07/13/2018
Criminal Records Information Management
System (CRIMS)
See
the Criminal Records Information Management System (CRIMS) website for information,
demonstration, screen shots, and manual.
Background Check Unit (BCU)
The
Background Check Unit (BCU) provides background check services and support to
all DHS and Oregon Health Authority (OHA) divisions for employment purposes,
for those who provide services or seek to provide services as a contractor,
subcontractor, vendor or volunteer, or are employed by qualified entities that
provide care and are licensed, certified, registered or otherwise regulated by
DHS or OHA.
Please
visit the BCU website for more information.
B. Community-Based Care (CBC) provider payment system
The
Community Based Care (CBC) provider payment system is a computer-based
information system for the issuance of 512s and payments to Adult Foster Care
providers, Residential Care Facilities (RCF), Assisted Living Facilities (ALF),
and Adult and Child Developmental Disabilities (DD) providers. Access to the
system, or certain screens within the system, is limited to authorized
individuals in each local office.
Earnings statement vs. 1099s. Please
refer tax questions to either a tax professional or the IRS.
1.
Frequently used
mainframe screens
A.
Consumer payment screens.
- SMRQ,prime# <enter>.
Indicates the last fourteen (14) 512s by consumer.
Screens inside the 512:
- SERF – Demographic information about the consumer;
- SNRS – Financial information;
- RATZ – Service rate information;
- SADD – Names and addresses for consumer contacts where
512s may be sent, if selected;
- SBEG – Automatically opens when a new 512 is entered
to allow the consumer’s service contribution to be adjusted for the first
month of service;
- DISB – Payment information including service amount,
consumer contribution, room and board, needs total, state and consumer pay
total;
- SCFD – Summary of information from the 512 including
payment status and paid-through date;
- SMSG –Displays a suspend message if the payment is
suspended.
WEBM – consumer case information. Displays consumer
information including name, Social Security number (SSN), prime number, date of
birth (DOB), and date of death (DOD).
- WEBM,FIND,prime# or WEBM,FIND,lastname,firstname;
- WLGR access:
- Tab to Prime and enter the consumer’s
prime number;
- Hold down the Shift key and press F1;
- Press F3 to return to WEBM.
- UCMS access:
- Tab down to Type Case;
-
The
line with a Prime ID and Medl Elig File listed is the active
line;
- Enter any
character on the dot at the left of this line;
- Hold down the Shift key and press F1;
- Press F3 to return to WEBM.
WLGR – consumer eligibility information. Displays case
eligibility information by date lines. Includes case descriptors, program
codes, branch, and dates of eligibility. Consumers must have both APD and CBF case descriptors to be eligible for
a CBC 512 payment.
- WLGR,prime# <enter>,or access from
WEBM,FIND,prime#;
- Tab down to Prime and enter the consumer’s
prime number;
- Enter any
character on the dot at the left of this line;
- Hold down the Shift key and press F1;
- Use F3 to return to WEBM.
UCMS – consumer case information. Displays the consumer
name, address, effective date, and information pulled from the consumer
information (CI) file.
- Access from WEBM, with UCMS,case# <enter>;
- Case effective date; 512s must start on or after the
UCMS effective date. Any 512s necessary prior to the UCMS effective date
must be entered at Central Office via an APD
0287F, CBC Late Payment Request form;
- Example: Existing 512
set up from 10/1 and continuing. If the Eff Date in UCMS is changed to 10/15, the 512 will go into
suspense. Touch the 10/1 512 with a 10/15 start date and an action code 1 to begin a new 512 on the start
date entered. Both 512s should be in Normal status after touching;
-
COMPUTE
or SUPPLE the UCMS date back to the beginning of the month or previous month
and enter a 512;
-
If
unable to COMPUTE or SUPPLE the UCMS date back far enough to pay necessary
dates, set up a 512 beginning the date of the UCMS effective date and submit an APD 0287F, CBC Late Payment Request to pay dates
prior to the UCMS effective date.
SELG - CAPS information.
- The consumer must have current and correct CAPS for
a 512 payment to issue.
B.
Provider screens
PRV8 – Provider information. PRV8,provider#
<enter>. Displays all provider information.
- Active providers show an end date of 12/31/9999
under Program;
- Inactive providers have an end date when their
license expired rather than an ongoing date.
- Note: Active will show next to the dates of licensing, even if a provider is no
longer active.
- Indicates if the provider is licensed for serving
consumers in their primary residence under with either a Y or N Facility.
o
The
designation affects the provider’s tax liability, per IRS Publication 525.
