waiver support application · 2020. 9. 21. · waiver support application – autism user training...

AUTISM (AUT) USER TRAINING MANUAL

Last Updated: April 2019

Waiver Support Application

State of Michigan Department of Health and Human Services

State of Michigan Department of Health and Human Services Waiver Support Application – Autism User Training Manual

Table of Contents

1 Introduction .................................................................................1

1.1 About the Application .................................................................. 1

1.2 Requesting AUT Access ................................................................ 2

1.3 Accessing the AUT Application ..................................................... 3

1.4 Move to My Work Queue ............................................................. 6

1.5 Mozilla Firefox Warning ............................................................... 7

2 Creating a Case .............................................................................8

2.1 Create the Case ............................................................................ 8

2.2 Verify and Complete Enrollment Details .................................... 12

2.3 Enter Evaluation Details ............................................................. 14

2.4 Enter Case Comments ................................................................ 17

2.5 Submit Initial Enrollment for Approval ....................................... 18

3 Searching for a Beneficiary .......................................................... 19

4 Recording Final Enrollment Approval .......................................... 21

4.1 Verify Enrollment Details ........................................................... 21

4.2 Record Decision .......................................................................... 23

4.3 Record Initial Enrollment Final Approval .................................... 25

5 Entering the Individual Plan of Service ........................................ 26

6 Entering Telepractice Authorization Details ................................. 30

7 Maintaining Case Details ............................................................. 33

7.1 View Current Case Details .......................................................... 33

7.2 Maintain Enrollment Status ....................................................... 35

7.3 Maintain Evaluation Details ....................................................... 38


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7.4 Maintain IPOS ............................................................................ 43

7.5 Add Period of Inactivity .............................................................. 48

7.6 Record Approval of Case Updates .............................................. 50

7.7 Delete a Record .......................................................................... 52

8 Ending Eligibility ......................................................................... 53

9 Performing Case Transfers .......................................................... 55

10 Generating Reports ..................................................................... 59

11 Performing AUT Administrative Functions ................................... 61

11.1 Assign User Roles ..................................................................... 61

11.2 Bulk Update ADOS Scores ........................................................ 65

11.3 Use Autism Admin Tools .......................................................... 67


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1 Introduction

1.1 About the Application

The Waiver Support Application (WSA) is the enrollment, maintenance, and management tool for the following waivers and programs: Autism (AUT), Children’s Waiver Program (CWP), Habilitation Supports (HAB), Health Home Benefit (HHB), Opioid Health Home (HHO), Integrated Care Organization (ICO), MI Care Team Health Home (MIC), and Serious Emotional Disturbance (SED).

The Autism Benefit program is housed within the WSA. Security roles determine a user’s access level and depend upon whether the user is a Community Mental Health (CMH) user, a Prepaid Inpatient Health Plan (PIHP) user, or a Michigan Department of Health and Human Services (MDHHS) user. AUT roles include:

AUTCMH = CMH users, Managed Care Provider Network (MCPN) users, and core providers

AUTPIHP = PIHP users

AUTAdmin = MDHHS administrator

The PIHP user creates the case, verifies the initial enrollment information, enters evaluation details, and submits the case to MDHHS for final review and authorization. Upon MDHHS authorization the case becomes live/current case data in the AUT application, signaling commencement of Autism Benefit enrollment and payments. While not required for MDHHS initial enrollment authorization, the PIHP or CMH user enters the Individual Plan of Service (IPOS) details as soon as possible after case creation.

Each AUT security role has an associated work queue. The work queue operates as a task list for the specific role; access is limited by role security and assigned PIHP/CMH. A case must reside in the work queue matching the user’s security role in order to enable functionality. For example, a CMH user can only modify/approve a case when the case resides in the ‘CMH’ work queue. A PIHP user can only modify/approve a case when the case resides in the ‘PIHP’ work queue. Finally, an MDHHS user can only modify/approve a case when the case resides in the ‘DHHS’ work queue.

PIHP User

Creates Case

MDHHS User

Approves Initial Enrollment

PIHP or CMH User

Enters IPOS


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1.2 Requesting AUT Access The Autism Benefit (AUT) program is housed within the WSA. All users request access to AUT by completing the WSA-AUT access request form, which is located in the Database Security Application (DSA). Both the WSA and the DSA are accessed through the State of Michigan (SOM) single sign-on portal, called MILogin*. Users must first request secure access to both applications (WSA and DSA) using MILogin. When access is approved, the user receives an email notification and the WSA Waivers link or Database Security Application (DSA) link appears on the MILogin Home page accordingly. Users then request functional access by completing the WSA-AUT access request form within the DSA. This process determines the user’s security role (i.e., AUTCMH, AUTPIHP, AUTAdmin). Upon submission, the WSA-AUT access request progresses through a review and approval cycle. Requests must be marked approved prior to the user’s WSA-AUT security role being granted. The user’s security role must be manually assigned before access to any Autism Benefit data is granted.

IMPORTANT: Users must have a MILogin account before they can complete these steps. Please reference the MILogin training materials for instruction.

Please reference the training materials within the DSA for all DSA instruction.

* If experiencing any issues with MILogin, please contact the SOM Client Service Center: 517-241-9700 -or- 800-968-2644.


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1.3 Accessing the AUT Application

Note: Users access MILogin one of two ways.

MDHHS users/contractors with a michigan.gov email use https://miloginworker.michigan.gov

All others use https://milogintp.michigan.gov

Complete the following steps to access the AUT application:

1. Log into MILogin. The MILogin Home page displays.

2. Click WSA Waivers (Figure 1.3.1). The WSA Waivers Terms & Conditions display.

Figure 1.3.1: MILogin Home

3. Review the WSA Waivers Terms & Conditions and click Acknowledge/Agree (Figure 1.3.2).

Figure 1.3.2: WSA Waivers Terms & Conditions

https://miloginworker.michigan.gov/

https://milogintp.michigan.gov/


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4. (Users outside SOM network) The Multi-Factor Authentication page displays (Figure 1.3.3).

Every 24 hours, users outside the SOM network are required to perform an additional security measure called multi-factor authentication (MFA).

Note: MFA lasts for 24 hours.

