SPH, Appendix I-C, Mismatched ISP and MN End Dates Report

Revision 14-118-1; Effective March 320, 20142018

The Mismatched ISP and MN End Dates report shows individual service plan (ISP) end dates with medical necessity (MN) end dates that do not match.

Report Fields

PCN– The member's nine-digit Medicaid number.

Name– The member's last name, first name and middle initial (when provided).

SG– The Service Authorization System (SAS) Service Group (SG). The STAR+PLUS SG is 19.

SC– The SAS Service Code (SC). The STAR+PLUS SC is 12. SC 13 should not appear on this report; if SC 13 does appear, disregard the line item.

ISP Begin Date– The begin date of the last ISP registered in SAS.

ISP End Date– The end date of the last ISP registered in SAS.

MN Begin Date– The begin date of the last MN registered in SAS.

MN End Date– The end date of the last MN registered in SAS.

MN– The approval or denial of the MN referenced in the MN begin/end date:

  • "Y" means the MN was approved.
  • "N" means the MN was denied.

RG– The three-digit Risk Group number for the month the ISP expires.

Enroll Month– The most current enrollment month at the time of the report.

Plan– The two-digit managed care organization plan code.

TP– The member’s two-digit Medicaid Type Program.

Program Support Unit (PSU) Entry Fields

Comments (Date & Action taken)– PSU staff must enter appropriate comments after researching the ISP/MN end dates, which should match. For example, an ISP ends on May 31, 2017, and the MN ends on April 30, 20107. The PSU staff must research the reason for the mismatch.

There may be valid situations in which the two dates will not match. For example, a Money Follows the Person (MFP) case has an ISP registered for one day. The MN will not match the one-day registration in this case.

Mismatched ISP and MN End Dates is a periodic report sent on an as-needed basis. A response to state office is duePSU staff are required to research, resolve and respond to the requestor within five14business days of receipt.

Note:SAS files used by Managed Care Operations Services - Program Enrollment Support to produce this report are a snapshot in time and may not reflect registrations at the point of receipt.