Home and Community
Based Services
Big Sky Bonanza Manual
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TABLE OF CONTENTS |
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INDEXES |
DATE REVISED |
001 |
Index |
8/11/10 |
Alpha Subject Index |
8/11/10 |
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Definitions |
8/01/08 |
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Abbreviations/Acronyms/Initials |
8/01/08 |
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400 |
ELIGIBILITY FOR SERVICES |
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Big Sky Bonanza (BSB) Eligibility Requirements |
8/01/08 |
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Big Sky Bonanza (BSB) Training Requirements |
8/01/08 |
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Big Sky Bonanza (BSB) Enrollment |
8/11/10 |
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404 |
Entrance/Discharge into Medicaid and HCBS Instructions & Form (DPHHS-DD/SLTC-55) |
8/11/10 |
Termination of Services |
8/01/08 |
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Medically Needy Billing Procedures |
8/01/08 |
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Transferring Back to the Traditional HCBS |
8/01/08 |
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Residency Requirements |
8/01/08 |
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Out- Of- State Services |
8/01/08 |
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Retainer Reimbursement Days |
8/01/08 |
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500 |
BIG SKY BONANZA SCREENING REQUIREMENTS |
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Mountain-Pacific Quality Health (M-PQH) Initial Evaluation |
8/11/10 |
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Mountain-Pacific Quality Health (M-PQH) Reevaluations |
8/01/08 |
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503 |
BSB Consumer Profile (DPHHS-SLTC-155 ) Instructions and Form |
8/01/08 |
Level of Care Preadmission Criteria |
8/01/08 |
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505 |
Request for Level of Care (DPHHS-SLTC-85) Instructions & Form |
8/01/08 |
Screening Determination (DPHHS-SLTC-61) |
8/01/08 |
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600 |
ADMINISTRATIVE REQUIREMENTS |
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Consumer-Directed Provider Eligibility and Responsibility |
8/01/08 |
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Traditional Waiver Provider Eligibility and Responsibility |
8/01/08 |
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Consumer-Directed Provider Enrollment |
8/01/08 |
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Traditional Waiver Provider Enrollment |
8/01/08 |
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Consumer-Directed Provider Payment Requirements |
8/01/08 |
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Traditional Waiver Provider Payment Requirements |
8/01/08 |
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Consumer-Directed Provider Payment Processing |
8/11/10 |
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Traditional Waiver Provider Payment Processing |
8/11/10 |
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Consumer-Directed Reimbursement Methodology |
8/01/08 |
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Traditional Waiver Provider Reimbursement Methodology |
8/01/08 |
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Consumer-Directed Provider Licensure Requirements |
8/01/08 |
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Traditional Waiver Provider Licensure Requirements |
8/01/08 |
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Independence Advisor (IA) Requirements |
8/01/08 |
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Financial Manager (FM) Requirements |
8/01/08 |
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Quality Improvement Process |
8/11/10 |
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616 |
Provider Prepared Standards, Department Review Standards-IA |
8/11/10 |
617 |
Provider Prepared Standards, Department Review Standards-FM |
8/01/08 |
699-1 |
CMS 1500 Claim Form & Instructions |
8/11/10 |
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700 |
SERVICES |
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Covered Services |
8/01/08 |
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Service Limitations and Exclusions |
8/01/08 |
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Adult Day Health |
8/01/08 |
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Chemical Dependency Counseling |
8/01/08 |
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Community Support Services |
8/01/08 |
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Consumer-Directed Goods and Services |
8/01/08 |
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Environmental Accessibility Adaptations |
8/01/08 |
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Financial Management (FM) Services |
8/01/08 |
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Habilitation Aide |
8/01/08 |
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Independence Advisor (IA) Services |
8/01/08 |
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Nutrition and Dietitian Services |
8/01/08 |
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Occupational Therapy |
8/01/08 |
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Personal Emergency Response System (PERS) |
8/01/08 |
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Physical Therapy Services |
8/01/08 |
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Private Duty Nursing |
8/01/08 |
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Respiratory Therapy |
8/01/08 |
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Specialized Medical Equipment and Supplies |
