How an advisor can help you
Program Enrollment/Utilization Review (PE/UR) advisors manage the enrollment, termination, transfer and suspension of people who get services from the Home and Community-based Services waiver program.
The PE/UR advisor's primary responsibilities for the HCS program are:
- Authorizing individual HCS enrollments
- Authorizing individual transfers from one HCS provider to another
- Tracking individual suspensions
- Authorizing individual terminations from the HCS program
- Providing consultation and technical assistance to program providers, local authorities (LA) and Consumer Directed Services agencies (CDSAs).
If you don't know who your contact person is, please leave a description of the issue on our message line at 512-438-5055. The PE/UR support staff will retrieve these messages several times a day and direct them to the appropriate person, who will return your call as soon as possible. You can also send an e-mail to PE/UR's general email address and it will be routed to the proper PE/UR employee.
Who to call for other issues
- Call PE/UR at 512-438-5055 if you have questions about:
- Level of Need (LON)
- Level of Care (LOC)
- Individual Plan of Care (IPC)
- Intellectual Disability/Related Condition (ID/RC) assessments
- Inventory for Client and Agency Planning (ICAP)
- Call Special Programs and Services - HCS at 512-438-2200 (Option 5) if you would like to register for CARE Billing Authorization training (to learn how to enter claims) or if you have questions regarding
- denied payments; or
- reimbursement authorization for adaptive aids, minor home modifications and dental services.
- Call the Help Desk at 512-438-4720 or 1-888-952-4357 if you are having technical problems with the CARE system.
- Call Community Services - Contracts at 512-438-3550 if you have questions about or would like to make changes to your HCS/Texas Home Living (TxHmL) contract.
- Call Community Services - Billing and Payment at 512-438-3015 if you have questions regarding
- Billing Guidelines
- Bill Code Crosswalk
- Prior approval of Adaptive Aids and Minor Home Modifications.
- Call Regulatory Services Survey and Certification at 512-438-4163 if you have questions regarding
- the HCS principles;
- an upcoming or past certification review;
- pending approval of a four-bed location; or
- an existing four-bed location.
- Call your local authority if you have questions regarding an individual's HCS/TxHmL program vacancy.
- Call Consumer Rights and Services at 1-800-458-9858 if you have questions or concerns about an individual's rights, health or safety.
- Call the Texas Health and Human Services Commission (HHSC), Rates and Analysis, 512-491-1179 or 512-491-1362 if you have questions about HCS, TxHmL or CDS rates.
- Call your local HHSC office, Social Security Administration (SSA) or Texas Department of Family and Protective Services (DFPS) office (for children receiving Medicaid through DFPS) if you have questions regarding an individual's Medicaid eligibility:
- The SSA can be reached at 1-800-772-1213.
- HHSC and DFPS can be reached by calling 211. Please note that all Medicaid cases are now in the TIERS system. To contact someone about eligibility you must call 211 for information.
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September 5, 2012