Get N.c. Dma: Certification Of Need Form For Prtf Services For ... - Ncdhhs

Filling out the N.C. DMA: Certification Of Need Form for PRTF services is a crucial step in securing the necessary inpatient psychiatric services for recipients under the age of 21. This guide will provide you with clear, step-by-step instructions to navigate the form and ensure it is completed accurately and effectively.

Follow the steps to complete the certification of need form online.

1. Begin by selecting the ‘Get Form’ button to access the necessary document electronically for completion.
2. Fill in the recipient's details, including the name, Medicaid ID number, date of birth, and admission date. Ensure that the information provided is accurate and up-to-date.
3. Indicate the type of certification by checking the appropriate box for either pre-admission/elective services.
4. Check the eligibility status for Medicaid as it applies: Medicaid eligible on admission, pending Medicaid, no evidence of Medicaid, applied during stay, or applied after discharge.
5. The interdisciplinary team must certify the necessity of inpatient care. Ensure that you have all team members sign and print their names and titles in the designated areas, along with the date of certification.
6. Upon completion, review the form for accuracy and completeness before submitting it to the appropriate Utilization Review Vendor for processing.

Complete the N.C. DMA Certification of Need form online today to facilitate access to essential services.