The following are descriptions / instructions of each Section K (Waivered Services Authorizations) field in IMS:
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Field: Authorization Number.
PS-2 Block: K1
PS-2 Block: K1
Instructions: Computer-assigned when authorization is entered. On new authorizations + has been pre-entered to indicate authorization being added.
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Field: Person Number.
PS-2 Block: K4
PS-2 Block: K4
Instructions: Enter the appropriate person number from Section F for the person authorized for services.
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Field: Authorization Type.
PS-2 Block: K8
PS-2 Block: K8
Instructions: SW = Special Waiver Services
NOTE: This block must be entered when adding a new authorization
NOTE: This block must be entered when adding a new authorization
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Field: Action Taken.
PS-2 Block: K12
PS-2 Block: K12
Instructions: Enter the appropriate code for action taken on this authorization. This block must be completed each time authorization is updated.
- A = Application
- 1 = Open.
- 2 = Deny.
- 6 = Close.
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Field: Reason
PS-2 Block: K16
PS-2 Block: K16
Instructions: Enter the appropriate code from the list below to show why this authorization is being closed or denied.
- 1 = Death of client.
- 2 = You have withdrawn your request for SPPC.
- 3 = A change in level of care.
- 6 = A change in the DHS case number for authorization.
- 9 = You have not cooperated in the delivery of services.
- 10 = You do not meet the financial eligibility for SPPC.
- 11 = Not in targeted group for the ADvantage Waiver.
- 12 = Doctor did not recommend the ADvantage Waiver.
- 13 = Residing in a nursing home. (Denials Only)
- 14 = Cost of services exceeds the allowable capitalization.
- 15 = No open ADvantage Waiver slot.
- 16 = Needs cannot be met through the ADvantage Waiver services.
- 17 = Harm to self or others.
- 18 = A household member or frequent guest threatens harm to others.
- 20 = You do not meet the medical eligibility for SPPC and/or nursing home level of care.
- 22 = Moved out of state.
- 23 = Unable to locate.
- 44 = Failed or refused to cooperate in determining eligibility.
- 45 = Failed or refused to provide necessary verification within the time allowance.
- 49 = Entered nursing care facility.
- 59 = No longer participating – client decision.
- 69 = Other – no notice will be generated.
- 99 = State Office use only.
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Field: Level of Care.
PS-2 Block: K20
PS-2 Block: K20
Instructions: Enter the appropriate code for the level of care for this person.
AP = Receives personal care in own home by agency provider with vendor payment approved.
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Field: Provider Number.
PS-2 Block: K40
PS-2 Block: K40
Instructions: Enter J999999999.
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Field: Beginning Waiver Date.
PS-2 Block: K45
PS-2 Block: K45
Instructions: Enter the date the person became eligible for this waivered service.
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Field: End Date.
PS-2 Block: K47
PS-2 Block: K47
Instructions: Enter the date client’s eligibility for waivered services ended.
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Field: Primary Diagnosis.
PS-2 Block: K65
PS-2 Block: K65
Instructions: Computer entered from information in Section F.
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Field: Secondary Diagnosis
PS-2 Block: K66
PS-2 Block: K66
Instructions: Computer entered from information in Section F.
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