- TO:
- ALL COUNTY OFFICES
- FROM:
- ALYSON CAMPBELL, DIRECTOR
- SUBJECT:
- GUIDE TO INTERPRETING THE DA-124 INQUIRY SCREEN
DISCUSSION:
Recent review of MO HealthNet Vendor cases has prompted Program and Policy to issue this memorandum reminding staff of how to interpret and apply the information displayed on the IMNF screen.
Areas of concern that were found during the review were:
- Vendor payments authorized before the DA 124 assessment was completed
- Vendor payments authorized when information on the IMNF screen indicated that the individual did not meet the criteria for a vendor placement
- Vendor coverage continued after individual had left the facility.
- Vendor coverage authorized when screen displayed not in an appropriate placement
Errors of this type creates incorrect payments to vendor facilities and liabilities in the form of claims for the participants.
The IMNF screen was introduced to staff in IM-45 05/11/05 DA-124 SCREENS, IMNF. The DA-124 Inquiry Report Screen, I124, replaced paper copies of the DA-124 A/B, and C forms that had been sent to FSD from the Department of Health and Senior Services, Central Office Medical Review Unit (COMRU). COMRU reviews the information on the DA-124 forms that must be submitted on any individual entering a Medicaid certified bed in a nursing facility. COMRU determines if the individual is in need of the level of care provided by a nursing facility. If so, and the individual is not suspected of being Mentally Ill (MI), Mentally Retarded (MR), or Developmentally Delayed (DD), COMRU will enter information on I124 to be viewed by FSD staff. If the individual is suspected of being MI, MR, or DD, COMRU forwards the forms to the Department of Mental Health (DMH) for a Level II screening. DMH will notify COMRU if it is appropriate for the individual to be placed in a nursing facility. Then, COMRU will enter the information on I124 to be viewed by FSD staff.
Staff must access a menu screen by typing IMNF space DCN and pressing control to select the desired screening information that will be displayed on I124. The IMNF and I124 screens must continue to be used once cases are converted to FAMIS. Staff may access the IMNF screen from FAMIS by using a function key that displays at the bottom of the Facility and Placement Information Details (FMJ5) screen.
Attached is a quick guide developed to clarify the information entered by COMRU and to assist staff in identifying important fields on the I124 screen. To avoid payment errors and unnecessary claims for participants, staff must be careful to enter information from the I124 screen correctly in Legacy or in FAMIS.
To avoid duplicate DA-124s being sent, staff should instruct facilities to check with COMRU before sending a new one. Staff and facilities may contact the COMRU Unit at (573) 526-8609 or email Brenda.Seaton@dhss.mo.gov.
NECESSARY ACTION:
- Review this memorandum with appropriate staff.
AC/KE