I/DD UR Resources

• Weekly NC Innovations Q&A Conference Call
• CAP Webinar for TCM Agencies
• LME Guide to Viewing CAP UR Decisions in ProviderConnect
• Service Provider Guide to Viewing CAP UR Decisions in ProviderConnect
• DHHS Implementation Updates
• Medicaid Bulletins

CAP Requests

Service Definition

• Clinical Coverage Policy 8M

CAP Services

• Adult Day Health
• Augmentative Communication Devices
• Crisis Respite
• Crisis Services (Revised 05/09)
• Day Supports
• Home And Community Supports
• Home Modifications
• Home Supports
• Individual Caregiver Training And Education
• Long Term Vocational Supports
• Personal Emergency Response System (Pers)
• Residential Supports
• Respite Services
• Specialized Consultative Services
• Specialized Equipment And Supplies
• Supported Employment
• Transportation
• Vehicle Adaptations

Required Information for Initial and Concurrent CAP CNR Authorization Requests

• CTCM (Electronic Version)
• CTCM (Written/Typed Version)
• MR-2
  MR-2 including the LME Representative signature and the signature of a psychiatrist or MD (contact EDS (HP Enterprise Services) at 919-851-8888 to obtain blank forms)
• PCP with signature page
• Risk Assessment
• Cost Summary
• NC-SNAP
• Any other required forms appropriate to the services requested

CAP Revision

Service Definition

Medicaid TCM Only Requests

Service Definition

• Clinical Coverage Policy 8N

Items Required for a Request

• CTCM (Electronic Version)
• CTCM (Written/Typed Version)
• PCP with signature page
• NC-SNAP
• Current psychological (initial request only)