SH/AIS Services Overview 2013 Update

Transcription

1 Welcome to the Supplemental Habilitation and Additional Individualized Staffing Services Overview 2013 update webcast. My name is Sarah Naughton and I am with the Office of Developmental Programs Consulting System. Resources for Consistent Statewide Practices is the third set of trainings in the Enhancing the Quality of the Individual Support Plan series. Resources for Consistent Statewide Practices includes information that supports the consistent development and implementation of Individual Support Plans, or ISPs, throughout Pennsylvania. The first resource for consistent statewide practice was the Individual Support Plan Manual webcast. This particular webcast will focus on prior authorization for Supplemental Habilitation and Additional Individualized Staffing services. Per Bulletin number , the Office of Developmental Programs, ODP, requires prior authorization of Supplemental Habilitation 1:1 and 2:1 staffing and Additional Individualized Staffing 1:1 and 2:1 services. Supplemental Habilitation, or SH, and Additional Individualized Staffing, or AIS, services help to ensure health and safety when an individual experiences a change in need. The information in this webcast was updated in February 2013 in order to integrate changes in ODP policy and procedures regarding the updated ISP Review Checklist, the DP Although the DP 1050 form replaced the DP 1035 effective March 1, 2013, all stakeholders should begin using the DP 1050 form for SH and AIS requests that have a start date of July 1, 2013 or later. Use of the DP 1050 for SH and AIS requests that have a start date before July 1, 2013 is optional. 1

2 This webcast includes spoken narration. To adjust the volume, use the controls at the bottom of the screen. While viewing this webcast, there are pause and reverse buttons that can be used throughout the presentation. The written version of the narration appears to the right of the screen. 2

3 This webcast will provide an overview of the prior authorization process for Supplemental Habilitation and Additional Individualized Staffing services. At the end of the webcast, you should be able to describe when to use Supplemental Habilitation and Additional Individualized Staffing services. Throughout this webcast you will be directed to specific areas in the SH/AIS User Guide. By following the references in the webcast to the SH/AIS User Guide, you will become familiar with the prior authorization process and be able to locate information more easily. The last portion of the webcast focuses on specific areas of the ISP that ODP has found to lack sufficient evidence to justify the need for either SH or AIS services. As you view the webcast, you may find that there are sections that may not pertain to your current role. However, the information demonstrates the relationships between the various roles and provides insights to the process. It is important to recognize the interrelationships present in the prior authorization process so the process can occur smoothly and efficiently. 3

4 The SH/AIS User Guide will be referenced frequently throughout this webcast. Therefore, make sure you have it available for easy reference before continuing on with the webcast. Two additional resources that are available to you are the printed version of this webcast and Bulletin # Links to the materials and resources can be found where you launched the webcast. An additional resource that you may wish to review is the approved service definitions which define Supplemental Habilitation and Additional Individualized Staffing services. The current fiscal year s service definitions can be found in the approved Consolidated and P/FDS Waivers. The approved service definitions are located in Section 13 of the ISP Manual. The ISP Manual is located in Attachment #1 of Bulletin # Bulletins are stored on the DPW website using the following hyperlink: Once you reach the Bulletin Search page, click the link called Search for a bulletin. Next, enter the bulletin number in the space provided then depress the Search button. The bulletin and all its attachments will be returned and viewable on the screen. 4

5 SH and AIS services provided through base funding do not require PROMISe TM prior authorization. Due to this, it is at the county s discretion to process base funded requests and provide payment for SH and AIS services. It is at the county s discretion to use the same or similar process as for waiver funded services to assist the county in determining the need and appropriateness of the prior authorization request. This webcast will focus on the SH and AIS services for waiver participants. 5

6 Supplemental Habilitation is used to temporarily meet the short term unique behavioral or medical needs of an individual who resides in a licensed residential habilitation setting. Supplemental Habilitation may be authorized for a maximum of 12 consecutive calendar months. Supplemental Habilitation cannot be requested for start up budgets. The individual s ISP must include both the waiver funded licensed residential habilitation and Supplemental Habilitation procedure codes. An example of when Supplemental Habilitation may be used is when an individual is discharged from the hospital with additional needs and requires two additional hours of temporary one to one staffing each day. Keep in mind that enhanced staffing is only to be used for the person for whom the request was made and not for others that reside in the same home. For example, an SH staff person for Bill may not take Jim on an outing when the staff person s time is being billed as Supplemental Habilitation. 6