If a user logs into WSA at 9am on a Tuesday, the MFA will last until 8:59am Wednesday. If the user logs out or “times out” of WSA and logs back in prior to the end of that 24-hour period, MFA will not need to be performed again.

However, if the user logs out or “times out” of WSA and does not log back in prior to the end of that 24-hour period, MFA will need to be performed again.

Figure 1.3.3: Multi-Factor Authentication (users outside SOM network only)

a. To satisfy MFA, perform one of the following actions:

i. Click Text Message. MILogin texts a passcode to the mobile phone number you provided when you created your MILogin account. Enter the code in the Passcode field that displays, and click Submit.

ii. Click Register Device. MILogin texts instructions to the mobile phone number you provided. Follow the instructions to register your mobile phone and begin generating your own passcodes. Enter your generated code into the Passcode field that displays and click Submit.

iii. Click Phone Call Back. MILogin calls you at the work phone number you provided. Answer the call, listen to the brief message, and press any key on your phone keypad.


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iv. Click Email. MILogin emails a passcode to the email address you provided. Enter the

code in the Passcode field that displays and click Submit.

b. Upon completion, MILogin automatically continues logging you in.

5. The WSA Home page displays (Figure 1.3.4).

Figure 1.3.4: WSA Home

Note: The first time you access WSA Waivers, the Demographic Form displays (Figure 1.3.5). Complete the fields and click Update; an email is sent to the MDHHS Administrator prompting them to assign your AUT security role.

Appropriate system functionality is not enabled until your security role has been manually assigned.

Figure 1.3.5: Demographic Form


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1.4 Move to My Work Queue

Once an Autism Benefit initial enrollment has been approved (i.e., is an open case), it does not initially reside in any particular work queue; the Work Queue displays a ‘Completed’ value. Users click the Move to my Work Queue button (Figure 1.4.1) to pull the case into their work queue and enable the modify functionality. An instance of ‘pending’ data is created, allowing the user to add/edit/delete case information and move it through the approval cycle without affecting the current live production case data; this pending instance runs parallel to the existing live production data. Upon appropriate approval, the production data is overwritten with the updated/approved data, making the ‘pending’ data the new live production case data that all users see.

Figure 1.4.1: Move to my Work Queue

Note: Information displayed in the production system always reflects the most current live case information.

To assist users, the AUT application provides cues to help differentiate between the pending instance and the production system. Upon initiating a new pending instance, the Pending button is disabled. This allows the Production button to remain active and available for selection.

Upon accessing the production system, the Production button is disabled. This allows the Pending button to remain active and available for selection. Changing between the two views requires only one click.

Note: Data displayed in the pending instance may mirror the live production data; it will differ during initial enrollment (no production data exists until MDHHS approval) and if modifications have been made but not yet approved.


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1.5 Mozilla Firefox Warning ATTENTION Mozilla Firefox users: To ensure optimal AUT application performance, complete the following.

1. Access Mozilla Firefox.

2. In the address bar, enter about:config.

3. Press the keyboard Enter key.

Note: A “This might void your warranty!” message may display. Click I’ll be careful, I promise! to continue.

4. Locate dom.allow_scripts_to_close_windows in the Preference Name list.

Note: Enter “dom.allow” in the Search field to easily locate.

5. Double-click the dom.allow_scripts_to_close_windows line to update the Value to ‘true’; the default Value is ‘false’.

Note: The use of Internet Explorer is highly recommended for accessing the AUT application; even after performing the above steps, some application links may not work with Mozilla Firefox.


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2 Creating a Case

After receiving a referral and completing diagnostic testing the PIHP user creates the case, enters the diagnostic classification and evaluation details, and submits the case to the MDHHS administrator for review and authorization. The MDHHS administrator reviews the initial enrollment details, indicates the eligibility decision, and records final authorization (please reference 4 Recording Final Enrollment Approval for additional information). Upon MDHHS authorization the case becomes live data in the AUT application, signaling commencement of Autism Benefit and payments.

Note: The Autism application maintains a record of all referrals, including those where the family is not interested in Autism Benefit services. In these cases, complete only the steps in 2.1 Create the Case, then in 2.5 Submit Initial Enrollment for Approval select ‘Not Interested’ (instead of ‘Approve’) and submit the referral for MDHHS review.

* All steps are required for all other referrals, including those not meeting medical necessity criteria.

Note: The IPOS, while not required for MDHHS initial enrollment authorization, must be entered as soon as possible after case creation. Please reference 5 Entering the Individual Plan of Service for more information.

2.1 Create the Case

Complete the following steps to create a new Autism Benefit case:

1. Perform the steps in 1.3 Accessing the AUT Application.

2. Select Persons from the Person sub-menu (Figure 2.1.1). The Person List page displays.

Figure 2.1.1: Person – Persons

3. Enter the individual’s Medicaid ID in the Beneficiary ID field (Figure 2.1.2), or enter the individual’s name in the Name field.

Note: When searching by Name enter just last name, or use the format: last name, first name (include the comma).

4. Click Filter. Verify an ongoing Autism Benefit case does not already exist for the individual.


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Figure 2.1.2: Person List

Note: If an Autism Benefit case exists please reference 5 Entering the Individual Plan of Service , 6 Entering Telepractice Authorization Details, or 7 Maintaining Case Details.

5. Upon confirming an Autism Benefit case doesn’t already exist, click Add AUT Case (Figure 2.1.3). The Case Search page displays.

Figure 2.1.3: Person List

6. Enter the individual’s Medicaid ID or MIChild ID (Figure 2.1.4).

7. Click the associated Search. Matching records display.

Figure 2.1.4: Case Search


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8. Click Add Case (Figure 2.1.5). The message “This will add a new case for this person. Are you

sure this is what you wish to do?” displays.

9. Click OK. The Person Maintenance page displays.


10. In the PIHP/CMH list (Figure 2.1.6), select the appropriate PIHP and CMH combination.

11. Enter the date the referral was received in the Referral Date field.

12. Click Save. The message “A new case will be created. This cannot be undone. Are you sure this is what you wish to do?” displays.

