Medicaid Services Update

To:  All ADvantage Case Management and Home Delivered Meal providers

Subject:  Communicating with Outgoing Provider Before Submitting Request to End Authorization

Date:  April 11, 2022  

When ending an ADvantage authorization, the Case Manager (CM) must communicate with the outgoing meal provider to:  1) notify them that their service authorization is ending, and 2) obtain information to appropriately end the service authorization.   This is especially important for Home Delivered Meal authorizations.  MSU requests that Case Managers use the following process when ending or changing providers for Home Delivered Meals: 

Step 1:
The CM should contact the outgoing meal provider (by phone or Harmony note) to advise their service is ending and request an appropriate end date for their authorization.  This information is required by MSU to avoid billing issues on this service.  

Step 2:
When updating the Service Plan, the CM will update the line status on the existing S5170 line to End Service (Provider Use Only) and add the end date information provided in Step 1 to the Comments area on the same line. 

Step 3:
If the Member has selected a new provider, the CM will use the outgoing provider’s authorization end date + 1 day as the begin date on the S5170 line for the new provider using a line status of New Request (Provider Use Only). 

The process for submission of requests to end meals or change meal providers remains the same. Please note that if no end date is provided, MSU will process a request to end meals or change the meal provider using the next Sunday/Monday after the date of processing for the end/begin dates. 

If you have any questions regarding the information provided above, please feel free to contact us via Harmony Provider Question.     

COMMUNITY LIVING, AGING AND PROTECTIVE SERVICES (CAP)
MEDICAID SERVICES UNIT (MSU)
ADvantage Administration | State Plan Care Unit | Medical Eligibility Services
Office: 918-933-4900 | CareLine: 800-435-4711