Navigating the path through the Department of Medical Assistance Services’ (DMAS) enrollment process for Medicaid EDCD Waiver services can be complex, but understanding the significance of the DMAS 99 form is a crucial step in this journey. Developed as part of a comprehensive suite of forms, including the DMAS 96 for physician certification, the DMAS 97 series for plans of care, and others vital for the Medicaid waiver process, the DMAS 99 form specifically caters to the assessment phase conducted by a Nurse or Service Facilitator on a consumer-directed basis. This form plays a pivotal role in identifying the service needs of applicants, which is essential for starting care and facilitating the payment of claims. Its successful submission and processing lead to the approval of Prior Authorization (PA), determine the level of care (LOC) required, and enable the enrollment of participants with their chosen providers. Moreover, the information from DMAS 99, along with related documents, is entered into the Virginia Medicaid Management Information System (VAMMIS), an action which sets the foundation for ongoing and future care management and reviews, ensuring that individuals receive the appropriate level of support tailored to their specific health needs. The DMAS 99 form, therefore, is more than just paperwork; it is a key component in a larger workflow designed to connect eligible Virginians with the long-term care services they require for a better quality of life.
Question | Answer |
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Form Name | Dmas 99 |
Form Length | 1 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 15 sec |
Other names | dmas 99 blank, dmas 99 form, dmas 99 blank form, dmas 99 download |
Department of Medical Assistance Services
Division of
November 2010
Medicaid EDCD Waiver
Process Flow for Enrollment
Services begin
Submission of and payment of claims
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Submit: UAI, DMAS 96, 97, 97a/b, 98, 99, Start of Care date |
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KePRO |
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Approve PA |
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PROVIDER |
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Deny PA |
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Participant‘s |
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Approval and entry of PA |
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screening packet to |
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& Enrollment on LOC |
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selected provider |
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UAI, DMAS 95, and 96 |
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sent for entry into VAMMIS |
VAMMIS |
VAMMIS |
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ACS |
ACS |
Local Screening Team |
Acute Screening |
UAI |
Claims Paid |
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Local |
DSS |
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Health Dept |
Hospital |
Ends LOC & PA |
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LOCERI monthly SAS for |
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Annual LOC review |
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LEGEND |
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DMAS 95 – Supplemental screening for MI/ID/MR |
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DMAS 96 – Physician certificate |
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DMAS 97 – Screeners plan of care |
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DMAS 97a/b – Provider plan of care |
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DMAS 98 – KePRO request for services |
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DMAS 99 – Assessment by Nurse/ Service Facilitator (consumer directed) |
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LOC – |
Level of Care file in MMIS system |
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Home |
LOCERI – Level of Care Eligibility Review Instrument |
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PA – |
Prior authorization |
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SAS – |
Statistical Analysis System (a data sort from VAMMIS) |
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UAI – |
Uniform Assessment Instrument |
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VAMMIS – Virginia Medicaid Management Information System |