13. Click OK. The case opens, defaulting to the Status tab.

Figure 2.1.6: Person Maintenance

Note: A bold ‘P’ displays on any tab containing pending case information (Figure 2.1.7); all pending data must be approved.


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Figure 2.1.7: Status


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2.2 Verify and Complete Enrollment Details

Note: The End Date defaults to the date one day prior to the individual’s 21st birthday, however the Begin Date remains blank. When MDHHS authorizes the initial enrollment, indicating the beginning of Autism Benefit eligibility, the Begin Date automatically populates with the authorization approval date.

Complete the following steps to verify and complete the Autism Benefit enrollment details:

1. Perform the steps in 2.1 Create the Case.

Note: If necessary, complete the steps in 3 Searching for a Beneficiary to locate the beneficiary’s enrollment details.

2. On the Status tab, click Modify Status (Figure 2.2.1). The enrollment detail fields enable.


3. Review the enrollment details (Figure 2.2.2).

4. If the determination of diagnosis was conducted by a qualified licensed practitioner, select the Practitioner Diagnosed check box (checked = Yes).

5. Enter Comments as necessary.

6. Click Save.


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Figure 2.2.2: Status – modify mode


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2.3 Enter Evaluation Details

Note: Due to a January 1, 2016 policy change, data requirements for evaluations with a start date before January 1, 2016 differed from evaluations with a start date on or after January 1, 2016. Please reference the Autism Evaluation Data Entry Guidelines for additional information.

Complete the following steps to enter the diagnostic evaluation information:

1. Perform the steps in 2.2 Verify and Complete Enrollment Details.

2. Click the Evaluation tab (Figure 2.3.1).

3. Click Modify Evaluation. The Action links update to include an ‘add’ option.

Figure 2.3.1: Evaluation

4. Click Add Evaluation (Figure 2.3.2). The Add New Evaluation fields appear.

Figure 2.3.2: Evaluation – modify actions

5. Enter the date the most recent evaluation began in the Initial Evaluation Start Date field (Figure 2.3.3) (must be on or before the current date, but no more than 364 days prior to the current date).

Note: If the evaluation was completed over multiple days, enter the date the evaluation began (e.g., if the evaluation occurred 03/02/2019 and 03/03/2019, enter 03/02/2019).

6. In the ADOS-2 Classification list, select the diagnostic classification per the evaluation results.

Note: If the child does not meet medical necessity criteria, select ‘Not Qualified’ in the ADOS-2 Classification list and again in 2.5 Submit Initial Enrollment for Approval.

7. In the ADOS-2 Module list, select the module used during the evaluation.

8. Enter the ADOS-2 Overall Total Score.


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9. Select the appropriate Impairment in Social Communication & Social Interaction. Lack of:

check box(es); select all that apply.

10. Select the appropriate Restricted, repetitive and stereotypical patterns of behavior, interests and activities check box(es); select all that apply.

Note: A child meets medical necessity criteria if all three (3) Impairment in Social Communication & Social Interaction. Lack of: check boxes and at least two (2) Restricted, repetitive and stereotypical patterns of behavior, interests and activities check boxes are selected.

Figure 2.3.3: Evaluation – Add New Evaluation

11. Enter the Developmental Disabilities – Children’s Global Assessment Scale (DD-CGAS) score in the Children’s Global Assessment Score field.


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12. If the recommendation and medical necessity were determined by a physician or other licensed

practitioner, select the Medical necessity determination and recommendation for ABA services were both made by a physician or other licensed practitioner in the state of Michigan check box (checked = Yes).

13. Enter additional evaluation details in the Notes field.

14. Click Save Evaluation (Figure 2.3.3 above).

Note: If the individual does not meet medical necessity criteria, a warning message displays. The ability to continue adding a case not meeting medical necessity criteria allows the user to document cases that do not qualify for the Autism Benefit, thus maintaining a record of all referrals regardless of eligibility determination.


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2.4 Enter Case Comments Comments entered on the Comments tab are a permanent part of the case record; they cannot be modified or deleted. Case comments can be added to a case at any time; enter initial enrollment-related comments while completing the enrollment details. Use the Comments tab to capture information that needs to remain permanently with the case, such as a transfer between two PIHPs. Complete the following steps to enter a case comment:

1. Perform the steps in 2.3 Enter Evaluation Details.

2. Click the Comments tab (Figure 2.4.1).

3. Click Add New Comment. The Comments field appears.

Figure 2.4.1: Comments

4. Enter a detailed comment (Figure 2.4.2).

5. Click Save. The most recent comment always displays at the top of the list.

Figure 2.4.2: Comments – add mode


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2.5 Submit Initial Enrollment for Approval

Once all initial enrollment information is verified and complete, the PIHP user records approval. Upon PIHP approval, the initial enrollment is submitted to MDHHS for final review and authorization.

Complete the following steps to record initial enrollment approval:

1. Perform the steps in 2.3 Enter Evaluation Details (required) and/or 2.4 Enter Case Comments.

2. Select ‘Approve’ in the Actions list (Figure 2.5.1).

Note: The Actions options change depending on the user’s security role.

Figure 2.5.1: Initial Enrollment – Actions

Note: If selecting the ‘Not Interested’ or ‘Not Qualified’ option, the Notes field appears; enter detailed notes regarding the selected option.

3. Click Submit. The initial enrollment automatically moves to the MDHHS work queue for final review and authorization.

Note: If errors exist, the AUT application provides a comprehensive list of issues using red text on the current tab. Navigate to the associated tab(s), correct the issue(s), and resubmit.

User Initial Enrollment Actions

PIHP Approve: Moves the initial enrollment to the MDHHS work queue for review and approval

Not Interested: The individual meets medical necessity criteria, but the individual/family is not interested in ABA services; moves the initial enrollment to the MDHHS work queue for review and approval

Not Qualified: The individual does not meet medical necessity; moves the initial enrollment to the MDHHS work queue for review and approval

Send back to CMH*: Sends the initial enrollment to the CMH work queue for additional work prior to further approval

Table 2.5.1: Autism Initial Enrollment Actions

* When selecting ‘Send back to CMH’, the required Pend Back Reason field displays.