SPVF – Provider search. SPVF <enter>;
- Fill in the search field by last and first name,
SSN/TIN, or business name and press <enter> to search;
- Enter any character on the dot at the left of this
line and press <enter> to open PRV8;
- Use F12 to return to SPVF.
C.
Payment screens
PESM – Payments to provider. PESM,p,provider# <enter>. Displays payments
issued to the specified provider number.
- Type an S next to the payment line and press <enter> to view;
- Use F7 to
go to SCLM to view consumers and amounts paid;
- Payments issued via direct deposit will show under EFT Nmbr and EFT Date;
- Payments issued via check will show under Chk Nmbr and Chk Date;
- Provider year-to-date (YTD) earnings show on the
right of the screen under Prov YTD.
SCFS – Payment status screen. This is a good screen
to begin troubleshooting missing payments if the missing payment does not
appear on a full suspend list or report.
- SCFS,P,provider# <enter>. Displays
current and open 512s and consumers for the provider number specified;
- SCFS,R,prime# <enter>. Displays current and open
512s for the consumer specified;
o
Indicates
suspended payments: S = suspended, N = normal.
SCLM – Payment history by consumer. SCLM,R,prime# <enter>.
- Displays payments made for a consumer, dates of
payment, issued amount, provider name, and the provider number which
received the payments;
- Use F1 to
page through payments;
- Use F4 to
go to the bottom for the most recent payments.
D.
Other screens
HZIP – zip code check, HZIP,
<enter>.
- Enter an address to find the correct Zip Plus-4
code;
- Note: All addresses entered into mainframe
should have a Plus-4 code to reduce postage costs.
PUTL – Utilities, Putl
<enter>. Main menu for 512 utilities.
- MRAT – Option 1
calculates prorated room and board rates for consumers who enter care
mid-month;
- DPRT –Option 2
displays all 512s by branch which are waiting to be printed.
o
Delete
a 512 from printing and mailing out by placing a D next to the line to delete; press <enter>, and confirm
delete with Y <enter>;
- URAT – View current
rate schedules for different types of CBCs.
RCIQ – Check records, RCIQ <enter>. Displays check
information as paid (PD), outstanding
(OS), if there is a payment alert, or
has been replaced.
- 1 <check number> to view a check;
- 2 <provider number> to view checks issued to a
provider.
E.
Rate exception screens:
- SRXQ,prime# or provider# - View only the list of
rate exception records for the consumer or provider number;
- SRXI – Viewable from inside SRXQ, displays detailed
information on adjustment selected.
On a
clear mainframe screen, type SMRQ,prime# <enter>;
- Displays the most recent 512s entered for the
consumer;
- If touching an ongoing 512, type any character next
to that line and press <enter> to continue to SMFR;
- If beginning a new 512, type F10 to continue to SMRF.
In
SMRF, fill in all blanks on the form, if entering a new 512:
·
Prime ID;
·
Provider number;
·
2nd provider, Y or N; used when a consumer is staying with a new provider for a trial visit. A second
provider can only be entered for seven (7) days and the system will
automatically truncate to seven (7) days if entered for longer;
·
Effective Begin Date - date to start the
512;
·
Effective End Date - cannot be entered;
·
Operator ID - load code;
·
Action Type – Change to a 1 to open a new 512 (see below for
action type descriptions);
Page
through the 512 using F7 to navigate
through the 512;
- Verify all information is correct on all the pages;
- On the DISB screen, specify how many prints to make and to whom they will be sent;
- Select Y at the cursor, and F7 to complete the entry.
- 1 = New,
financial, or assessment changes; “touching the 512”
- Pulls new
information and changes over to the 512 system.
- 4 = Viewing a 512
- Read/print only
to view or print copies of the 512.
- 5 = Closing a 512
- Permanently
close a 512 and stop paying the provider as of the close date.
- 6 = Deleting a 512
- Use to delete
an unpaid 512 and permanently remove the 512 and all narratives from the
system.
A.
Entering a 512
Dates are within an SCF time period for same prime. The
consumer has already been paid through these dates, or there is already a 512
setup for these dates
- Go to SMRQ,prime# to view
512s for the specified consumer. Adjust the new 512 dates to those dates
which have not already been setup for payment.
Provider not active during 512 period. Provider
is not currently licensed through this time period.
