Once NF medical eligibility is determined, it remains valid regardless of which nursing facility the client chooses to reside. A new UCAT is not needed if client moves from the original facility to a new facility. A New UCAT is only needed if there has been a 90 day break in NH stay excluding hospital and skill care.
The following steps detail the process when the client moves from one nursing facility to another after the UCAT was submitted or approved.
Example:
Brad Shelton previously lived in the Claremore Nursing Facility. He just moved into the Tuttle Nursing Center to be closer to his family.
Step 1: Close the authorization for the previous nursing facility (in this example, Claremore nursing facility).
- In IMS, type EKL (space) and the case number.
- Type AUL beside the authorization to be closed and press the “Enter” key.
This will take you to the Authorization Update (AUL) screen. Make the following updates:
- Action-6 (closed)
- Reason-4 (change of providers)
- End Date (enter last date individual resided in the facility)
- Press “enter”
NOTE: When a client transfers from one nursing home to another the end and begin dates can overlap one day.
A message will appear at the bottom of the screen indicating the authorization is closed once you press “enter”.
Step 2: Put the authorization for the current nursing facility (in this example, Tuttle nursing center) into application status.
- In IMS, type AUL (space) case number (space) NEW
On the AUL screen, enter the following:
- Person Number
- Level of Care (In this example, IC, nursing facility care)
- Begin Date (enter the date you were notified client entered the new nursing facility)
- Provider (Enter the provider number of the new/current nursing facility. In this example, Tuttle Nursing Care)
- Press “Enter”
Step 3: Confirm the EKL screen shows the previous authorization is closed and the new/current authorization is in application status.
Step 4: Put the authorization for the current nursing facility (in this example, Tuttle nursing center) into financial status.
On the EKL screen, type AUL beside the new authorization which is in application status and press “enter” :
On the AUL screen, enter the following:
- Action (enter “F” for financially eligible)
- Vendor Co-payment*
- Effective Date (enter the date you were notified client entered the new nursing facility)
- Press “enter”
*NOTE: The vendor payment must be the same for each authorization when transferring from one facility to another during the same month. If amount is incorrect it must be changed the next effective month. A remedy ticket can be submitted to correct previous months if the client gives permission to do so.
A message will appear at the bottom of the screen indicating the authorization is in financial status (Fin Eli) when you press enter.
Step 5: Open the authorization for the current nursing facility (in this example, Tuttle nursing center).
At the bottom on the screen, type AUL (space) case number and press “enter”:
On the AUL screen, enter the following:
- Action-1 (Open)
- Reason-4 (change of providers)
- Level Care (Update only if different from IC, in this example, the client is still in nursing care)
- Begin Date (Enter the date the client entered the new facility)
- Vendor Payment (Enter vendor payment. In this example the client had a vendor payment of $16 for the month he moved into the new facility. If after 1st deadline, enter the vendor payment for following month underneath. )
- Eff Date: On the first line enter the same date as begin date. For the second line enter the next effective month.
Press “Enter”
Step 6: Confirm the EKL screen shows the new authorization as opened.
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