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3 Searching for a Beneficiary Complete the following steps to search for a beneficiary:


2. Select AUT > Autism Case Search from the Program sub-menu (Figure 3.1). The Autism Case Search page displays.

Figure 3.1: Program – AUT – Autism Case Search

3. Either enter the individual’s Medicaid ID, MI Child ID, or Autism Benefit Case ID, or enter a combination of other search criteria (Figure 3.2).

4. Click Search. Matching result(s) display.

Figure 3.2: Case Search

Note: Simply clicking Search using default criteria selections returns all ‘Open/Pending’ and ‘Closed’ Autism Benefit cases. To include disenrolled/no longer eligible cases, the Include Disenrolled check box must be selected.

Note: The Medicaid ID takes precedence; if populated, the search is performed solely on the Medicaid ID regardless of any additional criteria entered.


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4 Recording Final Enrollment Approval The MDHHS administrator reviews and authorizes all new Autism Benefit cases. Upon MDHHS authorization the case becomes live/current case data in the AUT application, signaling commencement of Autism Benefit enrollment and payments. When a new Autism Benefit case is ready for final review and authorization, the MDHHS administrator receives the following email notification:

“Initial Enrollment data has been added for Case ID: <case identification number>. Please verify and approve.”

4.1 Verify Enrollment Details Complete the following steps to verify the enrollment status:

1. Perform the steps in 3 Searching for a Beneficiary.

2. Click Pending View beside the record (Figure 4.1.1). The Status tab displays.


Note: A bold ‘P’ displays on each tab containing pending case information; all pending data must be approved. The initial enrollment only becomes a live case upon MDHHS authorization.


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3. Verify the enrollment status information. To make modifications or enter enrollment-related

comments:

a. Click Modify Status (Figure 4.1.2). The enrollment detail fields enable.


b. Enter or update the appropriate details (Figure 4.1.3).

c. Click Save.



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4.2 Record Decision Complete the following steps to enter the Autism Benefit decision:

1. Perform the steps in 4.1 Verify Enrollment Details.

2. Click the Evaluation tab (Figure 4.2.1).

3. Click Modify Evaluation. The Functions links update to include an ‘edit’ option.


4. Click Edit beside the evaluation record (Figure 4.2.2). The Update Evaluation fields appear.

Figure 4.2.2: Evaluation – modify functions

5. Select the Authorization Review determination (Figure 4.2.3) (e.g., Authorized – Meets medical necessity criteria, Does not meet medical necessity criteria).

6. Enter a detailed Decision Reason; required when the Authorization Review equals ‘Does not meet medical necessity criteria’.

7. Click Save Evaluation.


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Figure 4.2.3: Evaluation – Update Evaluation


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4.3 Record Initial Enrollment Final Approval Once all initial enrollment information is verified and the Autism Benefit decision selected, the MDHHS administrator records final case authorization. Only upon MDHHS authorization does the case become a live case, signaling commencement of Autism Benefit enrollment and payments. Complete the following steps to record final approval of the Autism Benefit enrollment:

1. Perform the steps in 4.2 Record Decision.


Note: As the initial enrollment moves through the approval process, the Actions change depending on the user’s security role.

Figure 4.3.1: Initial Enrollment – Actions

3. Click Submit. The application finalizes the initial enrollment, updates the case Status to ‘Open’, and moves the case to the live AUT production system. In addition, the Work Queue automatically updates to ‘PIHP’ for entry of the IPOS. Please reference 5 Entering the Individual Plan of Service for additional information.

Note: If errors exist, upon clicking Submit the AUT application provides a comprehensive list of issues using red text on the current tab. Navigate to the associated tab(s), correct the issue(s), and resubmit.

User Initial Enrollment Actions

MDHHS Approve: Finalizes the initial enrollment, moves the case to the Autism live system, updates the status to ‘Open’, and moves the case to the PIHP work queue for IPOS entry

Send back to PIHP*: Returns the initial enrollment to the PIHP work queue for additional work prior to further approval

Table 4.3.1: Autism Initial Enrollment Actions

* When selecting ‘Send back to PIHP’, the required Pend Back Reason field displays.


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5 Entering the Individual Plan of Service After initial enrollment authorization, users enter IPOS details. Both CMH users and PIHP users have the ability to enter the IPOS, however the PIHP must record final IPOS approval. When PIHP approval is recorded, the IPOS details become live case data. Complete the following steps to enter IPOS details:


2. Click Pending View beside the record (Figure 5.1). The Status tab displays.


Note: If necessary, click Move to my Work Queue. Please reference 1.4 Move to My Work Queue for additional information.


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3. Click the Plan Of Service tab (Figure 5.2). The Plan of Service page displays.

Figure 5.2: Status

4. Click Modify IPOS (Figure 5.3). The Action links update to include an ‘add’ option.

Figure 5.3: Individual Plan of Service

5. Click Add IPOS (Figure 5.4). The Add New Plan of Service fields appear.

Figure 5.4: Individual Plan of Service – modify actions

6. Enter the IPOS effective date in the Start Date field (Figure 5.5). The End Date automatically populates with the date one year minus one day from the Start Date.

7. Enter the date the direct ABA services began (i.e., the first U5 direct service encounter following evaluation and assessment), or the expected date authorized services are scheduled to begin in the ABA Service Start Date field.

8. Enter the number of service hours per week in the Behavior Treatment Service Hours per Week field.


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9. If the Behavior Treatment Service Hours per Week equals zero (0), select the appropriate

Auxiliary Services.

NOTE: The Service Level automatically populates based on the number of service hours entered in the Behavior Treatment Service Hours per Week field. Hours per week range from zero (0) to 50. * If zero (0) to 15 hours per week, the Service Level automatically populates with ‘Focused Behavioral Intervention (FBI)’

* If 16 to 50 hours per week, the Service Level automatically populates with ‘Comprehensive Behavioral Intervention (CBI)’

Figure 5.5: Individual Plan of Service – Add New Plan of Service

10. Select ‘Yes’ or ‘No’ in the Informed of right to choose services and providers (Y/N) list.

11. Enter the name of the Agency Providing ABA Services.

12. Enter the supervisor’s name in the Supervisor of ABA Services field.

13. Select the supervisor’s Credential.

14. Enter additional IPOS details in the Notes field.


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Note: If the Behavior Treatment Service Hours per Week) equals zero (0) Notes are required.

