Updating Authorization to Denial “2”
If found either financially or medically ineligible the AFS worker must code the ACTION BLOCK in the NF authorization
In IMS, type EKL <space> case number and press enter.
Tab down to the authorization in application status , type aul and press enter.
Enter the following
- Tab to the action block and enter a 2 (denial) over the “A”
- Enter a reason for denial in the reason block. Refer to article IMS: IMS Codes for LTC Authorization Actions
NOTE: There is no need to enter an end date as the computer will automatically match the “end date” to the previously coded “begin date.
Communication with the area nurse is extremely important. If financial eligibility is delayed due to spending down of assets, transfer penalty, etc., an e-mail must be sent to the nurse and copied to the area nurse and AFS supervisor.
Once the NF authorization is denied, certify or deny the Medical “D” section appropriately.
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