Provider Update: Febuary 13, 2019
To: All Case Management Providers (ADvantage) and Home Care Providers (SPPC)
Subject:Provider updates to Planned Service lines
Effective February 15, 2019 a change to the Harmony system will be made on the Planned Services area of the Member Record.
Provider roles will no longer have the ability to edit a planned service after it is saved.
- If an error is made while creating a planned service and it is saved before correcting the error, as long as the status on the Plan Information sub-tab has not been set to a Review Status (SPA, Clinical, CD-PASS) and saved, the provider role can delete the planned service and re-enter as appropriate.
- If a response to a Condition/Plan Change is required, or the planned services was authorized with incorrect information (such as incorrect provider, incorrect units, etc.), the CM (ADvantage) or HC Nurse (SPPC) will do the following:
- Enter a new planned service line with the correct information as normal with the requested start date.
- DO NOT CHANGE the end date of any prior lines. Instead, enter a Plan Note with specific detail about what needs to change on the planned services.
- If the status on the Plan Information sub-tab has been set to a Review Status (SPA, Clinical, CD-PASS) the provider role will enter a Plan Note with specific detail regarding any planned service line changes needed. MSU will see the note when the plan is reviewed.
Example Plan Notes:
- On a new ADvantage case the CM does not need to make a note about the 175 units for T1016 and 10 units for T1002. Those will be updated automatically by our SPA team. If units other than the standard 175 and 10 are needed for the Member centered plan, please indicate those needs in a plan note along with completing the appropriate document to request the additional units.
- MSU staff should not be added as a note recipient to any notes.
- To submit a plan or plan change to the MSU for authorization, the status must be updated to SPA Review (or Clinical or CD-PASS review, if appropriate) on the Planned Information sub-tab to alert MSU that a review is needed.
The changes outlined above will facilitate faster review and authorization by MSU.
Please send any questions regarding the information above through the Harmony PQ chapter.