15. Click Browse… beside the Attach IPOS/application documentation field. The Choose File to Upload window appears.

a. Locate the appropriate documentation and select the file Name.

b. Click Open. The file path displays in the Attach IPOS/applicable documentation field.

Note: Telepractice services must be prior authorized by MDHHS. For this to occur, the attached IPOS must clearly detail the anticipated amount, scope, and duration of telepractice services to be requested. Please reference 6 Entering Telepractice Authorization Details for further information.

16. Click Save IPOS (Figure 5.5. above).

17. Select ‘Approve’ in the Actions list (Figure 5.6).

18. Click Submit.

Figure 5.6: Ongoing Case – Actions


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6 Entering Telepractice Authorization Details Telepractice is the use of telecommunications/information technology for real-time exchange between an individual and a provider for the provision of services. All telepractice services must be prior authorized by MDHHS. For this to occur, the associated IPOS must clearly detail the anticipated amount, scope, and duration of telepractice services. Please reference 5 Entering the Individual Plan of Service for additional information. Complete the following steps to enter telepractice authorization details:






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3. Click the Telepractice tab (Figure 6.2).

Figure 6.2: Status

4. Click Modify Telepractice (Figure 6.3). The Action links update to include an ‘add’ option.

Figure 6.3: Telepractice

5. Click Add Telepractice (Figure 6.4). The Add New Telepractice fields appear.

Figure 6.4: Telepractice – modify actions

6. Select the Service Requested (Figure 6.5).

7. Enter detailed Comments as appropriate.

8. Click Save Telepractice. The End Date automatically populates with the end date of the current, active IPOS.


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Figure 6.5: Add New Telepractice

9. Select ‘Approve’ in the Actions list (Figure 6.6).

10. Click Submit.

Figure 6.6: Ongoing Case – Actions

Note: MDHHS reviews the telepractice prior authorization request/IPOS details, and records a determination.

If the determination is ‘Authorized’ the Start Date automatically populates with the date of MDHHS authorization, approving commencement of telepractice for the service option indicated.

If ‘Not Authorized’, MDHHS enters comments indicating the changes required to acquire prior authorization.

Please reference 7.6 Record Approval of Case Updates for additional instruction.


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7 Maintaining Case Details

A case becomes an ‘Open’ case when the MDHHS administrator authorizes the initial enrollment. Both CMH users and PIHP users have the ability to maintain case enrollment status, evaluations, IPOS, telepractice, case comments, and inactivity periods. The PIHP user also has the ability to end eligibility; please reference 8 Ending Eligibility for additional information.

All users complete the same steps to access case information; the results are automatically narrowed according to the user’s assigned security role. The MDHHS administrator can view all cases, the PIHP user can view cases within their PIHP, and the CMH user can view cases within their CMH.

Note: All case updates are entered as pending case data and require approval prior to becoming live case data. Please reference 1.4 Move to My Work Queue for additional information regarding pending case data and live case data.

7.1 View Current Case Details

Complete the following steps to view current case details:


2. Click Prod View beside the record (Figure 7.1.1). The Status tab displays.


3. Click each tab to view current/live case data (Figure 7.1.2).


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Figure 7.1.2: Status – Production view


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7.2 Maintain Enrollment Status Complete the following steps to maintain the ABA services enrollment status:


2. Click Pending View beside the record (Figure 7.2.1). The Status tab displays.


Note: If accessing the case’s Prod View first (as outlined in 7.1 View Current Case Details), you can also access the Pending View by clicking Pending in the Change View section (Figure 7.2.2).

Figure 7.2.2: Change View



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3. Click Modify Status (Figure 7.2.3). The enrollment detail fields enable.

Figure 7.2.3: Status – Pending View

4. To update an existing enrollment record:

a. Enter or update the appropriate information (Figure 7.2.4).

b. Click Save.

Note: The Save link is specific to each row of data. If updating multiple rows, you must click Save for each updated row.



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Note: When modifying an individual’s Medicaid ID or MIChild ID, a confirmation/warning message displays (Figure 7.2.5); click OK to continue.

Figure 7.2.5: Confirmation/warning message

5. To add a new enrollment record:

a. Enter the enrollment details in the bottom (green) row (Figure 7.2.6).

b. Click Add.



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7.3 Maintain Evaluation Details Each evaluation displays a sequentially-assigned ID number and Evaluation Type (i.e., Initial or Re-Evaluation), allowing users to easily determine the evaluation timeline.

Note: Due to a January 1, 2016 policy change, data requirements for re-evaluations with a start date before January 1, 2016 differed from re-evaluations with a start date on or after January 1, 2016. Please reference the Autism Evaluation Data Entry Guidelines for additional information.

Complete the following steps to maintain existing evaluation details or enter annual re-evaluation details:

1. Complete Steps 1-2 of 7.2 Maintain Enrollment Status.

2. Click the Evaluation tab.

3. To view an existing evaluation, click View beside the record (Figure 7.3.1). The View Evaluation fields display.


4. Review the evaluation details (Figure 7.3.2).


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Figure 7.3.2: Evaluation – View Evaluation

5. To update an existing evaluation:

a. Click Modify Evaluation (Figure 7.3.3). The evaluation Functions update to include an Edit option.



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b. Click Edit beside the evaluation record (Figure 7.3.4). The Update Evaluation fields display.

Figure 7.3.4: Evaluation – modify mode

c. Enter updates as necessary (Figure 7.3.5).

d. Click Save Evaluation.

Figure 7.3.5: Evaluation – Update Evaluation


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6. To enter an annual re-evaluation:

Note: As the required annual re-evaluation due date approaches, the AUT application sends the following email reminder to PIHP and CMH users 60 days, 30 days, and 14 days prior to the due date:

“Evaluation for Case ID: <case identification number> is due in <60, 30 or 14> days. Please add a new evaluation if not already completed.”

a. Click Modify Evaluation (Figure 7.3.6). The Action links update to include an ‘add’ option.


b. Click Add Evaluation (Figure 7.3.7). The Add New Evaluation fields display.

