Contact For Service Notification (CFSN) Process
& APS CareConnection® Instructions for
Non-MaineCare CFSN

The Contact for Service Notification (CFSN) Review is an administrative submission of data which allows APS Healthcare to provide required data to DHHS. This data helps APS Healthcare and DHHS monitor and initiate quality improvement activities regarding waiting lists, unmet needs, and continuity of care.

1. CFSN for CI; Adult ACT; DLSS- Submitted by Providers or DHHS

1. CFSN is used to track consumer referrals/request for these services, and wait list for services.

2. CFSN for Adult PNMI- Submitted ONLY by DHHS.  Not Providers.

1. The CFSN is completed by DHHS staff only to update the record in CareConnection when consumers are approved for placement by DHHS.

3. CFSN for Children’s PNMI- Submitted ONLY by DHHS.  Not Providers.

1. The CFSN is completed by DHHS staff only to update the record in CareConnection when children are approved for placement by DHHS.

For CI, Adult ACT and DLS Services submit a Contact for Service Notification to APS Healthcare at the point that a consumer first contacts the provider for service.

• For MaineCare Members with current eligibility, use the Contact for Service Notification Authorization Type in APS CareConnection® with the regular service procedure code.

• For consumers who are Grant Funded or without current MaineCare eligibility, submit using the Initial Courtesy Review with the procedure code for “Non-MaineCare Contact for Service Notification” procedure code for the appropriate service.

1. If the member is assigned immediately to a service, with no waiting time, the provider may submit a Prior Authorization request, without first submitting a Contact for Service Notification.

2. In APS CareConnection®, on the Administrative page:

1. The “Start Date for Current Authorization Request” must be the date of the consumer’s first contact for service.

2. The “Date of Referral” is the date the consumer was first referred to your agency (it may be the same as the consumer’s first contact for service).

3. Make sure to select the “Location at Time of Referral”.

3. If the consumer is removed from the provider’s wait list without starting service, the provider will discharge the Contact for Service Notification (follow discharge process described later in this manual).

1. In the discharge submission, select appropriate items in the “Anticipated Stepdown Service”

2. In the “Plan for Transition Discharge” section note the names of other agencies that the consumer was referred to.

4. When the consumer is assigned in the provider’s service, the provider submits a Prior Authorization (PA) request and the Contact for Service Notification does not need to be discharged.

Using the Initial Courtesy Review to Submit a Contact For Service Notification for Grant Funded Consumers and Consumers without MaineCare Eligibility

Instructions for entering a Contact for Service Notification for a consumer without current MaineCare eligibility, using Authorization Type: Initial Courtesy Review

1. Begin at New Request tab.

• Enter MaineCare number (enter “0” if none yet available) and one other field.

• Click Verify.

• When Eligibility Info does not show current eligibility, click Add New Request.

• Record Case ID for future reference.

• Enter Member Information, and click Save and Continue

• Enter Guardian Information if applicable, and click Save and Continue to proceed to Administrative page.

• If Contact for Service Notification is not available for Authorization type, choose Initial Courtesy Review.

2. In APS CareConnection®, on the Administrative page:

• The “Start Date for Current Authorization Request” must be the date of the consumer’s first contact for service.

• The “Date of Referral” is the date the consumer was first referred to your agency. (It may be the same as the consumer’s first contact for service).

• Make sure to select the “Location at Time of Referral”

• Once this page has been completed, click Save and Continue to proceed to the next page

3. At the Requesting Agency page:

• Fill in the Name of the Agency

• Your Name and Phone number

• Click “yes,” to indicate that this agency is the treating provider

• Click Save and Continue

4. Click on the Services Requested Page

• Click Add New Procedure Request

• Choose ONLY one of the following Services (as appropriate):

CFSNH2015 - Non-MaineCare Contact for Service- Community Integration (CI)
CFSNCBB10 - Non-MaineCare Contact for Service- Adult ACT
CFSNH2017 - Non-MaineCare Contact for Service- Daily Living Support Services
CFSNRMI - Non-MaineCare Contact for Service- Adult PNMI
CFSNRTS - Non-MaineCare Contact for Service- Child PNMI

• Select frequency needed

• Choose the billing ID of the Provider who will be providing the service.

• Accept Default days (730 days) and units (1 unit). Click into the Service Length box and Tab down to calculate end date

• Click Save

• Click blue Submit to APS button

5. If the consumer is removed from the provider’s wait list without starting service, the provider will discharge this Initial Courtesy Review exactly per the instructions for discharging a Contact for Service Notification.

• In the discharge submission, select appropriate items in the “Anticipated Stepdown Service”

• In the “Plan for Transition Discharge” section note the names of other agencies that the consumer was referred to.

6. When the consumer is assigned in the provider’s service, this Initial Courtesy Review does not need to be discharged.