WAG 20-08-04-a: Second Opinion

PM 20-08-04-a.

  1. (FCRC) Tell anyone wanting Revised texta second opinion on screening decision to have medical provider contact HFS's designated physician at (217) 782-5565.
  2. (Designated Physician) Calls FCRC with Revised textsecond opinion decision.
  3. (Designated Physician) Completes Interagency Certification of Screening Results (Form 2536).
  4. (Designated Physician) Sends Form 2536 to FCRC to confirm phone call.
  5. (FCRC) Send Notice of Second Opinion Decision (Form 2539) on Request for SLF, SNF, ICF or ICF/MR Facility Payment to Revised textcustomer on day Form 2536 is received or on following workday.
  6. (FCRC) Send copy of Form 2539 to facility if Revised textcustomer is already living in facility.
  7. (FCRC) Make decision about payment.
    1. Approve payment for care if designated physician decides care is needed.
    2. Do not approve payment for care if designated physician decides care is not needed.