Figure 7.3.7: Evaluation – modify mode

c. Enter the date the re-evaluation began in the Re-evaluation Eligibility Start Date field (Figure 7.3.8).

Note: If the re-evaluation was completed over multiple days, enter the date the re-evaluation began (e.g., if the re-evaluation occurred 03/02/2016 and 03/03/2016, enter 03/02/2016).

d. Enter the Re-evaluation Eligibility End Date.

e. In the ADOS-2 Classification list, select the diagnostic classification per the evaluation results.

f. In the ADOS-2 Module list, select the module used during the evaluation.

g. Enter the ADOS-2 Overall Total Score.

h. Select the appropriate Impairment in Social Communication & Social Interaction. Lack of: check box(es); select all that apply.


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Figure 7.3.8: Add New Re-Evaluation

i. Select the appropriate Restricted, repetitive and stereotypical patterns of behavior, interest and activities check box(es); select all that apply.

Note: A child meets medical necessity criteria if all three (3) Impairment in Social Communication & Social Interaction. Lack of: check boxes and at least two (2) Restricted, repetitive and stereotypical patterns of behavior, interests and activities check boxes are selected.

j. Enter the DD-CGAS score in the Children’s Global Assessment Score field.

k. If the recommendation and medical necessity were determined by a physician or other licensed practitioner, select the Medical necessity determination and recommendation for ABA services were both made by a physician or other licensed practitioner in the state of Michigan check box (checked = Yes).

l. Enter additional re-evaluation details in the Notes field.

m. Click Save Evaluation.


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7.4 Maintain IPOS Each IPOS displays a sequentially-assigned ID number and Plan Type (i.e., Initial or Update), allowing users to easily determine the IPOS timeline. Complete the following steps to maintain existing IPOS details or add annual IPOS details:


2. Click the Plan of Service tab.

3. To view an existing IPOS, click View beside the record (Figure 7.4.1). The View Service Plan fields display.

Figure 7.4.1: Plan of Service

4. Review the IPOS details (Figure 7.4.2).

Figure 7.4.2: Plan of Service – View Service Plan


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5. To update an existing IPOS:

a. Click Modify IPOS (Figure 7.5.3). The IPOS Functions update to include an Edit option.


b. Click Edit beside the IPOS record (Figure 7.4.4). The Update Plan of Service fields display.

Figure 7.4.4: Plan of Service – modify mode


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c. Enter updates as necessary (Figure 7.4.5).

Note: If the previously-attached IPOS/applicable documentation has not changed, you are not required to upload the document again.

d. Click Save IPOS. The Last Updated field updates to the current date.

Figure 7.4.5: Plan of Service – Update Plan of Service

6. To enter an annual IPOS:

Note: As the required annual IPOS due date approaches, the AUT application sends the following email reminder to PIHP and CMH users 30 days, 14 days, and 7 days prior to the due date:

“Individual Plan of Service for Case ID: <case identification number> is due in <30, 14, or 7> days. Please add a new IPOS if not already completed.”


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a. Click Modify IPOS (Figure 7.4.6). The Action links update to include an ‘add’ option.


b. Click Add IPOS (Figure 7.4.7). The Add New Plan of Service fields display.

Figure 7.4.7: Plan of Service – modify mode

c. Enter the effective date of the new IPOS in the Start Date field (must be on or before the current date) (Figure 7.4.8).

d. Enter the date the new IPOS expires in the End Date field.

Note: The Service Level automatically populates based on the number of service hours entered in the Behavior Treatment Service Hours per Week field. Hours per week range from zero (0) to 50.

* If zero (0) to 15 hours per week, the Service Level automatically populates with ‘Focused Behavioral Intervention (FBI)’

* If 16 to 50 hours per week, the Service Level automatically populates with ‘Comprehensive Behavioral Intervention (CBI)’

e. Enter the ABA Service Start Date.

f. Enter the number of service hours per week in the Behavior Treatment Service Hours per Week field.

g. If the Behavior Treatment Service Hours per Week equals zero (0), select the appropriate Auxiliary Services.

h. Select ‘Yes’ or ‘No’ in the Informed of right to choose services and providers (Y/N) list.

i. Enter the name of the Agency Providing ABA Services.

j. Enter the supervisor’s name in the Supervisor of ABA Services field.

k. Select the supervisor’s Credential.


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Figure 7.4.8: Plan of Service – Add New Plan of Service

l. Enter additional IPOS details in the Notes field.

Note: If the Behavior Treatment Service Hours per Week equals zero (0), Notes are required.

m. Click Browse… beside the Attach IPOS/application documentation field. The Choose File to Upload window appears.

i. Locate the appropriate documentation and select the file Name.

ii. Click Open. The file path displays in the Attach IPOS/applicable documentation field.

n. Click Save IPOS.


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7.5 Add Period of Inactivity Users can record a period of inactivity for an individual for reasons such as ‘Dual Insurance’, ‘Suspended by Guardian’, or ‘Temporarily Out-of-State’. Autism Benefit eligibility is on hold during a period of inactivity. Complete the following steps to enter a period of inactivity:


2. Click the Inactivity tab.

3. Click Modify Inactivity (Figure 7.5.1). The detail fields enable.

Figure 7.5.1: Inactivity

4. Enter the inactivity period’s Begin Date (Figure 7.5.2).

5. Enter the inactivity period’s End Date.

Note: The End Date automatically defaults to the individual’s 21st birthday minus one day; update as necessary.

6. Select the Reason for the inactivity period (e.g., Dual Insurance, Suspended by Guardian, Temporarily Out-of-State).

7. Enter additional Comments regarding the inactivity period as appropriate.

Note: Comments are required when the Reason is ‘Other’.

8. Click Add.


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Figure 7.5.2: Inactivity – modify mode


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7.6 Record Approval of Case Updates As appropriate, enter a detailed explanation regarding the case updates on the Comments tab. Please reference 2.4 Enter Case Comments for additional instruction. All case updates made by a CMH user require additional approval by the PIHP user prior to becoming live case data, with the exception of updates made on the Comments tab. Case updates made/approved by a PIHP user on the following tabs also require MDHHS approval: Status, Evaluation, Telepractice, and End Eligibility. Complete the following steps to record approval of case updates:

1. Complete Steps 1-2 of 7.2 Maintain Enrollment Status and complete any necessary case updates as described in sections 7.2 through 7.5 above.