7 Additional Individualized Staffing is used to meet the unique long term additional individualized staffing needs of an individual who resides in a licensed residential habilitation setting and the individual s staffing needs can no longer be met as part of the routine residential habilitation staffing pattern. The individual s ISP must include both Residential Habilitation and Additional Individualized Staffing service procedure codes. Additional Individualized Staffing may be needed when an individual has been diagnosed with a terminal illness and will require long term additional staffing. Another example of when Additional Individualized Staffing may be needed is when an individual who resides in a licensed residential habilitation setting retires from employment and wants to receive all future services from the residential habilitation provider. 7

8 The next few slides are questions that will assist you with reviewing the information just presented. 8

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14 The SH/AIS User Guide describes the provider s, Administrative Entity s, or AE s, and Supports Coordinator s, or SC s, role in the prior authorization request process for Supplemental Habilitation and Additional Individualized Staffing services. We will begin by reviewing the provider s role. 14

15 The provider s role in the prior authorization request process for Supplemental Habilitation or Additional Individualized Staffing services is described in the PRIOR AUTHORIZATION REQUEST PROCESS: Provider s Role and Information section of the SH/AIS User Guide. The first step providers must take is to add the service and procedure code for SH or AIS service to the provider s Services and Supports Directory, also known as the SSD, for each service location where the service will be rendered. This is completed in the Provider Access area of HCSIS. Providers who intend on rendering SH or AIS services should ensure that the services are present in the Provider s SSD. 15

16 To request prior authorization for waiver funded SH or AIS services, the provider is responsible for completing several sections of the ISP Review Checklist (DP 1050 form) which include: 1. Checking off Provider in the Initiator of checklist section and checking off SH/AIS in the Activity section of the ISP Review Ccecklist 2. Completing the Provider Information section on page 1 and the Provider to Complete (SH/AIS ONLY) section on page 2 3. Entering a Reason for service need/justification of ongoing service need and an Explanation of what type of support the staff will be providing Once the provider s portion of the SH/AIS ISP Review Checklist has been completed, it should be e mailed to the SC, Supports Coordination Organization (or SCO) Director and the AE. Between steps two and three, there are a variety of activities that occur. The SC would convene an ISP team discussion. The provider is expected to be a part of that team discussion. The ISP team discussion should occur after the provider has e mailed the SH or AIS prior authorization request to the AE. The ISP team discussion does not replace the provider s prior authorization e mail request to the AE. After the team discussion, the ISP is updated in HCSIS by the SC and submitted to the AE. The AE would then complete its review of the request. The provider is expected to respond to any questions from the AE in a timely manner. The AE then submits the prior authorization request with an authorization recommendation to ODP using the following e mail address: RA CentralO.SHAIS@pa.gov. Once a prior authorization decision is determined, step three begins. 16

17 If the request for SH or AIS services is approved, the provider should review the service authorization notice in HCSIS. The provider should confirm that the authorized units and begin and end dates on the service authorization notice generated from HCSIS match the Notice of Prior Authorization Decision letter received from PROMISe TM. Keep in mind that if a provider renders and bills for SH or AIS services before receiving prior authorization from ODP, there is no guarantee the provider will be paid for the services rendered. 17

18 Step four then is the provider billing for the service. Providers should be sure to include the PROMISe TM prior authorization number in the Prior Authorization Number field when submitting claims. This number can be found in the Notice of Prior Authorization Decision letter received from PROMISe TM. The 10 digit Medical Assistance Recipient Identification Number, also known as the RID, must also be entered on the claim for SH or AIS services. PROMISe TM will not accept the 9 digit MCI number when processing claim transactions. More specific information about these steps can be found in the SH/AIS User Guide in the section titled PROVIDER BILLING. 18

