Enter or update service agreement (SA) lines for DD Waiver.

Enter a short comment (Box 23 is optional). Comment will appear on the recipient and provider service agreement (SA) letters. Only the provider listed in the PROVIDER NAME/NBR field of this line will see the comment.

Enter the appropriate procedure code for designated service (Box 24).

Enter a modifier (Box 25-28) when appropriate or tab past the four modifier fields.

Enter the correct dates (Box 30-31) in MMDDYY format. Line start and end dates must be within the AGMT START and END dates on the ASA1 panel.

Update or close SA for DD Waiver

Change a line end date
1. Tab to END DT field.
2. Press the End key.
3. Enter new end date in line END DT field.

View existing lines on a service agreement
1. Press function key F8 to advance to additional line items.
2. Press function key F7 to view previous lines.

Add a line to an approved service agreement
1. Press function key F11 to display a new line.
2. Enter line completing required fields on ASA3 panel.
3. Press function key F9 to run exception control function in MMIS.
4. Resolve exception codes as needed.
5. Type code A (approved) over the S in the STAT CD field.

Deny a line on an approved service agreement
1. Access the SA in change mode.
2. MMIS turns the code displayed in the STAT CD field green when no units have been used (i.e., the TOT USED UNIT/AMT field is blank).
3. Type code D over the A in the STAT CD field.
4. MMIS auto populates the STAT DT field when function key F9 is used.

Enter the current allowed dollar amount per unit (Box 32). Most procedure codes have an allowed rate that is stored in the MMIS Reference File Application.

View the current allowed rate in MMIS
1. Move the cursor over the procedure code.
2. Left click with the mouse to place cursor on the procedure code.
3. Press function key F4 to navigate to the REFERENCE FILE APPLICATION.
4. Press transmit key to advance to the MMIS PROCEDURE CODE4 – FPR4 panel. The VALUE column displays the current allowed rate.
5. Press function key F6 one time to return to the ASA3 panel.

Enter the requested total number of units for the line date span (Box 33).

Update or close SA for DD waiver

Reduce the total number of requested units in the REQ TOT UNITS field. MMIS displays the number of units used in the TOT USED UNITS field. The number of units in the REQ TOT UNITS field must be equal to or more than the number of units displayed in the TOT USED UNITS field. MMIS adjusts and auto-populates the REQ TOT AMT field when changes are made to the REQ TOT UNITS field after function key F9 is used.

Do not make changes to the REQ TOT AMT field.

Leave the requested total amount field blank (Box 34). MMIS auto-populates the field after function key F9 is used.

Enter the provider’s National Provider Index (NPI) number or the Unique Minnesota Provider Index (UMPI) number. Enter the consolidated provider NPI number when applicable on personal care assistance (PCA) line.

Look up a provider number in MMIS
1. Press function key F5 to navigate to the MMIS PROV RECIP KEY – CPRK panel.
2. Type the provider’s name in the PROVIDER NAME LOOKUP, ENTER FULL OR PARTIAL NAME IN LAST, FIRST, MI SEQUENCE: field.
3. Press function key F4 to navigate to the MMIS PROVIDER LIST – PINQ panel in the Provider file.
4. Press function key F8 to advance to next page of list. Press function key F7 to return to the previous page of the list.
5. Locate the correct provider and copy the NPI or UMPI number.
6. Press function key F6 once to return to the service agreement.
7. Enter the provider number in the PROV NBR field.

How to select the correct consolidated provider
1. Enter the consolidated provider NPI number in the PROV NBR field on the ASA3 panel.
2. MMIS automatically opens the PPOP panel after the transmit key is pressed.
3. Use the tab key to place the cursor in front of provider type 38 PERS CARE in the PROV TYPE field on the PPOP panel.
4. Type an X to select the entry.
5. Press a transmit key to return to the ASA3 panel.
6. Repeat this process for each consolidated provider number entered on the ASA3 panel.

Leave the provider name field blank. MMIS auto-populates this field based on the provider number entered after function key F9 is used.

Enter Y in the SHR field when the recipient is receiving shared services (Box 38). Leave this field blank and tab to the FREQ field when the recipient is not receiving shared services.

Enter frequency code 1 (daily-standard PCA) or 5 (flexible use) on PCA lines. Leave the frequency field blank when recipient is not receiving PCA services.

Enter up to three reason codes when appropriate. MMIS adds text associated with a reason code to the service agreement letters.

View reason code text in MMIS
1. Enter a reason code (three-digit number) in the RSN CD field.
2. Move the cursor over the reason code.
3. Left click to place cursor on the reason code.
4. Press function key F4 to navigate to the MMIS PA/SA RSN TEXT – FPAD panel in the Reference File Application to view text.
5. Press function key F6 one time to return to the ASA3 panel.