- Verify the correct provider number;
- If the provider number is correct, go to PRV8,provider# to verify when the
license began or ended and adjust 512 dates accordingly;
- If the provider is supposed to be licensed through
the time period entered, contact licensing.
CMS effective date is later than 512 effective date. The
CMS effective date is in the middle or before the 512 requested time frame
·
Verify
the CMS effective date in UCMS;
·
SUPPLE or COMPUTE back to the date needed to begin
the 512 and enter the new 512 with that date;
·
If
unable to SUPPLE or COMPUTE back to the necessary date,
enter the new 512 beginning as of the CMS effective date and submit an APD 0287F, CBC Late Payment Request, for dates of
payment necessary prior to the UCMS effective date.
A pending 512 exists for this time. Cancel or
complete it to continue.
- Go into SMRQ to view 512s. The pending 512 will be
marked on the right side with a P for Pending;
- Complete, close, or delete the pending 512 before
continuing with the new 512.
B.
Closing a 512
Act type not possible. (Paid thru > eff date.) The consumer has already
been paid through the dates requested to close. A 512 cannot be closed on or
before a date already paid.
- Close the 512 as of the last paid date shown on SCLM,R,Prime#).If this resulted in
an overpayment to the provider, submit an APD
0287D, CBC Adjustment Request Overpayment form
to Payment Support.
Cannot close 512 past existing end date. 512
has an ending date before the date of closure.
- Close the 512 before, or as of, the existing end
date.
C.
Suspend messages
Late
payments.
When a provider has not been paid for a specific time period for which they are
owed and the staff member is unable to enter a new 512, an APD 0287F Late Payment Request must be submitted to Apd-dd cbcpayments on Outlook, or apd.dd-cbcpayments@state.or.us for Central Office
to enter the payment.
Complete
all contact, consumer, and provider information at the top of the form.
- Late pay begin date:
o
Enter
the date the late payment is to begin: month, day, year. This is the first day the
provider should have been paid.
- Late pay end date:
o
Enter
the date the late payment is to end: month, day, year. This is the last day the
provider should have been paid.
- Consumer service
contribution amount: Amount the consumer is mandated to pay towards their
own cost of care for the specified dates only.
o
Does not include room and board or other needs;;
o
Amount
is found in the 512 on the DISB screen near the bottom right across from SVC
CNTRB;
o
Do NOT use the CLNT
PAY which includes the room and board amount;
Enter
what the consumer should have paid for their service
contribution. If the service contribution in DISB is incorrect, enter the correct amount of what the consumer
owes for the dates requested on the late payment request;
If
the consumer does not have a service contribution, or does not owe a service
contribution for the dates requested, enter 0 (zero).
- Service amount: Full monthly
service rate/amount the State is authorized to pay for the consumer, per
month.
o
Include
the full monthly amount on the payment requests;
o
Do
NOT prorate this amount for a partial month of service;
o
Amount
is found in the 512 on the DISB screen across from SERV AMT;
Do NOT use TOT DUE which includes the
room and board;
If
the service amount is not correct on the 512 enter the correct amount that
should have been used for payment.
- Reason for late payment: Describe why the
payment was late.
o
Example: Late entry;
Overpayment requests. When
a provider has been paid for services, but an incorrect amount was paid, an APD 0287D, CBC
Adjustment Request Overpayment form must be submitted. Complete all
contact, consumer, and provider information at the top of the form.
- Overpayment
begin date:
o
Enter
the date the overpayment began: month, day, year. This is the first incorrect
date for which the consumer was paid;
- Example: If January
paid from the 1st – 31st, but the consumer moved
out on the 25th, the begin date would be January 1st as the whole payment needs to be adjusted.
- Overpayment
end date:
o
Enter
the date the overpayment ended: month, day, year. This is the last date for
which the incorrect payment occurred;
- Example: If January
paid from the 1st – 31st, but the consumer moved
out on the 25th, the end date would be January 31st as the whole payment needs to be adjusted.
o
Consumer service contribution amount: Amount the consumer
is mandated to pay towards their cost of own care for the specified dates only.
o
Does
not include room and board or other needs;
Amount
is found in the 512 on the DISB screen near the bottom right across from SVC
CNTRB.
Do NOT use the CLNT
PAY which includes the room and board amount;
Enter
what the consumer should have paid for their service
contribution. If the service contribution in DISB is incorrect, enter the correct amount the consumer owes for
the dates requested on the late payment request;
o
If
the consumer does not have a service contribution, or does not owe a service
contribution for the dates requested, enter 0 (zero).
