GENERAL COMMENT:
While Service Facilitation does not require service authorization under the DD Waivers, it is a listed BI/FIS/CL Waiver Service in the regs and should be listed in the section of this Appendix where all other Waiver Services are listed. It is mentioned in the CD sections of this appendix, but it is not specifically listed as its own waiver service, and it should. We have billable codes just like every other service on these waivers. This manual should spell out who can and cannot be an SF, when it's appropriate to engage an SF (CD services only, for example), and what the minimum requirements are in order to provide SF services, etc.
ASSISTIVE TECHNOLOGY
Page 2-3. “Pend for Additional Information”
Page 5. “To assure the provider that the individual is eligible and that services are authorized as requested, it is recommended that the required documents be submitted at least 30 days prior to the requested start of services.”
Page 6. “Review Process: The DBHDS has 10 business days to review a request for service authorization… Upon the receipt of a response to a pend, DBHDS has 10 additional business days to process the request.”
Page 7:
Page 8-9. “For children under the age of 21 – EPSDT ASSISTIVE TECHNOLOGY (T5999) over $5000…. T5999 code for requests over $5000.”
Page 9. “A 30% markup based on the provider cost is required.”
Page 9. “Items covered under DME cannot be considered as AT, if the AT item doesn’t meet the EPSDT criteria, then the item cannot be approved under the waiver.”
Page 10. “Requests for new Assistive Technology devices must contain the following: Provider to submit quote, showing cost and if request approved, then markup cost 30%.”
Page 18, COMPANION SERVICES:
Page 20:
ELECTRONIC HOME BASED SUPPORTS
Page 23. “Service authorization request must include a description of the item requested by the support coordinator… A preliminary needs assessment shall be completed by an independent technology specialist (cannot be employed by the requesting provider) to determine the best type and use of technology and overall cost effectiveness of various options.”
INDIVIDUAL SUPPORTED EMPLOYMENT
Page 33 – Individual SE – Paragraph 3
Page 33 – Individual SE – Paragraph 6
Page 52 - CD Respite:
THERAPEUTIC CONSULTATION
Page 64 – Therapeutic Consult – Bullet Point 3