Provider Notice Issued 05/16/2019

Date:   May 16, 2019                                                            
 
To:      Long Term Care Facilities - Nursing Facilities (NF), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID), Medically Complex for the Developmentally Disabled Facilities (MC/DD), Supportive Living Program (SLP) Providers, and Specialized Mental Health Rehabilitation Facilities (SMHRF)
 
Re:      Long Term Care Admission Transaction Rejections without Notification
______________________________________________________________________
 
Healthcare and Family Services (HFS) is establishing a process for Long Term Care (LTC) providers to inquire and follow up on LTC Admission Transactions that were rejected by the State without notification being sent to the LTC provider. From March 2016 through October 2018, notification letters were not consistently sent to LTC providers when an admission transaction was rejected. Therefore, LTC providers were unable to follow up with the State for an opportunity to reconcile the rejection.
 
LTC providers that want to receive information on rejected admission transactions must submit a list of all admission Transaction Audit Numbers (TANs) in question to HFS. HFS has attached a template of the required information for each TAN that should be filled out.
 
The template includes the following data fields:
 
·         LTC Hub
·         LTC Provider
·         LTC Provider ID
·         TAN Status Code
·         TAN
·         Date of Admission
·         Date of Discharge
·         Discharge Destination
·         Last Name
·         First Name
·         Social Security Number
·         Recipient Identification Number (RIN)
·         Date Requesting Medicaid Coverage Begin
·         Private Pay Conversion (Y/N)
 
Submit this list, via a Sharepoint site detailed in the May 16, 2019 provider notice on Advance Payments, no later than June 30, 2019. HFS will work with the Department of Human Services to obtain rejection letters which detail the reason for the rejection for each TAN.  Providers will be given the same opportunity for recourse as they would have received if notified timely. If the State determines that a TAN was rejected incorrectly, it will be processed.
 
The timeline for this process will be dependent upon the volume of requests, but it is expected to require a substantial amount of time to complete.
 
Questions regarding this bulletin may be directed to the Bureau of Long Term Care at
1-844-528-8444.
 
  
Doug Elwell
Medicaid Director
 
 

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