Long Term Care (LTC): Alerts to Social Services Specialist (SSS) Requesting Financial Eligibility

The following are examples of standardized wording that is sent to Family Support Specialist and Supervisor when the medical decision has been made on an application and it is pending the financial decision.

If the alert shown here is sent:

Applicant is medically eligible for ______. Please code the authorization lines in IMS as soon as the financial eligibility decision has been determined.

There is no need for the worker to email the nurse  back once financial is determined. Their action of changing the auth lines to “F” or “D” will trigger the auth batch that runs every night to certify or deny the app as appropriate. If the auth lines are not updated, a reminder alert will not be sent from the nurse and the app will not process until the auths are appropriately updated. A regular report is run and emails are sent out on anything over 45 days old as a precaution to make sure something wasn’t missed due to missing the step of updating auth lines.

If the alert shown here is sent requesting a return email:

Applicant is medically eligible for __________.  This application requires a specific certification date. Please email me when the financial decision has been determined and authorization lines have been coded in IMS.

It is very important that the worker respond to the nurse when the financial determination is made. They will still update their auth lines to “F” or “D” as appropriate, but that action will not be caught by our auth batch due to the nurse holding the application to certify it for a specific date. This happens on reopens, transitions, etc.

As a reminder if a worker needs to respond back to an alert they will need to select “forward” instead of “reply”. Worker’s forward needs to go back to individual that initiated the alert. Choosing “reply” sends the communication back to the SUPP-ASD-Helpdesk and not to the individual.

Was this article helpful?

Comments or Suggestions?

We want Quest to be your source for important information that you need to succeed at in your work but we need your help:

Was this article helpful? Was it missing something you needed to get the job done?

Tell us what you think, what you know about this article. What are we doing well, and what we could do better.

All fields are required.