1.3.4 Responsibilities of the Medical Services Coordinator (MSC)

1.3.4 Responsibilities of the Medical Services Coordinator (MSC)

(Revised 12/09)

The medical services coordinator (MSC)

·  reviews referral information, and discusses with the counselor

o  problems encountered,

o  additional medical information needed, or

o  related medical questions;

·  confirms known comparable services and benefits, and seeks out other comparable services and benefits;

·  consults with the following as needed:

o  Consumer Procurement and Business Services (CPBS) physical restoration specialist (PRS),

o  program specialist for physical disabilities (PSPD), and

o  program specialist for comprehensive rehabilitation services (PSCRS)as needed;

·  informs the counselor of estimated costs for medical services before encumbering funds;

·  discusses with the provider or provider's staff the payment allowances for related medical services;

·  schedules services;

·  issues purchase orders;

·  communicates with the consumer, the counselor, and providers regarding ongoing services;

·  notifies the counselor and/or consumer of the date, time, location, and service provider for scheduled services;

·  provides documentation to the counselor of significant events in the medical-services process;

·  approves claims for payment after deduction of other payments;

·  processes the medical services encumbrance documents; and

·  maintains effective working relationships with DRS partnersDRS staff members and the medical community.;

·  recruits medical providers and consultants; and

·  serves as a resource to DRS field office staff members on coordinating consumer medical services.

Arranging for MSC Services

Use the following procedure to arrange for services of an MSC.

1.  determine whether an MSC is assigned to an area by phoning the regional office where services will be provided;

2.  if contacted by a service provider about services arranged in the MSC's area, refer the provider to the MSC;

3.  before the scheduled date of a service, delegate an action item to the MSC and provide the following information:

o  specific diagnostic, physical restoration, and/or rehabilitation facility services to be arranged;

o  DARS1517, Notice and Consent for Disclosure of Personal Information and, when a specific need is identified, a current DARS1514, Permission to Collect Information;

o  application for services (see DARS3490, Consumer Application Information, also available in the electronic case system);

o  current IPE;

o  initial case notes;

o  comparable benefits information, including a copy of the insurance card, if available;

o  for surgery services, DARS3101, Consultant Review (see 1.4.3 Regional Dental Consultant (RDC) Services for specific dental procedures that require RDC review);

o  for services requiring State Medical Director approval, relevant case note posted by Consumer Procurement and Business Services;

o  pertinent medical and psychological information; and

o  other pertinent information; and

4.  approve adequate funds to cover

o  the cost of the requested medical services, and

o  any unexpected complications.

Medical Services Arranged by the MSC

The MSC arranges all

o  hospital or ambulatory surgical center services for vocational rehabilitation (VR) and comprehensive rehabilitation services (CRS) consumers,

o  post-acute brain injury (PABI) services for VR and CRS consumers, and

o  evaluations and treatment provided by medical schools.

Procedures to Request Services of an MSC

Complete the following steps to request services of an MSC.

1.  Delegate an action item to the appropriate in-region MSC. If you are unsure of the MSC assignment, contact the regional office for guidance.

2.  Enter a case note stating the service to be arranged and the hospital or facility selected.

3.  Provide the following information to the MSC:

o  pertinent medical records;

o  DARS3101 Consultant Review (if applicable);

o  DARS3110 Surgery and Treatment (if applicable);

o  comparable benefits information, including a copy of the insurance card, Medicare or Medicaid documentation, etc.; and

o  prescriptions (if applicable).

Note: The MSC accesses the DARS3490, Consumer Application Information, the current Individual Plan for Employment (IPE), and pertinent case notes including necessary area manager and medical director approvals (if applicable) in the electronic case system if needed.

4.  Approve adequate funds to cover the cost of the requested medical services and any unexpected medical complications when notified by the MSC.

5.  If contacted by a medical provider about services arranged by the MSC, refer the provider to the MSC.

Note: To arrange out-of-region medical services, delegate an action item, enter a case note, and send the information to your home MSC. If you are unsure of your home MSC assignment, contact the regional office for guidance. The home MSC refers the request to the appropriate out-of-region service MSC for the coordination of the requested medical services.

1.3.5 Responsibilities of the Community Rehabilitation Program (CRP) Liaison Counselor

(Revised 12/08)

…