19 Next, we will review the SC s role. The SC has a crucial role in the SH and AIS services prior authorization request process. The SC s involvement during the ISP team discussion and the updates to the ISP as a result of the team discussion directly impact ODP s ability to make a prior authorization determination. After the AE, SCO Director and SC receive an e mail notification from the provider that there is a need for SH or AIS services, the SC will convene the ISP team to discuss the need for either service by reviewing the information in Section D of the ISP Review Checklist. A sample of the ISP Review Checklist is located in the SH/AIS User Guide in Appendix F. The form itself can be found on under ODP Resources > Forms. If the ISP team determines that the need for the service is aligned with the approved service definitions, then the SC will update the ISP by documenting the need for the service in the areas of the ISP outlined in Section D of the ISP Review Checklist. Section D, Intensive Staffing, of the DP 1050 outlines the required information to document and where to indicate the need for these services. If the documentation in the ISP does not support the need for these services, the request may be denied. Therefore, please be sure the ISP documents the need for the service in the areas indicated in Section D of the DP SCs should take the DP 1050 with them to the ISP team discussion so that all areas of the checklist are considered. It is important that the ISP team review Section D of the DP 1050 because the reviewer of the SH/AIS prior authorization request reviews the areas of HCSIS reflected in Section D of the DP 1050 when making a prior authorization determination. Take a moment to review all of the information in Section D of the ISP Review Checklist (DP 1050). 19

20 After the ISP team discussion, the SC should document the ISP team discussion information in a service note. This is step two. Step three for the SC involves updating the ISP and attaching the SH or AIS procedure codes in addition to the Consolidated Waiver Funded Licensed Residential Habilitation procedure code to the Service Details section of the ISP. The documentation in the ISP needs to be current to support the SH or AIS request. Be sure to include the proposed weekly schedules and total number of days or weeks of service. Service Details should be updated with not only the appropriate procedure codes, but also the appropriate begin and end dates and units of service. The ISP would then be submitted to the AE. At the same time, the SC should also submit the completed ISP Review Checklist (DP1050) to the AE. When updating an ISP, be sure to use the comments section in the ISP history to indicate why the plan is being updated and briefly summarize the changes made. Until the service is authorized by the AE, it will remain in Pending status. If ODP approves the request, the AE will then authorize the service consistent with the information found in the Notice of Prior Authorization Decision letter. If the prior authorization request is denied by ODP, the SC would reconvene the ISP team to discuss other service options. If the request was denied due to inadequate information, the information should be appropriately documented in the ISP and then the SC can submit the ISP again for prior authorization consideration. 20

21 Next we will look at the role of the AE. The AE s role is described in the SH/AIS User Guide in the section called PRIOR AUTHORIZATION REQUEST PROCESS: Administrative Entity s Role. The AE s first step begins when the AE receives a prior authorization request e mail from the provider with a completed ISP Review Checklist, DP 1050, attached. From the AE perspective, the ISP Review Checklist is a tool to verify that the ISP contains evidence that SH or AIS services will meet the assessed need. Once the ISP and the ISP Review Checklist (DP 1050) are submitted for review, the AE reviews the ISP and Service Details to ensure that the need for the service is documented in the ISP and that the units of service accurately reflect the needs of the individual for the timeframe requested. Step one is completed when the AE e mails its prior authorization recommendation for SH or AIS services and the ISP Review Checklist, DP 1050, to RA CentralO.SHAIS@pa.gov. 21

22 At the same time that the AE sends an e mail to ODP indicating its prior authorization recommendation, the AE should complete the MA97 Outpatient Service Authorization Request form and the attachment titled Supplemental Habilitation and Additional Individualized Staffing Prior Authorization Request, form DP Both forms should be completed even if the AE recommends denying the prior authorization request. The completed MA 97 and DP 1031 forms are required for the prior authorization request to be processed in PROMISe TM. The MA 97 is the Medical Assistance form for prior authorization requests. The DP 1031 is an ODP specific form that contains additional information that is needed to make a prior authorization determination. 22

23 After the MA 97 and DP 1031 forms have been completed, the AE will mail the two forms via the United States Postal Service to the address on the slide. After the AE has mailed the forms, the AE will send an e mail to RA CentralO.SHAIS@pa.gov and should enter AE_MCI#_Forms Mailed in the subject line of the e mail. This e mail alerts ODP staff to look for the information in PROMISe TM. This e mail should be sent the day the forms have been mailed and will include the provider s 13 digit MPI number and service location code in the body of the e mail. Once the AE has received the Notice of Prior Authorization Decision letter from PROMISe TM, the AE may authorize the SH or AIS service in the ISP if the service was approved or approved other than requested. The AE should not authorize SH or AIS services in the ISP until the AE has received the Notice of Prior Authorization Decision letter from PROMISe TM indicating the service was approved or approved other than requested. The AE should compare the information found in the determination notice to the units and begin and end dates of the service in the ISP to ensure that all the information matches. 23