8/01/08 |
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Speech Therapy and Audiology Services |
8/01/08 |
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HCBS Administrative Rules of Montana (ARM) |
8/01/08 |
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BSB Procedure Codes and Rates .xls |
8/01/08 |
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Directory of Assistive Technology |
8/01/08 |
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Consumer Equipment Recycling Agreement |
8/01/08 |
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800 |
SUPPORT BROKERAGE SYSTEM |
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Independence Advisor Checklist and Monthly Contact Form |
8/11/10 |
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FM Checklist and Reevaluation Form (DPPHS-SLTC 223) |
8/11/10 |
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IA Record Requirements |
8/11/10 |
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FM Record Requirements |
8/11/10 |
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IA Provider Termination and Transition |
8/01/08 |
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FM Provider Termination and Transition |
8/01/08 |
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Transfer of consumers |
8/01/08 |
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Medicaid Fraud and Abuse |
8/01/08 |
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899-1 |
Intake Instructions and Form (DPHHS-SLTC-136) |
8/01/08 |
899-2 |
Discharge Instructions and Form (DPHHS-SLTC-137) |
8/01/08 |
899-3 |
Incurment Instructions and Form (DPHHS-SLTC-131) |
8/01/08 |
Letter of Notification (DPHHS-SLTC-144) |
8/01/08 |
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899-5 |
Independence Advisor Oversight Instructions and Form (DPHHS-SLTC-221) |
8/01/08 |
899-6 |
Monthly Individual Spending Report & Instructions |
8/11/10 |
General Utilization |
8/11/10 |
900 |
Section – Consumer Section |
Big Sky Bonanza (BSB) Consumer-Directed Waiver Training Manual |
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Consumer Agreement and Form (DPHHS-SLTC-201) |
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Personal Representative Agreement and Form (DPHHS-SLTC-203) |
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Consumer and Independence Advisor (IA) Agreement and Form (DPHHS-SLTC-205) |
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Consumer and Financial Manager (FM) Agreement and Form (DPHHS-SLTC-207) |
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Person-Centered Planning Process |
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Support Services and Spending Plan (SSSP) Introduction |
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Preplanning Documents |
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Consumer-Directed Services List and Definitions |
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Traditional Waiver Services List and Definitions |
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Support Services and Spending Plan (SSSP) Development |
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911a |
Support Services and Spending Plan (SSSP)--Form and Sample (DPHHS-SLTC-209) |
Big Sky Bonanza (BSB) Budget |
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Monthly Spending Reports |
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Health Care Professional Authorization and Form (DPHHS-SLTC-213) |
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Sample Health Care Professional Letter |
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Risk Prevention, Assessment, Management, and Form (DPHHS-SLTC-250) |
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Risk Negotiation Agreement Process and Form (DPHHS-SLTC-251) |
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Emergency Backup Plans |
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Support Services and Spending Plan (SSSP) Approval |
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Support Services and Spending Plan (SSSP) Amendments |
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Amendment Process Flowchart |
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Amendment-Contingency Funds Form and Instructions (DPHHS-SLTC-219) |
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Contingency Funds |
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Independence Advisor Six-Month Oversight |
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Financial Manager Six-Month Reevaluation |
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Support Services and Spending Plan (SSSP) Annual Update |
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Reserved |
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Consumer Purchase Invoice and Sample Form |
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Paying Legally Responsible Relatives |
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Serious Occurrence Report (SOR) and Form |
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Co-Employer Responsibilities |
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Employer and Employee Relationship, Agreement, and Form |
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Service Delivery Record (SDR) and Form |
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Medicaid Fraud and Abuse |
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Corrective Action Plan (DPHHS-SLTC-230) |
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Corrective Action Plan form |
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Complaint Process and Form |
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Fair Hearings |
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Program Compliance Tool Form and Instructions (DPHHS-SLTC-999) |
