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03/23/2015 Accepted changes deleted comments and updated TOC for publication. 9/1/15 Removed the ICD-9 reference. Enter at least one but no more than twelve diagnosis codes based on the member s diagnosis/condition. Enter applicable ICD indicator to identify which version of ICD codes is being reported. ICD-10-CM DOS 10/1/15 and after ICD-9-CM DOS 9/30/15 and before HCBS HCBS may use R69 or R99 Medicaid Resubmission Code List the original reference number for resubmitted claims. Changed ICD-9...
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How to fill out home and community based

01
Step 1: Gather all necessary documents such as identification, proof of residency, and income verification.
02
Step 2: Contact the local home and community-based service provider to inquire about the application process.
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Step 3: Complete the application form accurately and provide all required information.
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Step 4: Attach any supporting documents as requested by the service provider.
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Step 5: Submit the completed application either online or in person at the designated location.
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Step 6: Wait for the service provider to review the application and determine eligibility.
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Step 7: If eligible, schedule an assessment or interview with a representative from the service provider.
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Step 8: Attend the assessment or interview as scheduled and answer all questions honestly.
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Step 9: The service provider will notify you of the final decision regarding your application.
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Step 10: If approved, work with the service provider to develop a care plan and start receiving home and community-based services.

Who needs home and community based?

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Individuals who require assistance with daily activities due to physical or cognitive limitations.
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Elderly individuals who wish to age in place and maintain their independence.
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People with disabilities who prefer to receive care in their own homes rather than in institutional settings.
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Families or caregivers who need support in taking care of a loved one with special needs.
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Individuals who need help accessing community resources and services to enhance their quality of life.
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Home and community based services are programs that provide long-term care and support to individuals in their homes or in community settings, rather than in institutions.
Individuals who are in need of long-term care and support services may be required to file for home and community based services.
To fill out home and community based services, individuals can contact their local health department or social services agency for assistance in determining eligibility and completing the necessary paperwork.
The purpose of home and community based services is to allow individuals to receive care and support in their own homes or community settings, promoting independence and improving quality of life.
Information that must be reported on home and community based services may include the individual's medical history, care needs, financial information, and any other relevant details.
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