Document Tag: Policy

I. INTRODUCTION II. POLICY PRINCIPLES III. ESTATE RECOVERY PROCEDURES AT APPLICATION AND RECERTIFICATION IV. ESTATE RECOVERY PROCEDURES WHEN A BENEFICIARY DIES V. WAIVER OF ESTATE RECOVERY VI. CLAIM OF UNDUE HARDSHIP

I. MANAGED CARE II. COMMUNITY CARE OF NORTH CAROLINA (CCNC)/CAROLINA ACCESS (CA) III. TYPES OF EXEMPTIONS IV. APPLICATION V. RE CERTIFICATION VI. CHANGE IN SITUATION VII. BENEFICIARY COMPLAINTS AND INQUIRIES VIII. PROVIDER INQUIRIES IX. LOCAL MANAGEMENT ENTITY/MANAGED CARE ORGANIZATION (LME-MCO) X. APPLICATION XI. RE CERTIFICATION XII. CHANGE IN SITUATION XIII. INCORRECT COUNTY XIV. APPEALS AND…

I. INTRODUCTION II. REQUESTING MFP SERVICES III. CHANGES IN SITUATION

DHB Administrative Letter 11-23, Request for NC Innovations Waiver Action Indicator Action Needed   I. INTRODUCTION II. INNOVATIONS PARTICIPATION III. REQUESTING INNOVATIONS SERVICES IV. BUDGETING V. INNOVATIONS PARTICIPATION VI. RECERTIFICATION VII. CHANGE IN SITUATION VIII. NOTICES IX. APPEALS  

I. INTRODUCTION II. REQUESTING TBI WAIVER SERVICES III. BUDGETING IV. TBI PARTICIPATION V. TBI RECERTIFICATION VI. CHANGES IN SITUATION VII. NOTICES VIII. APPEALS

  BACKGROUND & INTRODUCTION PACE AND MEDICAID REFERRAL PROCEDURES ELIGIBILITY DOCUMENTATION FOR PACE POLICY PRINCIPLES PACE BUDGETING ALLOWABLE DEDUCTIONS MEDICAID AUTHORIZATION FOR PACE SERVICES MEDICAID CERITIFCATION AND AUTHORIZATION FOR PACE REDETERMINATION OF ELIGIBILITY/REVIEW CHANGE IN SITUATION AUTOMATED AND MANUAL NOTICES FOR PACE SERVICES PACE APPLICATION REPORT PACE SERVICES – INTERNAL APPEAL PROCESS MEDICAID APPEAL PROCESS

I. INTRODUCTION II. WHEN TO USE LTC BUDGETING III. EXCEPTIONS TO LTC BUDGETING IV. DETERMINING ELIGIBILITY FOR THE MONTHS PRIOR TO LONG-TERM CARE BUDGETING V. LONG TERM CARE BUDGETING COMPUTATION VI. THE COMMUNITY SPOUSE INCOME ALLOWANCE (SPOUSE IN PLA) VII. THE DEPENDENT FAMILY MEMBER ALLOWANCE VIII. UNMET MEDICAL NEEDS ALLOWANCE IX. REPORTING PATIENT MONTHLY LIABILITY…