temporary Authorization |
|
07/01/2018 |
|
418 |
Reserved |
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|
|
419 |
Reserved |
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|
|
420 |
Reserved |
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|
|
421 |
Service Plan |
|
07/01/2018 |
500 |
Mountain Pacific Quality Health (MPQH) |
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|
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501 |
Prior Authorization Contract Requirements |
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04/01/2019 |
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504 |
MPQH Service Profile |
|
04/01/2019 |
600 |
Administrative Requirements |
|
605 |
Fair Hearings |
|
04/2017 |
|
606 |
Policy Memo CFC/PAS 606 Reimbursement* |
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06/2016 |
|
606 |
Reimbursement |
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01/2016 |
|
607 |
Recoveries |
|
04/01/2020 |
|
608 |
Quality Assurance Review |
|
04/2016 |
|
609 |
Quality Assurance Review Worksheet |
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10/2016 |
|
610 |
Quality Assurance Process-Provider Agency Reports |
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01/01/2019 |
|
611 |
Quality Assurance Communications |
|
10/01/2019 |
700 |
Service Requirements |
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701 |
Agency Requirements |
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07/01/2018 |
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702 |
Intake Visits |
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04/01/2018 |
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703 |
180 Day and Annual Recertification |
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07/01/2018 |
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704 |
Complaint Procedure |
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04/2015 |
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705 |
Termination, Discharge and Temporary Absences |
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04/2017 |
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706 |
Training Attendants |
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07/2015 |
|
707 |
Medical Escort and Medical Transportation Mileage |
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07/2015 |
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708 |
Shopping, Community Integration and Mileage |
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04/2017 |
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709 |
Serious Occurrence Report |
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04/2017 |
|
710 |
Home and Community Based Waiver Program |
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04/2015 |
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711 |
Live-In Attendants, Family and Significant Others |
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04/2015 |
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712 |
Home Health and Hospice Benefit and Third Party Programs |
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04/2015 |
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713 |
Services to Children Under the Age of 21 years |
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04/2015 |
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714 |
Services to Members with Developmental Disabilities |
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04/2015 |
|
715 |
Services to Pregnant Women |
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04/2015 |
|
716 |
Reserved |
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|
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717 |
Flexibility Parameters |
|
10/01/2019 |
|
718 |
Service Delivery Records |
|
07/2015 |
|
719 |
Amendments |
|
07/01/2018 |
|
720 |
Conflict of Interest |
|
04/2015 |
|
721 |
Skill Acquisition |
|
04/2015 |
|
722 |
Reserved |
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|
|
723 |
Shared Cases |
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04/2015 |
800 |
Rules and Resources |
900 |
Forms |
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901 |
General Information/Forms Requisition |
SLTC 100* |
01/01/2018 |
|
902 |
General Utilization |
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02/2015 |
|
903 |
Reserved |
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|
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904 |
Service Plan Form Instructions |
SLTC 170* |
02/2015 |
|
905 |
Member Referral Form Instructions |
SLTC-154 |
02/2015 |
|
906 |
Change in Demographics Form Instructions |
SLTC-157 |
02/2015 |
|
907 |
Unable to Admit/Discharge Form Instructions |
SLTC-158 |
02/2015 |
|
908 |
Agency Start of Care Form Instructions |
SLTC-163* |
04/2017 |
|
909 |
909 Person Centered Planning Form Instructions |
SLTC-200* |
04/2017 |
|
910 |
Reserved |
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|
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911 |
Service Delivery Record Form Instructions - Sample |
SLTC-220* |
02/2015 |
|
912 |
Mileage and Medical Escort Form Instructions |
SLTC-221* |
04/2017 |
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913 |
Request for Case Review Form Instructions |
SLTC-MA-128 |
02/2015 |
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914 |
Risk Negotiation Form Instructions |
SLTC-230 |
02/2015 |
|
915 |
Recertification Documentation Instructions |
SLTC-210 |
02/2015 |
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916 |
Skills Acquisition Endorsement Form Instructions |
SLTC-215 |
02/2015 |
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917 |
Skills Acquisition Training Plan Form Instructions |
SLTC-216 |
02/2015 |
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924 |
Internal Quality Assurance Review Summary |
SLTC-252* |
01/01/2018 |
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925 |
Provider Prepared Standards |
SLTC-253* |
01/01/2019 |
|
925 |
Provider Prepared Standards Policy Memo |
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01/04/2018 |
|
926 |
Intake Internal Review Worksheet |
SLTC-244* |
01/01/2018 |
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927 |
Recertification Internal Review Worksheet |
SLTC-245* |
01/01/2019 |
1000 |
Reserved |
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1100 |
CFC/PAS Person Centered Planning (PCP) |
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1101 |
PCP Requirements Overview |
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04/2017 |
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1102 |
Plan Facilitator vs. Provider Responsibilities |
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04/2017 |
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1103 |
Plan Facilitator Certification for CFC/PAS Providers |
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04/2017 |
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1104 |
PCP Coordinated Visits |
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04/2017 |
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1105 |
MPQH Authorization Documentation |
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04/2017 |
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1106 |
PCP Annual Visits |
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04/2017 |
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1107 |
PCP Re- Admission to CFC/PAS |
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04/2017 |
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1108 |
High Risk Admits |
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04/2017 |
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1109 |
Policy Memo: Plan Facilitator Policy Memo* |
|
10/2016 |
|
1109 |
Plan Facilitator Change: Intake to Waiver/Case Management, Switch in Agency, and Waiver Discharge |
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04/2017 |
|
1110 |
Short Term Admits |
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04/2017 |
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1111 |
Personal Emergency Response Systems (PERS) |
|
07/2017 |
|
1112 |
Person Centered Planning Form Instructions |
|
04/01/2019 |
|
1113 |
Level of Care |
|
04/2017 |
|
1115 |
Case Manager Plan Facilitator Role When a Member Changes CFC/PAS Provider Agency |
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07/2017 |
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Pre-printed Forms available from Central Office |
|
SLTC 901 |
CFC/PAS Requisition Form* |
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|
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CFC/PAS Booklet Requisition Request Form |
SLTC-260 |
01/01/2018 |