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Waiver Utilization Service

County and COGs recognize the need to regularly monitor the delivery of Waiver Funded services via their sub-Contracted providers. This includes utilization by consumer, site, vendor and/or service. Unfortunately, many of clients have found it difficult to consistently manage this process. We are offering our "Waiver Utilization Monitoring Service" to help fill this need.

Weekly Service:

  1. Importing paid claim files from ODMRDD into Gatekeeper.
    • County Board/COG will download files.
    • Reporting of any errors in import due to incorrect Medicaid Number, etc.
    • Reporting of any errors in processing claims due to incomplete
      •         or incorrect PAS, etc.
    • Reporting of # of claims imported.
  2. Processing paid claims in order to update utilization in Gatekeeper.
    • Reporting of any errors in utilization update due to non-confirmed PAS.
    • Re-processing of prior week's errors due to non-confirmed PAS.
  3. Reporting of Utilization to key personnel.
    • Emailed copy of up to three key utilization reports to key personnel.

More information?

Contact Brian Marshall at (614) 430-0355 Ext. 203 or brian.marshall@primarysolutions.net.