CCME finally admitted today what providers have been saying for weeks- that fax transmissions which CCME thought it had sent to providers may not have been received due to a “fax failure”. Also, when the provider who was supposed to have gotten the referral did not respond in 48 hours, CCME apparently did not in all cases refer the consumer to another agency. Providers in such cases who were selected by the consumer are getting a “second chance” to accept the consumer. The effective date that governs is the effective date stated in the most recent letter which the provider receives.
Here is the text of CCME’s announcement:
8/10/2010 – If you receive a “Second Attempt” fax from CCME, this indicates that CCME has attempted to make a referral to your agency and has not received a response. The provider agency should fax back the referral form with a response indicating whether the provider accepts or declines the PCS referral. This response must be returned to CCME within 2 business days. In some cases, providers may not have received CCME’s first attempt due to a fax failure. Currently, CCME is faxing “Second Attempt” letters to providers for whom referral responses have not been received. This is to ensure that agencies have every opportunity to accept a referral before CCME forwards it to the recipient’s second choice provider.
The effective date of the authorization is indicated near the bottom of the referral letter. This date varies depending on the type of independent assessment conducted (Admission, Change of Provider, etc.) and on the results of the assessment. The “Second Attempt” referral letter does not change the 10-day service authorization start period that is listed on the authorization letter. If the provider accepts the referral on the “Second Attempt” letter, the 10-day start period is effective based on the date of the authorization letter (not the referral letter). In cases where the referral letter indicates that the service authorization is effective on “the first business day following CCME’s receipt of your acceptance…”, this will be based on the date of the “Second Attempt” referral letter.