- Service
amount: Full monthly service rate/amount the State is authorized to pay
for the consumer, per month;
o
Include
the full monthly amount on the payment requests;
o
Do
NOT prorate this amount for a partial month of service;
o
Amount
is found in the 512 on the DISB screen across from SERV AMT;
Do NOT use TOT DUE as this includes the
room and board;
If
the service amount is not correct on the 512, enter the correct amount that
should have been used for payment.
- Incorrect
payment: Amount
the provider was incorrectly paid for the dates specified.
o
Payments
by the consumer can be found on SCLM,R,prime#.
Use F1 to page through to the month to be
corrected;
Use F4 to go to the last page for the
most recent payments;
o
Enter
the total amount the State paid for the dates of the requested adjustment;
Example: If submitting an adjustment for January 1st
– 31st, fill in the payment for January 1st - 31st that
issued, but is incorrect.
- Correct
payment: Amount
the provider should have been paid for the dates requested.
o
Full
month of service;
If
the consumer does NOT have a service contribution, the correct payment is the
full service amount;
If
the consumer does have a service contribution, subtract the consumer’s service
contribution from the service amount;
o
Partial
month of service:
Determine
what the provider should have been paid for the partial month by using our
standard calculation: CBC Service Payment Calculation form.
- Date client
left facility (MM/DD/YY).
- Date client
returned to the facility (MM/DD/YY).
- Reason for adjustment: Briefly
describe why the adjustment is requested.
o
Example:
Consumer went to hospital on 1/15 and returned to facility on 1/19;
C. Underpayment requests. Complete all contact,
consumer, or provider information at the top of the form
- SDS 287C Underpayment
Request.
- Underpayment
begin date.
o
Enter
the date the underpayment began: month day year;
o
This
is the first date for which the consumer was incorrectly paid;
Example:
If January paid from the 1st – 31st, but the consumer has an exception as of
the 25th, the begin date would be January 1st as the whole payment needs to be
adjusted.
- Underpayment
end date.
o
Enter
the date the underpayment ended: month/day/year;
o
This
is the last date for which the incorrect payment occurred;
Example:
If January paid from the 1st – 31st, but the consumer has an exception as of
the 25th, the end date would be January 31st as the whole payment needs to be
adjusted.
- Consumer
service contribution amount.
o
This
is the amount the consumer is mandated to pay towards their cost of care for
the specified dates only. This does not include room and board or other needs;
it is only a service contribution.
The
amount is found in the 512 on the DISB screen near the bottom right across from
SVC CNTRB;
Do
NOT use the CLNT PAY as this includes the room and board amount;
Enter
what the consumer should have paid for their service contribution. If the
service contribution on DISB is incorrect, enter the correct amount of what the
consumer owes for the dates requested on the late payment request;
o
If
the consumer does not have a service contribution, or does not owe a service
contribution for the dates requested, enter 0 (zero).
- Service
amount:
o
This
is the full monthly service rate/amount the State is authorized to pay for the
consumer, per month;
o
Include
the full monthly amount on the payment requests - Do NOT prorate this amount
for a partial month of service;
o
The
amount is found in the 512 on the DISB screen across from SERV AMT;
Do
NOT use TOT DUE as this includes the room and board;
If
the service amount is not correct on the 512, enter the correct amount that
should have been used for payment.
- Incorrect
payment:
o
This
is the amount the provider was incorrectly paid for the dates specified;
Payments
by consumers can be found in SCLM,R,prime#. Press F1
to page through to the month to be corrected, or press F4 to go to the last
page for the most recent payments;
o
Enter
the total amount the State paid for the dates of the requested adjustment;
Example:
If submitting an adjustment for January 1st – 31st, fill in the payment for
January 1st - 31st issued, but is incorrect.
- Correct
payment:
o
This
is the amount the provider should have been paid for the dates requested;
Full
month of service: If the consumer does NOT have a service contribution, the
correct payment is the full service amount;
If
the consumer does have a service contribution, subtract the consumer’s service
contribution from the Service amount.
o
Partial
month of service:
Determine
what the provider should have been paid for the partial month by using our
standard calculation: CBC Service
Payment Calculation form.
- Reason for
adjustment:
o
Briefly
describe why the adjustment is being made;
Example:
Consumer income level changed beginning January 1st.
D. Adjustment calculation tips. The CBC Service Payment Calculation form is available on the APD Case Management Tools website.
