SR 22-19 Dated 07/22 |
STATE OF NEW HAMPSHIRE
DEPARTMENT OF HEALTH & HUMAN SERVICES – DIVISION OF ECONOMIC AND HOUSING STABILITY
Bureau of family assistance (bfa)
INTER-DEPARTMENT COMMUNICATION
FROM: |
Bureau of Family Assistance (BFA) Administrator IV, Debra E. Sorli |
BFA SIGNATURE DATE: |
June 20, 2022 |
FROM: |
Director of Division of Medicaid Services (DMS) Henry Lipman |
DMS SIGNATURE DATE: |
June 24, 2022 |
AT (OFFICE): |
Bureau of Family Assistance Division of Medicaid Services
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TO: |
All BFA Staff All DMS Staff
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SUBJECT: |
Update to DFA Form 270R(T) Request For Skilled Nursing Facility (SNF) 270 Billing Form
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EFFECTIVE DATE: |
July 01, 2022 |
SUMMARY
This Supervisory Release (SR) releases an update to DFA Form 270R(T) Request For Skilled Nursing Facility (SNF) 270 Billing Form.
POLICY
No policy is being changed by the release of this SR.
NEW HEIGHTS & NH EASY SYSTEMS PROCEDURES AND IMPLEMENTATION
NH Easy was updated on June 17, 2022 with BFA Form 270R in the “Forms” section of the webpage to incorporate the revisions to the form as listed below.
DESCRIPTION OF REVISIONS MADE TO FORMS
The following changes have been made to DFA Form 270R(T) Request for Skilled Nursing Facility (SNF) 270 Billing Form and its Instruction page DFA Form 270R(i):
· “DFA” has been replaced with “BFA” to represent the organization change from “Division” to “Bureau”;
· Form number has been updated from 270R(T) to 270R to remove the “T” which represented the word “test”;
· DHHS website address and the Centralized Scanning Unit email address both have been updated; and
· The question “Is the client expected to return home within 90 days: Yes or No” has been added.
POLICY MANUAL REVISIONS
Revised Medical Assistance Manual Topics
Section 237.01 Verification: Nursing Facility
IMPLEMENTATION
Previous versions of DFA Form 270R(T) and DFA Form 270R(i) can continue to be used until the supply is absorbed.
Place an order through the DHHS Warehouse/Logistics via the District Office’s Quarterly Forms Order (QFO) when a supply of the new version of BFA Form 270R and its instruction page BFA Form 270R(i) is needed. BFA Form 270R will also be available externally on NH Easy Gateway to Services at https://nheasy.nh.gov/#/forms/. BFA Form 270Rand BFA 270R(i) will both be available internally, for Department staff only, on the N:\ drive.
CLIENT NOTIFICATION
No client notification is needed.
FORMS ONLINE MANUAL POSTING INSTRUCTIONS
Remove and Destroy |
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Insert/Replace
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Forms Manual
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DFA Form #270R(T), Request for Skilled Nursing Facility (SNF) 270 Billing Form, DFA SR 13-17 1 singled sided sheet |
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BFA Form #270R, Request for Skilled Nursing Facility (SNF) 270 Billing Form, BFA SR 22-19 1 singled sided sheet |
DFA Form #270R(i), Instructions Request for Skilled Nursing Facility (SNF) 270 Billing Form, DFA SR 13-17 1 singled sided sheet |
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BFA Form #270R(i), Instructions Request for Skilled Nursing Facility (SNF) 270 Billing Form, BFA SR 22-19 1 singled sided sheet |
DISPOSITION
This SR may be destroyed or deleted after its contents have been noted and the revised manual topics released by this SR have been posted to the On-line Manuals.
DISTRIBUTION
This SR will be distributed according to the electronic distribution list for Bureau of Family Assistance policy releases. This SR, and revised On-Line Manuals, will be available for agency staff in the On-Line Manual Library, and for public access on the Internet at www.dhhs.nh.gov/dfa/publications.htm, effective July 1, 2022.
BFA/DMS:rs