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Prior Authorization
1. Prior Authorization The Ohio Dept. of MRDD www.mrdd.ohio.gov Division of Medicaid Development & Administration Phone: (614) 644-7747 FAX: (614) 752-5303 Contact: [email_address] Last Revision Date: 11-20-07 Next
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10. PA - Simplified ISP Development Team discusses needs & waiver services Individual/guardian believe services above DDP range CB and Team believe service needs are above DDP range Service Plan Budget is developed CB Advises of PA Possibility Next Overview Due Process Index Submission Support Topics The Review Hints Last viewed
11. PA - Simplified Individual/guardian submits PA request to State CB assists in PA request & submits on behalf of Individual/Guardian MRDD receives request and notifies CB CB assists ind/guar with IRF application CB prepares and submits complete request packet to MRDD Next Overview Due Process Index Submission Support Topics The Review Hints Last viewed
12. PA - Simplified MRDD reviews packet MRDD requests clarification from CB ODMRDD issues Yes determination ODMRDD Determination CB submits needed info ODMRDD forwards to JFS for review Next Overview Due Process Index Submission Support Topics The Review Hints Last viewed
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36. CB Approval Criteria To Table of Contents This form helps the ODMRDD reviewer know the extent of the County Board’s support that the individual meets critical criteria to qualify for prior authorization of IO waiver services. Please be sure your response on this form relates to the PA request rather than to the alternative options. Section 1 From the ODJFS rule 5101:3-41-12 on prior authorization and all are required to be eligible for approval Section 2 From the ODMRDD rule 5123:2-9-06 Waiver Methodology and in addition to all Section 1 criteria, at least one of the 7 conditions must apply to be eligible for approval by the ODMRDD To Page 2… Next Overview Due Process Index Submission Support Topics The Review Hints Last viewed
37. CB Approval Criteria Check the box if the County Board feels that needs can be met within the range determined by the ODDP and it disagrees with the PA request. The County Board should state in narrative form its reasons for supporting or not supporting the PA request. Printable form Page 2 Next Overview Due Process Index Submission Support Topics The Review Hints Last viewed
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68. On-Site/On-Call Overview Due Process Index Submission Support Topics The Review Hints Last viewed Next
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70. Alone Time Assessment Overview Due Process Index Submission Support Topics The Review Hints Last viewed Next
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73. Index to Topics Overview Due Process Index Submission Support Topics The Review Hints Last viewed First slide What not to send Timeline Table of Contents Rules Responsible Parties Purpose Required Criteria Forms Forms-printable Flowchart Budget Due Process Delays & errors to avoid CBMRDD CB Submission CB PA Authorization CB Checklist form CB approval form Best Practices Behavior Add-On Alone Time 20/20 PA Rules Overview On-Site/On Call ODMRDD ODJFS ODDP Mid-span Changes Medical Add-On Key Points Individual Request form (IRF) Individual Service Plan Individual Guardian Hints
![Prior Authorization The Ohio Dept. of MRDD www.mrdd.ohio.gov Division of Medicaid Development & Administration Phone: (614) 644-7747 FAX: (614) 752-5303 Contact: [email_address] Last Revision Date: 11-20-07 Next](https://image.slidesharecdn.com/prior-authorization-1213281133484642-8/85/Prior-Authorization-1-320.jpg)
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