Note: As the case updates move through the approval process, the Actions options change depending on the user’s security role.

3. Click Submit.

Figure 7.6.1: Ongoing Case – Actions

Note: If additional approval is necessary, the AUT application automatically moves the case to the next appropriate work queue and sends the following email notification to the associated user:

“This is an automated email generated by WSA system to notify that there is an Autism case in your Work Queue.

Case ID: <case identification number> Current Work Queue: <work queue name> Case Transfer Type: <action selected>”

Note: A ‘Completed’ work queue indicates the pending and production case data match, and no entity is currently working on the case.


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User Ongoing Case Actions

CMH Approve: If modifications were made on the Comments tab, moves the comments to the live case and updates the work queue to ‘Completed’; for all other modifications, moves the case to the PIHP work queue for additional approval

Reset: Removes all pending data without saving, resetting the case details to the current live case values

PIHP Approve: If modifications were made on the Status, Evaluation, Plan of Service, Telepractice, and/or End Eligibility tab, moves the case to the MDHHS work queue for additional approval; for all other modifications, moves the updates to the live case and updates the work queue to ‘Completed’


Send back to CMH*: Returns the case to the CMH work queue for additional work prior to further approval

MDHHS Approve: Finalizes the modifications, moves the updates to the live case, and updates the work queue to ‘Completed’


Send back to PIHP*: Returns the case to the PIHP work queue for additional work prior to further approval

Table 7.6.1: Autism Ongoing Case Actions

* When selecting ‘Send back to CMH’ or ‘Send back to PIHP’, the required Pend Back Reason field displays.


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7.7 Delete a Record At times it may be appropriate to delete Autism Benefit case information. However, some records cannot be deleted:

The initial enrollment record on the Status tab

The initial evaluation

The initial IPOS Complete the following steps to delete a record on the Status, Evaluation, Plan of Service, Telepractice, or Inactivity tab:


2. Select the tab.

3. Click Modify <associated tab’s purpose>.

4. Click Delete beside the record (Figure 7.7.1).

5. The message “Are you sure you want to delete?” displays. Click OK.

Figure 7.7.1: Delete example

Note: A bold ‘P’ displays on each tab containing deleted case information, indicating the case deletions must be approved.

6. Select ‘Approve’ in the Actions list.

7. Click Submit.

Note: If additional approval is required, the AUT application automatically moves the case to the appropriate work queue and sends the associated email notification.


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8 Ending Eligibility PIHP users record the request to end Autism Benefit eligibility in the AUT application. All eligibility disenrollment requests require MDHHS approval. Complete the following steps to record a request to end Autism Benefit eligibility:





3. Click the End Eligibility tab.

4. In the Disenrollment/Most recent administered ADOS-2 list (Figure 8.2), select the appropriate module.

5. Enter the Disenrollment/Most recent administered ADOS-2 Overall Total Score.

6. Select the Reason for Disenrollment.

7. If the family was notified, select the Family notified check box and enter the associated date.

Note: The only exception for notifying the family in advance is in the event of the enrollee’s death. For all other disenrollment reasons, the family must be notified 12 days prior to the action.


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Figure 8.2: End Eligibility

8. Enter the Disenrollment Date.

9. If a hearing was requested, select the Family Requested Hearing check box and enter the associated date.

10. If the Reason for Disenrollment equals ‘Other’ or the family is not interested in the Autism Benefit, explain the discharge in the Reason/Comments field.

11. Click Disenroll Case. The AUT application automatically sets the End Date on the Status and Evaluation tabs to the Disenrollment Date (Figure 8.3).

12. Select ‘Approve’ in the Actions list.

13. Click Submit. The disenrollment request moves to the MDHHS work queue for review and approval (please reference 7.6 Record Approval of Case Updates for additional instruction).

Figure 8.3: Automatically updated tabs


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9 Performing Case Transfers PIHP and MDHHS users have the ability to transfer a case in the AUT application. PIHP users can transfer cases within their PIHP, and MDHHS users can transfer cases between PIHPs. Complete the following steps to transfer an Autism Benefit case:


2. Select Autism Case Transfer from the Admin sub-menu (Figure 9.1). The Case Transfer page displays.

Figure 9.1: Admin – Autism Case Transfer

3. Enter the Case Id or Beneficiary Id, and the PIHP and/or CMH (Figure 9.2).

4. Click Submit. Matching results display.

Figure 9.2 Case Transfer

5. Click Transfer Case beside the case (Figure 9.3). The Case Transfer History page displays.


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Figure 9.3: Case Transfer

6. End date the current PIHP/CMH assignment:

a. Click Edit beside the current assignment record (Figure 9.4). The Begin Date, End Date, and Comment fields enable.

Figure 9.4: Case Transfer History

b. Update the End Date to the date one day prior to the transfer begin date (Figure 9.5).

c. Enter case transfer Comments if necessary.

d. Click Save. The message “Are you sure you wish to save the data?” displays.

e. Click OK.



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Note: The following red error messages display. These will be automatically resolved by continuing with the steps below.

“There must be a record around the current date.”

“Data successfully updated, with errors.”

7. In the bottom (green) row, select the PIHP CMH Name to which the case is being transferred (Figure 9.6).

8. Select the transfer Begin Date. The End Date defaults to the individual’s 21st birthday minus one day.

9. Enter a detailed Comment explaining the transfer.

10. Click Add. The message “Are you sure you wish to add the data?” displays.


11. Click OK. The current record displays at the top (Figure 9.7).


12. Click Close Transfer History. The Case Transfer page displays the new PIHP/CMH assignment (Figure 9.8).


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Figure 9.8: Case Transfer


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10 Generating Reports All users complete the same steps to generate AUT application reports. The report options and results vary depending upon the user’s assigned security role. Complete the following steps to generate reports:


2. Select Reports in the main menu (Figure 10.1). The Reports page displays.

Figure 10.1: Reports

3. If necessary, select ‘AUT’ in the Program list (Figure 10.2). Only the Autism Waiver reports display.

4. Click PDF, Excel, or Word beside the report (each report can be generated in multiple formats). The parameter page displays.

