32 Miss. Code. R. 1-20.2
The case record should be organized in such a way as to allow for easy access of information. All materials should be filed in reverse chronological order (most recent on top) based on the date information was received.
The Client Case File maintained by the OSDP Counselor should contain all assessment and eligibility information.
The case file is considered to be deficient if it does not contain the following information, at a minimum:
* Running Record - Case notes
- Documentation of Quarterly Reviews
- Recertification Notes
- Monthly Contacts
*Some clients correspond with their Counselor via e-mail. If this occurs the e-mail shall become a part of Case notes and filed accordingly.
PAGE 1 - Application
- Referral Form
- Envision Sheet
- Application for Services
- Statement of Understanding
- Consent to Disclose Form
- HIPPA
- Insurance Declaration Form
- Appendix D/Medicaid Payment Authorization Sheet
- Medical Records
- Emergency Preparedness Form
PAGE 2 - Case Notes
- Case Notes
- AT Reports, Project Start, etc.
- Notice of Action Letter
PAGE 3 - Pre-Admission Screening (PAS)
- PAS Application
- Informed Choice
PAGE 4 - Physician's Form
- Physician's Summary
- TBI/SCI Verification Form
- Respite Tier Form
PAGE 5 - Plan of Care (POC)
- POC (Handwritten)
- POC (Electronic)
- Added Services
PAGE 6 Personal Care Attendant (PCA) Certification
- PCA Cert (not application)
- Change of Address
- PCA Task Assignment Sheet
PAGE 7 - Time Logs
- PCA Time Logs/payment sheets
- Respite Time Logs/payment sheets
PAGE 8 - Financial Documents
- Authorizations
- EOB
- FIN
- AT Reports
- Quotes/Bids
- Prescription
PAGE 9 Medicaid Correspondence
- NOD
- 105
- Two-Way Communication
PAGE 10 Independent Living Plan (ILP)
- ILP
- Certificate of Eligibility
32 Miss. Code. R. 1-20.2