Adult Mental Health Enrollment/RDS
Instructions for APS CareConnection®

* This Information Only Applies to Certain Adult MH Section 17 Services

Enrollment & RDS Entry in APS CareConnection® for CI, ACT and ICM
Providers of MaineCare and Grant funded services for Community Integration (CI), Assertive Community Treatment (ACT), or Intensive Case Management (ICM) services will no longer be required to enter Enrollment and RDS information through e-net ME to EIS as of September 1, 2008. The information will be collected as part of the APS prior authorization and continued stay review process.  Starting September 1, 2008, all Enrollment and RDS information will be submitted only via APS CareConnection®.  Providers will discontinue all separate submissions of Enrollment and RDS information to DHHS, including existing batch uploads and online submissions through eNetME. 

Since these instructions apply to people with and without MaineCare, the term “consumer” will be used in place of the term “member”.

New CI, ACT & ICM Consumers: MaineCare consumers Newly Admitted to Service

• For those consumers new to service, the provider will use the same process that they have been using for the prior authorization request and the continued stay request with APS Healthcare.
• Providers are expected to align the submission of the continued stay request with the time of the ISP review.
• This will align the ISP/RDS and the continued stay review into one process.
• A RDS is required with each 90 day continued stay request. 
• It is acceptable for the continued stay request and the RDS to be submitted sooner than the due date for the next ISP review, if the provider has used up the authorized units of service.  For example, if the ISP is due 10/15, but the units are used up by 10/1, the continued stay request and RDS may be submitted 10/1.

Enrollment & RDS Instructions for APS CareConnection®
Contact for Service Notification
Submit a Contact for Service Notification to APS Healthcare at the point that a consumer first contacts the provider for service.

Instructions for completing the Contact for Service Notification in APS CareConnection® are at this link: http://www.qualitycareforme.com/MaineProvider_Update012309.htm

Prior Authorization (PA)

1. In APS CareConnection®, on the Member Information page:

   • This page will auto-populate for consumers with current MaineCare.

2. Guardian Information page:

   • Complete if appropriate.

3. Administrative page:

   • 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”.

4. Requesting Agency page:

   • Correct/update if needed.

5. Multiaxial Assessment page:

   • Make certain that the diagnosis fields are complete and demonstrate eligibility for Section 17 services.

6. Services Requested page:

   • Add services as appropriate.

7. Symptoms/Behaviors page:

   • Complete the Symptoms/Behaviors Summary to demonstrate eligibility for Section 17 services.

   • If available: In the Assessment Tool box, complete the LOCUS date completed, LOCUS composite score, level of care and Rater ID#.

   • Indicate Agency Involvement and Family/Social Involvement.

8. RDS page:

   • Complete to the best of your knowledge.

9. Additional Info page:

   • Include any other information relevant to consumer eligibility for Section 17 services.

Continued Stay Review (CSR)
In APS CareConnection® use the EXT function in the “Search Request” tab, from the most recent PA or CSR to create the CSR. Many/most fields entered in the previous request will populate into the new request.  When submitting a CSR for the purpose of aligning it with the consumer’s ISP, note in the request “Submitted to Align CSR with ISP Date”.

1. In APS CareConnection®, on the Member Information page:

   • This page will auto-populate for consumers with current MaineCare.

2. Guardian Information page:

   • Complete if appropriate.

3. Administrative page:

   • 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”.

4. Requesting Agency page:

   • Correct/update if needed.

5. Multiaxial Assessment page:

   • Make certain that the diagnosis fields are complete and demonstrate continued eligibility for Section 17 services and are consistent with the units of service requested.

6. Services Requested page:

   • Add services as appropriate.

7. Symptoms/Behaviors page:

   • Complete the Symptoms/Behaviors Summary to demonstrate continued eligibility for Section 17 services.

   • In the Assessment Tool box, complete the LOCUS date completed, LOCUS composite score, level of care and Rater ID#.

   • Indicate Agency Involvement and Family/Social Involvement.

8. Psychiatric Medications page:

   • Answer the questions and enter medications, including non-psychiatric medications, if available.

9. Clinical Indicators page:

   • Complete this page to show the current clinical presentation that is consistent with the number of units of service requested.

10. Treatment and Service page:

    • Complete this information.

11. RDS page:

    • Complete/Revise the ISP Status at the top of the page.

    • Complete/Update the RDS as appropriate.

12. Treatment Plan page and Goals

    • Complete all information, consistent with the consumer’s ISP.

13. Additional Required Reporting Data page:

    • Fully complete this information.

14. Transition Discharge Plan page:

    • Complete this information.

15. Additional Info page:

    • Include any additional information needed to demonstrate continued eligibility for Section 17 services and/or to demonstrate that the authorization request is consistent with the consumer’s need.

    • When submitting a CSR for the purpose of aligning it with the consumer’s ISP, note on this page “Submitted to Align CSR with ISP Date”.

Discharge
Discharge the consumer in APS CareConnection® within 5 days of the actual discharge from services.  In the “Search Services” tab, discharge only the most current request for this consumer, for the service that the consumer is discharged from (in other words, if the consumer is authorized for multiple services with your agency, only discharge them from the most recent request, from only the service they’ve ended.

1. Fully complete the discharge page.

2. Make sure to include the most recent LOCUS date completed, score and LOCUS level of care.

3. Enter anticipated discharge services and include the names of all agencies to which the consumer is referred/transferred.