- The State does not pay for the day of
move out for any reason;
- The consumer service contribution is
never pro-rated to pay throughout the month. It is the “first dollar” paid
to the provider and is owed to the provider in its entirety at the
beginning of the month. The State picks up the balance to the provider AFTER the service contribution
has been paid;
- Complete calculations based on the days
the consumer is IN the home, rather than days the consumer was away from the home;
- Payments issue on the night of the first
of each month and Wednesday nights thereafter; checks mail the next business
day.
- Direct Deposit payments are sent to the
Department of Treasury and out to individual banks for processing the next
business day as well. Banks have up to three (3) banking days to deposit funds into provider accounts;
banking days do not include weekends or holidays. This is a federal
mandate and not something which DHS has ability to alter.
C. Customer Employed Provider (CEP) payment system
The Customer Employed Provider (CEP)
payment system is a computer-based information system which allows for the
issuance and payment of vouchers to enable homecare workers (HCWs) to be paid
for the care they provide to APD customers.
Access to the CEP system is limited
to authorized individuals in each local office.
Provider information screens
- SVDM
- Voluntary union deduction menu accesses several screens related to union
deductions, paid leave, and health insurance;
- SPVF,Social Security# - Look up provider by Social Security number;
- SPVF,provider#
- Search by provider number;
- SPVF,providername - Search by provider name;
- PRV8,provider# - Provider information detail.
Issue and pay voucher screens
- HATH,prime #,provider # - Online entry of authorization to generate a Medicaid
voucher;
- OATH, prin=me #,provider#–
Online entry of authorization to generate an OPI voucher;
- HPAY,voucher#
- Pay a Medicaid provider;
- OPAY, voucher# – Pay an OPI provider;
- HRDY,branch# - Vouchers by branch in ready-to-pay status; voucher
information can be printed at the local office printer.
Payment history screens
- HATH,voucher#
- Inquire about a particular voucher;
- HINQ,P,provider#
- Displays payment history for the provider;
- HINQ,V,voucher#
- Information regarding a particular voucher;
- HINQ,R,prime#
- All vouchers for a particular customer;
- HINV - Basic voucher detail; to access, select voucher
from HINQ;
- HDTL - Service dates, hours, gross wages, mileage, and
deduction detail for the selected voucher; to access, F10 from HINV;
- HSVC - Summary of services and detail for each service;
to access, press F10 from HINV or F11 from HDTL;
- HPAD, bracnh#,YYMMDD – All paid vouchers for the branch; voucher
information can be printed at the local office printer.;
- HFIQ,provider#
- Tax information by quarter and year; can be used for employment
verifications;
- RCIQ
– Check status screen;
§
Check number – Displays when the check was issued and paid;
§
Payee ID number – Displays all payments for this provider;
§
Payee name (partial) – Displays all payments for this
provider;
§
Payee name (exact spelling) – Displays all payments for this
provider.
Paid leave available screens
- HRSP,provider#-
Paid leave hours earned for live-in providers;
- SHLQ,provider#- Paid leave hours earned for hourly providers.
Recoupments, deductions, and
garnishment screens
- SLIA,P,provider#-
Displays if a provider has had recoupments, garnishments, voluntary
deductions, or similar activity;
- SUDI,provider#-
Information about SEIU dues deductions and is a HCW is a union member or
fair share; access this screen through SVDM;
- SPRQ,provider#-
Recoupments when an adjustment is due to an overpayment;
- SHHW,provider#-
Number of hours worked each month for health insurance;
- SVDM
- Voluntary union deduction menu. Accesses several screens related to
union deductions, leave, and health insurance.
CMS
questions
|
||
MMIS
questions
|
Client
Maintenance
|
503-378-4369
|
CAPS
questions
|
Service
Desk
|
503-945-5623
|
Provider
questions
|
Provider
Relations
|
503-947-1141
|
512
questions
|
||
512
policy questions
|
Michael
Avery
|
503-945-6410
|
512
exceptions
|
Margaret
May
|
503-945-3418
|
DD
payments
|
Coleen
Thompson
|
503-945-6741
|
APD
payments
|
Coleen
Thompson
|
503-945-6741
|
Mental
health
|
DMAP
|
503-947-5031
|
Licensing
inquiries
|
||
Adult
DD
|
Susan
Eggert
|
503-945-7804
|
Child
DD
|
Local
licensing office
|
|
Adult
APD
|
Local
licensing office
|
|
RCF/ALF
|
Becky
Mapes
Debra
Concidine
Warren
Bird
|
503-373-2076-
503-373-1975
503-373-1959
|