Mississippi Administrative Code › Title 32 - Rehabilitation And Disabilities › Part 1 - Office of Special Disability Programs Policy Manual › PROCEDURE MANUAL › Section 32-1-21.0 - AUTHORIZATION OF SERVICES

Current through June 25, 2024
All services purchased for OSDP/IL clients will be authorized in AACE either simultaneously with, or prior to, such purchases. Only a Counselor or other member of the OSDP/IL professional staff will authorize the purchase of services. Authorizations will be issued only after a case has been placed in Application Status. Authorizations are to be signed by the Counselor in the top and bottom sections where indicated.
All authorizations for specialized medical supply (SMS), home modifications, and durable medical equipment (DME) must be forwarded to, and reviewed by, the District Managers prior to submission to the State Office for payment.
District Managers are responsible for making sure all authorizations are submitted with the necessary documentation including remittance forms, final inspections, a current envision sheet and approval to pay vendors.
Any authorization with missing documentation will be sent back to the District Manager for correction.
(Authorizations will not be held at the State Office due to missing or incorrect information.)
All authorizations for SMS will be reviewed by the counselor, and then forwarded to the vendor, on the first day of each month.
Authorizations for SMS should
not
be printed for more than one month at a time for the following reasons:
a)
				The client's needs may change; therefore, the authorization will need to be
				amended.
b) Change in counselors.
				If transferred, a counselor cannot amend another counselor's
				authorization.
c) Overstock in
				supplies. If client has too many supplies, the authorization should not be
				submitted for the following month; thus saving money.
The file copy will be placed in an outstanding authorization
				  holding file until the original copy is received back from the vendor, paid in
				  AACE or the authorization is cancelled.
All SMS payments must be paid in AACE then forwarded to State
				  Office by the 15th of each month. This includes the
				  original signed authorization and two copies.
When making payments in AACE, enter all corresponding invoice
				  numbers on the AACE payment page.
All authorizations for SMS or DME must include client's
				  Medicaid, Medicare and private insurance information directly on the
				  authorization. Remember:
a) Medicare
				will not pay for adult diapers or blue pads, so an Explanation of Benefits
				(EOB) is not needed.
b) State
				Medicaid will not pay for adult diapers or blue pads for anyone 21 and above so
				an EOB is not needed. Please check the client's date of birth.
c) State Medicaid will pay for catheters, leg
				bags, adult diapers, blue pads, etc for all clients under 21. Please check
				client's date of birth.
When using waiver funds, a copy of the approved Plan of
				  Care (POC) should be attached to Madison's copy of the authorization. Keep in
				  mind, the services must be approved on the most recent POC.
Check the dates of services rendered to the authorization
				  date. If the date of service is prior to the authorization date, verify that a
				  draft authorization was done, and note on the statement of account that a draft
				  is in the file.
If for some reason the authorization was not issued in the
				  electronic case file prior to or simultaneously with provision of services, the
				  following should occur:
a) An
				authorization must be initiated and placed in DRAFT status.
b) The DRAFT authorization should then be
				forwarded to the District Manager with an explanation as to why the
				authorization that was verbally authorized was not issued simultaneously in the
				electronic file, AACE. This explanation can be entered in the comments section
				of the authorization.
c) The
				District Manager then must review the authorization and explanation and either
				approve or disapprove the issuance of the authorization.
d) If the District Manager approves the
				authorization, the authorization can then be issued in AACE and mailed to the
				vendor.
e) When the
				Authorization/Statement of Account is signed and returned to the Counselor
				prior to submitting to finance, DRAFT in file must be entered/written on the
				authorization. The dates of services should be recorded as the actual date the
				service was provided which in most case is prior to the authorization begin
				dates.
When bills are received from vendors to verify the service
				  was authorized and this is a valid expense, the authorization number should be
				  recorded on the bill, and the Counselor should initial the bill.
When checking the status of a vendor payment, the counselor
				  must:
a) Check with his/her District
				Manager on the status of a vendor's payment;
b) Managers will check to see if the
				authorization was received by the State Office;
c) Managers can check with Finance after the
				above has been checked.