24 ODP s role in the prior authorization process for SH and AIS services is located in the SH/AIS User Guide in the section titled ODP DETERMINATION PROCESS. Take a moment to review ODP s role in the prior authorization process. 24

25 Appendix E, PRIOR AUTHORIZATION TIMELINE, illustrates the entire prior authorization process in seven steps and includes the timelines associated with each step as it applies to the prior authorization of SH and AIS services. This appendix also provides a complete picture of the process and how all the steps for each role are interrelated with the other stakeholder s roles in the process. The SH/AIS prior authorization request process is structured as a team process where every participating entity has an important role that is associated with a specific timeframe for completion. If anyone who has a role in the SH/AIS prior authorization request process fails to respond or complete their tasks within the established timeline, the prior authorization determination decision is delayed which has a direct impact on the services rendered to the individual and the provider s ability to get paid for those services. The next set of slides will focus on the timelines associated with the prior authorization process for SH and AIS services. They will help to put the process in perspective as to which role is doing what and when. 25

26 The first step in the process is when the provider completes the applicable sections of the ISP Review Checklist, DP After the provider completes the applicable sections of the DP 1050, the provider will the form to the SC, SCO Director, and AE. 26

27 Step two of the process occurs between the second and sixth days. During this timeframe, the SC will convene the ISP team to discuss the need for SH or AIS services. Section D of the ISP Review Checklist provides guidance as to the information that should be discussed by the ISP team. The ISP team recommends the amount, frequency and duration of the services to meet the assessed needs of the individual. The SC will document the team discussion in a service note. 27

28 After the ISP team discussion, the SC will update the ISP information in HCSIS, complete the DP 1050, then e mail the ISP Review Checklist (DP 1050) to the AE. The type of information to document is described in the chart located in the PRIOR AUTHORIZATION REQUEST PROCESS: Supports Coordinator s Role, STEP 1: Convene ISP Team Meeting section of the SH/AIS User Guide. The information that is documented in the ISP must have sufficient detail so that the AE and ODP reviewers have enough information to fully understand the assessed need. The updating of the ISP is the third step in the process and should occur no later than days seven through nine of the process. 28

29 The 4th and 5th steps in the prior authorization request process are completed by the AE. In Step 4, the AE completes the AE sections of the ISP Review Checklist that was submitted by the provider. The AE then e mails the DP 1050 to ODP at RA CentralO.SHAIS@pa.gov. Step 5 consists of the AE completing and mailing the MA 97 and DP 1031 for loading of the information into PROMISe TM. The address to send the forms to DPW is: DPW, Office of Developmental Programs P.O. Box Harrisburg, PA Regardless of the AE s recommendation to approve or deny a prior authorization request, the AE should e mail the DP 1050 to ODP at RA CentralO.SHAIS@pa.gov and mail the MA 97 and DP 1031 to DPW. 29

30 In Step 6, ODP reviews the authorization request in PROMISe TM and makes a determination. PROMISe TM generates and mails the Notice of Prior Authorization Decision letter to the provider, AE, SCO and individual. If the SH or AIS prior authorization request is approved or approved other than requested, the prior authorization decision letter will include the PROMISe TM prior authorization number, which is also known as the PA Reference Number. If the SH or AIS prior authorization request is denied, the Notice of Prior Authorization Decision letter specifies the individual s right to a fair hearing. 30

31 Step 7 then is when the service is authorized in HCSIS according to the authorization decision. If the determination letter indicated an approval by ODP, the AE should first compare the information in the Notice of Prior Authorization Decision letter to the units and begin and end dates of the service in the ISP to ensure that all information matches. Once the information matches, then the AE can authorize the service. If the service is denied by ODP, then the AE should remove the service from the ISP. The AE will also let the SC know about the denial and that the SC should reconvene the ISP team to discuss other service options. Once the service authorization notice is available in HCSIS, the provider should confirm that the authorized units and begin and end dates match the Notice of Prior Authorization Decision letter. 31

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34 A block by block reference guide to assist AEs in completing the MA 97, Outpatient Service Authorization Request form, can be found in Appendix B of the SH/AIS User Guide. Press Pause if you would to review this information. 34

