32 Miss. Code. R. 1-12.3
The Counselor may request approval for added service(s) that were not included on the Plan of Care after it has been determined that the client has an unmet need for these items The request must be submitted for review and approval to their District Manager prior to any changes being made to the POC. When an added service is requested, the Counselor must proceed with the following steps:
* Evaluate the necessity of the added service and obtain appropriate documentation to support the request for additional services to the POC;
* Obtain a doctor's prescription for the service item needed;
* Obtain two quotes for each added service item in order to compare costs;
* Investigate all comparable benefits (Medicaid, Medicare, Home Health, any other third party resource);
* Complete and submit the following to your District Manager for approval and review of documentation to verify appropriate need for additional service item(s).
* Plan of Care
* Case Note documentation
* Approved Adaptive Aid Form
* Copy of the Prescription(s)
* Copy of Quotes
* AT Specification Report if applicable
The District Manger will indicate his or her approval by signing the Adaptive Aid Form and returning it to the Counselor. If there are questions regarding the documentation, a request will be made to the Counselor to submit or clarify documentation prior to final decision.
* A copy of the Plan of Care must remain in the file until the original is received back from DOM indicating approval/disapproval of the added service.
* When the information is received by OSDP state office, the Administrative RN will review information for completeness and approval by the District Manager. Once the request has been reviewed and approved, the counselor will then forward the service request to DOM once the request has been processed by the OSDP State Office. (See Resource Guide for detailed instructions for submission to State office and DOM).
* After approval is received from DOM, OSDP state office will notify the counselor and District Manager via a Notice of Determination that the service has been approved.
* Funds will then be distributed to the Counselor via the Manager to plan and authorize for the added service.
32 Miss. Code. R. 1-12.3