Figure 10.2: Reports

5. Enter the required information per the parameter prompts (Figure 10.3).

6. Click Generate Report. The Report Disclaimer displays.


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Figure 10.3: Report Parameters – example

7. Review the Report Disclaimer and click Agree (Figure 10.4). The report displays in a separate window (Figure 10.5).

Figure 10.4: Report Disclaimer

8. Follow standard procedures to save and/or print the report.

Figure 10.5: Example report

Note: If running multiple reports, it is important to close the Report Disclaimer window after running each report (by clicking Cancel). If left open, it may adversely affect the generation of additional reports.


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11 Performing AUT Administrative Functions Please reference the Waiver Support Application Administrative Functions training manual for instruction regarding general WSA administrative functions.

11.1 Assign User Roles After a user registers for a State of Michigan MILogin account, and requests and gains access to the WSA, the MDHHS administrator assigns the appropriate AUT application security role. The MDHHS administrator then associates the user to the appropriate PIHP and CMH, and indicates if the user is the PIHP/CMH point of contact to receive email notifications when certain actions are taken within the AUT application.

Note: Please reference 1.2 Requesting AUT Access for additional information.

Complete the following steps to assign the user’s security role, and associate the user to the appropriate PIHP/CMH:


2. Select User Maintenance from the DBA sub-menu (Figure 11.1.1). The User Maintenance page displays.

Figure 11.1.1: DBA – User Maintenance

3. Enter the user’s ID or name in the Filter field (Figure 11.1.2).

4. Click Search. Matching results display.


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Figure 11.1.2: User Maintenance

5. Click Edit beside the user’s record (Figure 11.1.3). The User Maintenance – Edit page displays.

Figure 11.1.3: User Maintenance

6. Verify the user’s name, email address, and phone number (Figure 11.1.4).

Note: If necessary, update the user details and click Update.

7. Click Roles. The Edit Roles box displays.

Figure 11.1.4: User Maintenance – Edit

8. Select the appropriate security role check box (Figure 11.1.5):

AUTAdmin = MDHHS administrator

AUTCMH = CMH users, Managed Care Provider Network (MCPN) users, and core providers

AUTPIHP = PIHP users

9. Click Save.


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Figure 11.1.5: Edit Roles

10. Select AUT > Autism User Assignment from the Admin sub-menu (Figure 11.1.6). The User Assignment page displays.

Figure 11.1.6: Admin – AUT – Autism User Assignment

11. In the bottom (green) row of the PIHP/CMH column, select the user’s PIHP/CMH combination from the list (Figure 11.1.7).

12. In the bottom row of the User Name column, select the user from the list.

13. If the user is the PIHP contact person, select the PIHP Contact check box.

14. If the user is the CMH contact person, select the CMH Contact check box.

15. Click Add.


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Figure 11.1.7: User Assignment

Note: Reassigning a user is a two-step process. First, mark the user’s current assignment as inactive by clicking Edit beside the record, selecting the Hidden check box (checked = Yes), and clicking Save (Figure 11.1.8). Then complete steps 11 through 15 above to record the user’s new assignment.

Figure 11.1.8: User Assignment – Edit


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11.2 Bulk Update ADOS Scores At times it may be necessary to update an individual’s ADOS score. The MDHHS administrator has the ability to access and update ADOS scores in bulk. Complete the following steps to update ADOS scores in bulk:


2. Select AUT > Autism Bulk Update ADOS Scores from the Admin sub-menu (Figure 11.2.1). The Bulk Update ADOS Scores page displays.

Figure 11.2.1: Admin – AUT – Autism Bulk Update ADOS Scores

3. Select the PIHP for which ADOS scores must be updated, enter the Score to be updated, and/or enter the Case ID for which the ADOS score(s) must be updated (Figure 11.2.2).

Note: Alternately, select the PIHP/CMH radio button and then select the PIHP/CMH combination for which ADOS scores must be updated.

4. Click Search. Matching results display.

Note: Simply clicking Search without entering search criteria returns all cases.

Figure 11.2.2: Bulk Update ADOS Scores

5. Locate the case(s) for which the ADOS score must be updated and enter the correct Score (Figure 11.2.3).

6. Click Update Scores.


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Figure 11.2.3: Bulk Update ADOS Scores


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11.3 Use Autism Admin Tools The autism administrative tools allow the MDHHS administrator to temporarily reopen a closed Autism Benefit case and/or update a case’s referral date. Complete the following steps to reopen a case or update the case’s referral date:


2. Select AUT > Autism Admin Tools from the Admin sub-menu (Figure 11.3.1). The Admin Tools page displays.

Figure 11.3.1: Admin – AUT – Autism Admin Tools

3. To temporarily reopen a closed Autism Benefit case:

a. Verify the Update Case Status to Open radio button is selected (default) (Figure 11.3.2).

b. Click Submit. The Update Case Status page displays.

Figure 11.3.2: Admin Tools

c. Enter the Autism Benefit WSA Case ID (Figure 11.3.3).

d. Click Load. The case’s Case Status and Current WorkQueue values populate.


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Figure 11.3.3: Update Case Status

e. Click Update Case Status (Figure 11.3.4). The message “Are you sure you want to change the case status?” displays.

f. Click OK. The case status is updated.

Figure 11.3.4: Update Case Status

4. To update an Autism Benefit case’s referral date:

a. Select the Update Referral Dates radio button (Figure 11.3.5).

b. Click Submit. The Update Referral Date page displays.

Figure 11.3.5: Admin Tools

c. Enter the Autism Benefit Case ID (Figure 11.3.6).

d. Click Load. The case’s Referral Date populates.


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Figure 11.3.6: Update Referral Date

e. Update the Referral Date as appropriate (Figure 11.3.7).

f. Click Update. The message “Are you sure you want to change the Referral Date?” displays.

g. Click OK. The referral date is updated.

Figure 11.3.7: Update Referral Date

waiver support application · 2020. 9. 21. · waiver support application – autism user training...

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