Mississippi Administrative Code
Title 23 - Division of Medicaid
Part 222 - Maternity Services
Chapter 2 - Perinatal High-Risk Management and Infant Services
Rule 23-222-2.3 - Documentation Requirements
Universal Citation: MS Code of Rules 23-222-2.3
Current through September 24, 2024
A. To qualify for reimbursement, a case file with adequate documentation must be maintained for each participant receiving Targeted Case Management (TCM) through the Perinatal High-Risk Management/Infant Services System (PHRM/ISS) program. Each TCM case file must, at a minimum, contain:
1. The name
of the individual, as well as other personal information including, but not
limited to:
a) Date of birth and Medicaid ID
number,
b) Expected date of
delivery,
c) Date when prenatal
care began,
d) Name of primary
provider,
e) Delivery
date,
f) Delivery method,
g) Birth control plan chosen by
participant,
h) Date(s) of
postpartum visit(s) with medical provider,
i) Date of postpartum home visit with
Extended Service RN,
j) Birth
weight, and
k) Dates of EPSDT
well-child visits
l) Release of
information consent;
2.
The dates and other information regarding case management services including:
a) Medical risk screening form including, but
not limited to:
1) Date screening was
performed,
2) Name of
person/provider completing medical risk screen, and
3) Specific risk factors identified
b) Referral date and referral
source,
b) Enrollment
date,
c) Assessment
dates;
3. The name of the
provider agency (if relevant) and the person providing the case management
service.
a) Participant transfer to new TCM
provider including, but not limited to:
1)
Reason for transfer to new TCM provider,
2) Transfer consent form signed and dated by
participant, and
3) Transfer
notes;
4. The
nature, content, units of the case management services received and whether
goals specified in the care plan have been achieved.
a) Screening/assessment results,
b) Long and short-term goals with time frame
for completion,
c) Planned
interventions,
d) Outcome of
interventions,
e) Dates and reasons
for review and/or revision, and
f)
Discharge plans and case closure documentation including, but not limited to:
(1) Reason for closure,
(2) Services provided and outcomes, including
any unmet goals and/or ongoing needs,
(3) Referrals to providers and other
resources to address unmet goals and ongoing needs, and
(4) Notification to participant and primary
care provider(s) regarding case closure and any post case closure referrals
that have been made;
5. Whether the individual has declined
services in the care plan and the individual's signature declining the
service.
6. The need for, and
occurrences of, coordination with other case managers, including:
a) Documentation of referrals:
(1) Date of referral,
(2) Name of provider/entity to whom the
referral was made,
(3) Reason for
referral, and
(4) Outcome of
referral(s);
b) Case
Conference including, but not limited to:
(1)
Date of case conference,
(2) Case
conference attendees, and
(3) Case
conference notes including interdisciplinary team recommendations/plans and any
revisions to the POC;
7. A timeline for obtaining needed
services.
8. A timeline for
reevaluation of the plan.
Miss. Code Ann. §§ 43-13-121, 43-13-117, 43-13-118, 43-13-129; 42 CFR § 441.18.
Disclaimer: These regulations may not be the most recent version. Mississippi may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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