ELIGIBILITY AND ENROLLMENT UNIT PROCEDURES

DEPARTMENT OF HEALTH AND SOCIAL SERVICES
DIVISION OF SUBSTANCE ABUSE AND MENTAL HEALTH

LONG TERM CARE SYSTEM

1. CLINICAL ELIGIBILITY DETERMINATION
2. DETERMINATION DENIALS AND APPEALS
3. ENROLLMENT
4. UTILIZATION REVIEW
5. TRANSFERS BETWEEN PROVIDERS
6. ANNUAL RE-DETERMINATION
7. REQUESTS FOR RE-DETERMINATION
8. RE-DETERMINATION DENIALS AND APPEALS
9. DISENROLLMENT

Last Updated: Friday November 03 2006