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Revision 24-3; Effective July 1, 2024
After the caseworker implements the Utilization Review (UR) findings, the region must complete the Completed by Region items in the Findings/Summary section of the UR tool to show the following:
- Date of regional exception to state office: If applicable, enter the date the exception was sent to state office for review and decision.
- CM action complete date: Enter the date the caseworker completed the UR recommended change. This should be the date the change was entered in the Service Authorization System Online (SASO), and the notice was sent to the person receiving services.
- Effective date of action: Enter the date the UR change is effective. This should be the same effective date entered in SASO and on the notice to the person receiving services.
- Regional Comments/Reason for Exception: Enter regional observations or conclusions. If an exception was filed, note the rule and policy basis for the exception and the outcome of the state office review.
The completed UR tool must be returned by email to the referring UR nurse manager within five business days of implementation of the UR recommended change. A copy of the Baseline Information and Findings page(s), not the entire tool, and all service planning documents completed by the UR nurse must be filed in the case folder.