35 Appendix C of the SH/AIS User Guide contains a blank sample of the DP 1031 that the AE completes. There are some tip boxes on the sample form to assist with the completion of this form. Please pause if you would like to review this information. 35

36 Appendix F of the SH/AIS User Guide contains a blank sample of the ISP Review Checklist. Press pause if you would like to review this information. 36

37 The ISP Review Checklist (DP 1050) is a critical document in the entire SH/AIS prior authorization request process. This slide demonstrates how the Checklist flows through the process. Earlier in the webcast it was mentioned that when it is recognized that SH or AIS services may be needed, the provider is responsible for completing the applicable sections of the ISP Review Checklist. Once the provider has completed the required sections in the DP 1050, the provider will e mail it to the SC, SCO Director and the AE to communicate the need for SH or AIS services. Once the SC receives the ISP Review Checklist (DP 1050) from the provider, the SC will complete the appropriate sections and e mail the checklist to the AE. Next, the AE completes its sections of the DP After the AE sections are completed, the AE sends an e mail to ODP at RA CentralO.SHAIS@pa.gov, and indicates its authorization recommendation. The DP 1050 must accompany every new SH or AIS prior authorization request made to ODP. 37

38 All of the mentioned forms can be found on When you reach the odpconsulting.net homepage, select ODP Forms from the dropdown list under Resources on the menu bar. You will then be taken to a page that contains links to all the forms. All SH and AIS forms related to requesting prior authorization are also stored on the Provider Information Center, the Administrative Entity Information Center and the Supports Coordination Organization Information Center under ODP Business Practice Information > Prior Authorization Processes. 38

39 There may be times when there is an immediate need for SH or AIS services. In these instances, there are a couple of variations to the standard prior authorization process. An example of an immediate need request is when there is less than 24 hours notice that an individual will be discharged from the hospital and there is a health and safety issue that has been identified. This type of situation would warrant an immediate need request because the service is needed effective the day of the request. Immediate need requests should only be submitted up to 48 hours after the immediate need has been identified. If an immediate need was identified but the request was not submitted within a 48 hour period, then the need is no longer considered immediate. In this situation, the prior authorization request should be submitted using the standard SH/AIS prior authorization request process. This request will be reviewed as a prior authorization intensive staffing need request instead of an immediate need request. The next set of slides will review the differences in the process for immediate need requests. 39

40 One difference when there is an immediate need request is that the provider needs to clearly indicate the immediate need in the e mail to the AE and SCO. 40

41 When the AE receives an immediate need request, the provider s e mail should be forwarded to ODP at RA CentralO.SHAIS@pa.gov no later than the next business day to confirm that the SH or AIS services are needed immediately. The AE should enter AE_MCI#_Immediate Need in the subject line of the e mail to ODP. Simultaneously, the AE should also complete the MA 97 and DP 1031 and mail both documents so that the information can be loaded into PROMISe TM. The address to mail the immediate need prior authorization request documents is: DPW, Office of Developmental Programs P.O. Box Harrisburg, PA ODP s approval of the request for immediate staffing will only be for 14 calendar days. This decision will be communicated by ODP to the AE via e mail. The AE will also receive the Notice of Prior Authorization Decision letter which will include the approved number of units and the authorization period that reflect 14 calendar days. 41

42 Fourteen calendar days is a key number to keep in mind in regard to immediate need requests. When the AE contacts ODP about the immediate need request, if approved, the request can only initially be approved for 14 calendar days. The ISP Team has 14 calendar days from the date of the AE e mail request to ODP to meet, discuss, and determine the number of days that would meet the assessed need of the individual. If the ISP Team agrees that more than 14 calendar days of service are needed to meet the assessed need of the individual, then the AE should e mail RA CentralO.SHAIS@pa.gov, attach the ISP Review Checklist (DP 1050), and indicate the total units and begin and end dates agreed to by the ISP Team. The AE should e mail the checklist to RA CentralO.SHAIS@pa.gov no later than 14 calendar days from the date of the initial immediate need request. ODP will review the ISP Review Checklist (DP 1050) and use the timeframe and quantity requested on the checklist to make a final determination for the continuation of services beyond the 14 calendar days. The final determination will be made through the PROMISe TM prior authorization system. This final determination will confirm whether the immediate need request is approved or denied for the continuance of service beyond the 14 calendar day period and will be documented on a second Notice of Prior Authorization Decision letter that is mailed to the individual, provider, AE and SCO. 42

