ALTCS cannot approve a potential member unless he/she is in living in an appropriate ALTCS setting.
If the ALTCS potential member has a hospital stay and must go to a rehab center thereafter, please do not allow the hospital to discharge the potential member to a non-ALTCS approved rehabilitation center. If you do, ALTCS can approve the case, BUT ALTCS will not pay any unpaid bills for that rehab.
If you wish to move the potential member to an assisted living facility/home, please make sure this assisted living facility/home already has an AHCCCS provider ID number. If this assisted living facility/home does not, ALTCS will NOT approve benefits in that assisted living facility/home.
And finally, check to see with which program contractor(s) the providers are already contracted. This will help you choose a program contractor during the application process.
If you are searching for an assisted living facility/home …
- Confirm with the assisted living facility/home that they ALREADY have an AHCCCS provider ID number. If the assisted living facility/home does not, there is no guarantee that they will by the time ALTCS is ready to approve the case. From past customer’s experiences, it is not worth the headache to have to move your loved one at the last minute to gain the ALTCS approval. Failure to move by the ALTCS “move” date will result in an ALTCS denial and need to reapply for the program.
- Confirm with which program contractor(s) the assisted living facility/home already contracts (have them double-check their contracts to prevent any issues with this later)
- Confirm with the program contractor(s) that the assisted living facility/home is showing in their list of contracted providers before moving them into that setting
Proper discharges to ALTCS approved settings and asking the right information upfront can save you time, energy, and frustration.
Working with an ALTCS planning firm, like Montgomery & Associates, Inc., can help you navigate all of the pitfalls of applying on your own.
Written by Carol Aragon-Montgomery 05/16/19 | P: 480-464-4968 | www.altcsplanning.net