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Absence from the Home: Temporary vs Permanent

Last Updated July 17, 2023

Determining whether an absence is temporary or permanent.

Subject: Aged, Blind, Disabled (ABD) Topics: ABD, Absence, Aged, alone, Blind, camper, Care, countable, Disabled, dwelling, Exempt, feasible, fixed, health, home, hospital, house, improve, long, Medical, mobile, Nursing Home, Payment, permanent, plan, possible, primary, property, QI-1, QMBP, Qualified Individual – Group 1, Qualified Medicare Beneficiary Plus, realistic, recreational vehicle, rehabilitation, Residence, Resource, RV, Shelter, short, sick, SLMB, Specified Low Income Medicare Beneficiary, SSP, state, supplemental, temporary, time, trailer, trip, vacation, viable, visit, well

Disability Due to Death

Last Updated September 22, 2022

Determining Category Relationship due to Death and FACS Coding

Subject: Aged, Blind, Disabled (ABD) Topics: 3 months, ambulance, Categorical Relationship, Death, deceased, Disability, hospital, Medicaid, QMBP, Qualified Medicare Beneficiary Plus, treatment

Applications – ABD Related & SSA Appeal

Last Updated September 22, 2022

Information regarding previously denied applications and when they can be used again to certify a medical benefit.

Subject: Aged, Blind, Disabled (ABD) Topics: ABD, Application, BEN, Bendex, Certify, decision, Denial, doctor bill, Eligibility, emergency room, hospital, invoice, Liability, Medicaid, Medical, medical bill, previous application, Retirement, retro cert, RSDI, SDX, Social Security Administration, SoonerCare, SSA, SSI

Vendor Payments: ZERO vs FULL Vendor Payments

Last Updated September 22, 2022

Determining what month a vendor payment begins once a person enters ICF or ICF/IID.

Subject: Long Term Care (LTC) Topics: community spouse, full vendor payment, hospital, institutionalized, Nursing Home, reduced SSI, skilled care, vendor payment, zero vendor payment

How to Certify Alien Emergency Medical

Last Updated August 28, 2017

The steps to take in certifying someone for emergency medical.

Subject: Aged, Blind, Disabled (ABD) Topics: ABD, AFDC, Alien, Categorical Relationship, Disability, Emergency, hospital, Illegal Alien, LOCEU, Medical, Remedy Ticket, undocumented

Skilled Care Overview

Last Updated February 23, 2023

Policy 317:35-19-19 Skilled care can be provided in a nursing facility and/or hospital if they have the staff and services, and are licensed, to provide the skilled care. Care that can be provided by non-professional staff is not considered to be skilled care. Only Persons enrolled in Medicare Part A are eligible for payment for […]

Subject: Long Term Care (LTC) Topics: 30 days out of home, ABD Related, hospital, Long Term care, Medicare Part A, MIPT, Non ABD Related, nursing facility, OHCA, skilled care, SNF