43 If the SH or AIS prior authorization request has been approved for continuance beyond the 14 calendar day period, the AE should adjust the units, begin date and end date on the individual s ISP and authorize the service accordingly. If the SH or AIS prior authorization request is denied beyond the 14 calendar day period and the AE initially authorized more than 14 calendar days of service, then the AE needs to adjust the units and end date on the individual s ISP accordingly. 43

44 The PROMISe TM prior authorization system will be updated accordingly with the approved units, begin date and end date if more than 14 calendar days of service have been approved. If no more than 14 calendar days of service are approved by ODP, then the units and end date in the PROMISe TM prior authorization system will reflect 14 calendar days of service and units. Any units submitted for dates of service beyond the period reflected in PROMISe TM will be denied. Providers may begin billing once they receive the Notice of Prior Authorization Decision letter in the mail confirming that the SH or AIS service has been approved in PROMISe TM. Providers should not begin billing for SH or AIS services until the prior authorization request has been approved in PROMISe TM. 44

45 Information about immediate need requests can be found in the SH/AIS User Guide in the section called IMMEDIATE NEED REQUESTS. 45

46 It is critical that the ISP sufficiently documents the need for the SH or AIS service. The AE and ODP conduct a critical review of the language in the individual s ISP. The language must justify the prior authorization request. 46

47 The review activities performed using the DP 1050 form, the ISP Review Checklist, are a critical task in the prior authorization request process. The following slides highlight areas of the ISP that ODP pays particular attention to when making a determination. 47

48 The third item in the Intensive Staffing Area of the DP 1050, Why is this support needed?, has been found to be the cause of many prior authorization denials. The ISP sections associated with this area of the Checklist should contain current language that is consistent with and justifies the intensive staffing need. ODP will review this area of the ISP to ensure the language contained in it is consistent with the prior authorization intensive staffing need request. The individual s change of need should be sufficiently described and documented in the ISP to describe the individual s assessed need for the service. It is essential that when the team meets to discuss the need for SH or AIS services, that all questions in this item are answered and documented in the areas indicated in the ISP. Another key point to remember is that the information that is documented needs to have sufficient detail so that the AE and ODP reviewers have enough information to understand the assessed need. ODP is looking for documented evidence that alternate supports have been attempted and will not adequately support the individual s assessed needs. For example, would the receipt of Behavior Therapy services, Behavior Support services, or medication management better support the individual s assessed need rather than SH or AIS services? If not, the ISP should indicate what specific alternate supports were investigated and what factors led to the ISP team s determination that the alternate supports did not meet the individual s assessed needs. 48

49 Insufficient or incomplete information in Section D: Intensive Staffing, item #10 of the DP 1050 has caused many prior authorizations to be denied. This item states The ISP includes the plan for the eventual discontinuance or reduction of the intensive staffing that includes the information to be collected and used to determine the effectiveness of intensive staffing and the progress being made toward the reduction criteria. Again, detail is a key component. Be sure to define in the ISP the specific evaluation criteria and timeframe that will be used to determine whether supports should be reduced. ODP will review the ISP before a final prior authorization determination is made. They will ensure that specific evaluation criteria and a timeframe is present and that the information documented in the ISP demonstrates an intensive staffing need. 49

50 If an individual already receives either SH or AIS but they move to a new service location with a different staffing pattern and new staff, then a new MA97 and DP1031 must be completed and mailed to the following address: DPW, Office of Developmental Programs P.O. Box Harrisburg, PA If this step is not completed, then it will delay review of the prior authorization request which will delay payment to the provider. To ensure health and safety of the individual at the new service location it is imperative a new prior authorization request is completed and mailed. If an individual already receives SH or AIS and they move to a new service location with their existing staff, then a new prior authorization request is not needed. 50

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53 When the SC conducts regular monitoring visits, as with any service, it is essential that Supplemental Habilitation and Additional Individualized Staffing services are monitored too. The SC should make sure that the staff person is present and supporting the person as described in the ISP. The SC should also monitor to see if the enhanced support is still needed. 53

54 Thank you for viewing this webcast. This webcast provided you with an overview of the prior authorization process for SH and AIS services. Have a good day. 54