Waiver case management definition

Waiver case management means the process of assisting recipients to gain access to needed waiver and other state plan services in addition to medical, social, educational, and other services without regard to the funding source of the service.
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Examples of Waiver case management in a sentence

  • The following are services provided under the TBI/SCI Waiver: case management, personal care attendant service, environmental accessibility adaptation, specialized medical equipment and supplies, respite, and transition assistance.

  • The New Choices Waiver case management agency is responsible for receiving, reviewing, and responding to all incident reports.

  • Waiver case management may include contact with non-eligible individuals, that are directly related to identifying the eligible individual’s needs and care, for the purposes of helping the eligible individual access services; identifying needs and supports to assist the eligible individual in obtaining services; providing case managers with useful feedback, and alerting case managers to changes in the eligible individual’s needs.

  • The following are services that are provided under the IL Waiver: case management, personal care attendant service, environmental accessibility adaptations, specialized medical equipment and supplies, and transition assistance.

  • Services cannot be provided to NCW clients until the services (including amount, frequency and duration) are authorized by a New Choices Waiver case management agency representative in an approved comprehensive care plan.

  • Direct service providers may only claim Medicaid reimbursement for services that are ordered by the responsible New Choices Waiver case management agency and for which the provider has a current, signed service authorization form for the individual participant for whom the service is authorized.

  • Waiver case management service providers receive the existing case management rate in the Medi-Cal fee schedule.

  • Under DHCS, case management is provided by willing and qualified HCBS providers enrolled in Medi-Cal to provide Waiver case management services.

  • Waiver case management has a set rate, is prior authorized as part of the Community Support Plan and included under the HCBS budget, and is billed in 15 minute units.

  • Waiver case management The service of case management is required to be provided to individuals participating in HCBS waiver programs.

Related to Waiver case management

  • Case management means a care management plan developed for a Member whose diagnosis requires timely coordination. All benefits, including travel and lodging, are limited to Covered Services that are Medically Necessary and set forth in the EOC. KFHPWA may review a Member's medical records for the purpose of verifying delivery and coverage of services and items. Based on a prospective, concurrent or retrospective review, KFHPWA may deny coverage if, in its determination, such services are not Medically Necessary. Such determination shall be based on established clinical criteria and may require Preauthorization.

  • Targeted case management means services that assist a beneficiary to access needed 2 medical, educational, social, prevocational, vocational, rehabilitative, or other community services. The 3 service activities may include, but are not limited to, communication, coordination and referral;

  • Case manager means a Department of Human Services or Area Agency on Aging employee who assesses the service needs of an applicant, determines eligibility, and offers service choices to the eligible individual. The case manager authorizes and implements the service plan and monitors the services delivered.

  • Case management services means planned referral, linkage, monitoring and support, and advocacy provided in partnership with a consumer to assist that consumer with self sufficiency and community tenure and take place in the individual’s home, in the community, or in the facility, in accordance with a service plan developed with and approved by the consumer and qualified staff.

  • Utilization management section means “you or your authorized representative.” Your representative will also receive all notices and benefit determinations.

  • Base Management Fee means the base management fee, calculated and payable monthly in arrears, in an amount equal to one-twelfth of 1.00% of Equity.

  • Management Group means the group consisting of the directors, executive officers and other management personnel of the Borrower, Holdings or any Parent Entity, as the case may be, on the Closing Date together with (a) any new directors whose election by such boards of directors or whose nomination for election by the shareholders of the Borrower, Holdings or any Parent Entity, as the case may be, was approved by a vote of a majority of the directors of the Borrower, Holdings or any Parent Entity, as the case may be, then still in office who were either directors on the Closing Date or whose election or nomination was previously so approved and (b) executive officers and other management personnel of the Borrower, Holdings or any Parent Entity, as the case may be, hired at a time when the directors on the Closing Date together with the directors so approved constituted a majority of the directors of the Borrower or Holdings, as the case may be.