MO HealthNet for the Aged, Blind, and Disabled

0815.020.05 Verification of Medical Certification

IM-#33, March 29, 2012

FSD must verify that the applicant or participant is medically certified by viewing the DA-124 Inquiry Report screen. The DA-124 Inquiry Report screen is accessed from the Facility Placement Detail screen (FACPLACE or FMJ4) in FAMIS (F14=I124) or from the screen IMNF. Print a copy of the DA-124 Inquiry Report screen and file in the case record because the results are only available on the DA-124 Inquiry Report screen for 16 months. Enter the determination on the Facility and Placement Information Details (FACPLACE or FMJ4) screen in the DA-124A/B Level of Care field.  See the FAMIS User Guide FACILITY AND PLACEMENT INFORMATION DETAILS.

NOTE: FAMIS will not display any outstanding verification for Level of Care on the Outstanding Verification screen (OUTVERF or FM3M). Level of care is not information the claimant can supply. Eligibility Specialists must set a Reminder in FAMIS to check for the Level of Care Determination on the DA-124 Inquiry Report screen. Set Reminders in FAMIS to track pending actions:

  • 30 days from the date of entry into the facility to determine if the DA-124 certification is available, if not;
  • at 10 day intervals check the IMNF screen until the information is available on the I124 screen.

Exception: For a child under age 21 who is receiving inpatient psychiatric services, FSD must obtain a copy of the IM-71 Certification of Need for Psychiatric Services form. See Section 0815.055.00.