Close Service Authorization

WINDOW OVERVIEW:

The Close Service Authorization window is used to close a service authorization. The authorization may be closed for a variety of reasons. Example: the service may no longer be needed or appropriate, the client may have chosen a different provider, etc.

Basic Rules:

  1. For all programs except CFS, JC, SA, SA/Med, SG, and SG/Med, the closed date must be on or after the current date.
  2. For CFS, JC, SA, SA/Med, SG, and SG/Med, the closing may be backdated within the following limits:
    1. The Program Service Type has a category of Adoption Services, Guardian Services, Out-of-Home Placement or Respite.
    2. The closing may be backdated to the last day of the month immediately prior to current month.
      Example: any date = or > than the last day of the preceding month. Example: if the current date is 09/25/2004, the Authorization may be closed using 8/31/04. This will prevent an erroneous auto payment for current month (since autoclaims run the last working day of a calendar month). It will provide the flexibility required by the autoclaim proration logic. If the service had actually ended several months before action was taken in the Service Authorization, Claims can be adjusted through the month immediately prior to current month.
    3. The (shortened) Service Auth end date must cover any Claim Items in paid, approved or authorized status. The system will not accept the backdated closure for any date that would leave a Claim Item Service End Date later that the Service Authorization end date.
  3. An Authorization for one of the above programs may also be closed with a future date.
  4. The system will update the end date on any rates to equal the Authorization end date. Rates with a begin date more than the new Service Authorization end date will be deleted. If a Claim Item in Preprint status has already been created for the period of time covered by the deleted Unit/Rate, the Claim Item will not be deleted.

FIELD DESCRIPTIONS:

Message:

To close a Service Authorization, enter the new end date according to the following rules.

1. Authorizations for Out of Home Placement services, Respite services, Adoption Services, or Guardian Services covered by CFS, JC, SA, SA/Med, SG, or SG/Med may be closed on or after the last calendar day of the month immediately prior to the current month.

2. Authorizations for all other services must be closed on or after the current date.
The system will change the end date on any rates to be the same as the Authorization end date. Any rates scheduled to begin after the Authorization ends will be deleted.
If the Mailed 'Notice of Discontinued Service Authorization' will reach the provider after the closure date, please give the provider verbal notification.

New End Date: Enter the end date (MM-DD-YYYY).

Check for system recalculation of units and balances: Check this box to have the system do the recalculation.

ACTION BUTTONS:

Select the OK button to save the changes.
Select the Cancel button to close the window without changing the information.

(02-2005)