32 Miss. Code. R. 22-3.10.1.3 - HRC Outpatient Procedure

It is not necessary for the counselor to refer clients needing outpatient services to the screening committees. The counselor may schedule appointments directly through the appropriate liaison counselor or secure the service through other outpatient clinics as long as the client has a prescription for the required treatment or service.

An appointment will be scheduled soon after the referral information is received. Instructions relative to the scheduled appointment for the appropriate outpatient clinic and physician will be mailed to the referring counselor who will use the following guidelines to authorize and pay for services:

* All Authorizations and Statements of Account for VR outpatient clinic visits will be prepared by the referring counselor using their district code with the appropriate fund code.

* All services (including appropriate codes and costs) identified on the appointment memo from the liaison counselor at the hospital will be used to complete the Authorization of Services (MDRS-VR-6) form.

* The referring counselor will send the Authorization and Statement of Account to the hospital's Business Office and to the physician (not to liaison VR staff). A copy of the authorization should be sent to the liaison counselor. When the services are completed, the Business Office will return these forms. The liaison counselor will assist in obtaining medical reports. This is to be done on all clinic visits.

A VR liaison counselor or coordinator will contact the referring counselor prior to making decisions on all proposed outpatient services to be rendered by the hospital's clinical staff and will verbally authorize services if approved by the referring counselor. Authorizations will then be issued, using his/her district code and fund code, using the same procedure as for clinic visits.

Recommendations for such items as wheelchairs, hydraulic lifts, home fixtures, braces, wheelchair cushions, artificial limbs, or other major items will be verbally authorized, and a prescription will be sent to the referring counselor, who will issue a written authorization for items over $35. All such items will be charged to the referring counselor's district code and fund code. Individual items costing under $35 are covered in the outpatient per diem paid by the Agency.

The referring counselor will be notified of scheduled follow-up appointments by telephone and he/she will be responsible for arranging the client's transportation and preparing Authorizations and Statements of Account just as he/she did for the initial clinic visit. If an appointment cannot be kept, the liaison counselor must be notified immediately so that the client can be rescheduled. This information should be communicated as quickly as it becomes known.

Individual instructions will be given to the referring counselor for purchasing consultations at the center and for purchasing consultations outside the center. These authorizations will be charged to his/her district code, using the appropriate fund code, and will be authorized by the referring counselor to the appropriate physician providing the consultation.

It is imperative that complete and accurate insurance information be included on MDRS-VR-24 referral form. Clients must bring private insurance card, Medicaid and/or Medicare cards with them to all center outpatient clinic visits.

Notes

32 Miss. Code. R. 22-3.10.1.3