H06- 011 - Procedure

February 23, 2006

TO: / Home and Community Services (HCS) Region 4 Regional Administrator
Area Agency on Aging (AAA) PSA 4 Director
Home and Community Services (HCS) Region 5 Regional Administrator
Area Agency on Aging (AAA) PSA 5 Director
FROM: / Bill Moss, Director, Home and Community Services Division
SUBJECT: /
SSPS Provider Number for the Medicare/Medicaid Integration Project (MMIP/Evercare) For Use in CARE and Clarification on Communication Process with Evercare
Purpose: / To notify staff of the SSPS provider number for United Health Group (Evercare) for use when assigning them as the paid provider in CARE and to clarify the process staff and Evercare will use to effectively communicate client changes.
Background: / The Medicare/Medicaid Integration Project (MMIP) has been available to clients age 65 and older, living in King or PierceCounty since June 2005. This provider number has been available in CARE, but some staff were unaware of how to access it. Although Evercare has an SSPS provider number, MMIP is still paid through the MMIS system and not through SSPS. There is no SSPS payment code for MMIP.
What’s new, changed, or
Clarified / This MB notifies staff of the United Health Group (Evercare) SSPS provider number for use in CARE and outlines the procedure for communicating with Evercare staff.
ACTION: / To move an MMIP client’s CARE assessment to current status, go to the CARE Supports screen, open the provider list, and search:
  • By SSPS provider number: 546937; or
  • By provider name: United Healthcare Ins. Co. (Evercare)
Anytime you become aware of changes in a client’s address, telephone number, provider, and/or living situation (short or long-term), report them on the Financial/Social Service Communication Form (DSHS 14-443) and fax the form to Evercare Premier at 206-749-4341. You may use the “Comments” box for all changes not specifically listed on the form. Certain circumstances will prompt the need for an assessment. See the MMIP section of the LTC Manual for additional information on when to perform assessments on MMIP clients.
Evercare will fax a communication form to you, when changes occur.
Related
REFERENCES: / Financial/Social Communication Form (DSHS 14-443)
ATTACHMENT(S):
CONTACT(S): / Tiffany Sevruk, Prog. Manager Karen Fitzharris, Prog. Manager
(360) 725-2538 (360) 725-2446

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