Tools and Resources
Maximus reviews Level I PASRR screens; provides onsite, independent PASRR Level II mental health and intellectual/developmental evaluations.
Are you a licensed Behavioral Health Clinician or Registered Nurse with behavioral health experience interested in working as an assessor with the MS PASRR program? Contact our Recruiting team to learn more: Recruiting@maximus.com
8:00 am - 6:00 pm CST, M-F
- Quarterly Newsletter: Service Monitoring Insights, Resources & Reminders
Hello Mississippi Providers,
We hope this finds you well! We would like to take a moment to thank you all for being so available to both our staff, when they have questions regarding PASRR referrals, as well as our assessors, as they continue to navigate completing PASRR assessments telephonically. We realize this has been a challenging time for all involved and are grateful for the collaboration with each of you!
We have had several questions come up recently regarding our Service Monitoring process and the documents required when submitting a PAS or status change referral. We hope you will find the information below helpful in addressing some of the questions you may have.
Lori Crawford, MS PASRR Program Manager
What is Service Monitoring?
Service Monitoring is a thorough quality review of referrals with a completed Level II PASRR assessment (for those completed 3 months prior) to ensure all recommended specialized and rehabilitative services were/have been incorporated into the individual's care plan.
Here are the steps involved in the Service Monitoring process - our Maximus Quality Clinician:
1. Contacts the facility to verify the individual is still onsite or their stay was >15 days.
2. Faxes a notification letter to the facility submitter to notify of the Service Monitoring review and requests required supporting documents be faxed to Maximus. The provider has 15 days from date of receiving the first fax notification. If there is no response within 15 days, a second notification is faxed. There's an additional 15 days provided from that point for a response. Documents requested to be faxed include:
- The Maximus DBR form (found on the MS PASRR - Maximus provider website but also faxed with the notification from the Quality Reviewer)
- The individual's Plan of Care (POC) documenting the recommended specialized and rehabilitative services
- Psych evaluation
- MD notes
3. Once received, the Quality Reviewer reviews all documents to confirm inclusion of all recommended services.
4. If not included in the POC, the Quality Reviewer will work with provider to incorporate them into the POC.
5. Once the Service Monitoring process is complete, the Quality Reviewer will fax an outcome letter to the provider.
6. To be considered compliant with this process, all documents must be received no later than 15 days after receipt of the request. If there are no documents received after the first and second attempts, Maximus will notify the Mississippi Division of Medicaid of Service Monitoring non-compliance.
The Service Monitoring process is not required for any individuals who weren't admitted or were on site <15 days. Additional notification requests are faxed to the facility if no response is received within 15 days. It is possible a facility may be required to complete Service Monitoring for more than one referral within a month.
Our Maximus Quality Clinician is here to help with this process! Please don't hesitate to reach out to our MS PASRR Help Desk if you have any questions.
What documents are required for submission of a PAS or a Status Change Referral?
It is important that Maximus receives the required documents at the time of submission each referral. This allows Maximus clinicians to complete the process of reviewing the referrals in a timely manner.
Here is a list of required documents when submitting a referral:
- Pre-admission Screening (PAS) submitted via Envision: the PAS and the PAS summary, and the H&P (dated within the past year).
- Resident Review submitted via fax: Status Change form (please make sure this is signed and dated), the H & P (dated within the past year), MAR. Psych eval (if a recent one has been done), and 3-5 days of nursing notes.
Service Monitoring - Helpful Tips
- Make sure to check that all documents submitted are ONLY for the individual being referred.
- If submitting more than one referral at a time via the Maximus fax line, submit each referral and supporting documentation in separate faxes.
- Consider breaking up larger groups of pages in a fax or Envision into two faxes/attachments. This prevents files from being corrupted.
CONTACT: Reach Out to the Help Desk
- Quarterly Provider Newsletter: Best Practice Reminders
This quarter we've gathered some helpful guidance for the state's provider community. Please read on below for an important best practice tip regarding required assessment documents, as well as the program's Help Desk contact details.
BEST PRACTICE: Documents to Include with Assessments
There are several critical documents that should be included with each referral submission. A few items to keep in mind:
- When submitting a Level II, the Level of Care form must be included and completed in full.
- Be sure that the individual's History and Physical is included with every assessment. The H&P is vital for decisions regarding appropriate placement.
- Always include the practitioner certification and/or MD attestation when asking for an exemption or categorical approval.
Note: None of these documents should be more than one year old, when submitted.
SUPPORT: Contact the MS PASRR Help Desk
Have questions about the upcoming transition? Contact the MS PASRR Help Desk:
Ascend-MSPASRR@maximus.com | 833.967.2777