|
Traumatic Brain Injury Waiver
The Traumatic Brain Injury (TBI) Waiver Program is a long-term care alterative, which provides services that enable individuals to live at home rather than receiving nursing facility care. The program provides home and community-based services to West Virginia residents who are medically and financially eligible to participate.
KEPRO, contracted by the Bureau for Medical services (BMS) is responsible for the day-to-day operations and oversight of the TBI Waiver program. This includes conducting the evaluations that determine medical eligibility for applicants and members, performing provider agency certification and quality/utilization reviews, reviewing requests for prior authorization, providing training and technical assistance to all stakeholders and reviewing requests for prior authorization of TBI Waiver services.
Atrezzo for Traumatic Brain Injury (TBI) Waiver *New
Beginning May 3, 2021, TBI Waiver Case Management Providers will utilize Atrezzo Next Generation (ANG) to submit Member’s Service Request. In addition, TBI Waiver Providers and/or PPL who are assigned to an applicant/ member will be able to access and review applicant/member’s case records including: the completed Pre-Admission Screening (PAS), the applicable Rancho scale used to determine initial and reevaluation medical eligibility; medical eligibility determination letters; and Selection and Service Delivery Model (SDM), to name a few. Assigned TBI Waiver Providers and/or PPL will have the capacity to review and download attached documents and letters from the Member’s Case records for their files.
Atrezzo User Guides
- Atrezzo Provider & Client MFA Registration Process
- Atrezzo User Guide Access and Login Instructions
- Atrezzo User Guide Provider Portal (Provider Training Material PDF)
- Atrezzo WV TBIW Provider Portal User Guide
Provider Training Material
- How to Add a User - Quick Reference Guide
- How to Add Chrome Browser - Quick Reference Guide
- How to Add Supporting Documentation - Quick Reference Guide
- How to Complete a Saved Request - Quick Reference Guide
- How to Make Revisions to Submitted Requests - Quick Reference Guide
- How to Reset Password or Unlock Account - Quick Reference Guide
- How to Update User Profile - Quick Reference Guide
- How to View a Determination Letter - Quick Reference Guide
- Atrezzo TBI Waiver PPL Training 04.15.2021
Instructional Videos
- Provider Admin Registration Training Video
- Provider Admin Add & Manager User Accounts Training Video
- Atrezzo Provider Portal - Add Documentation and View Determination Letters
- Atrezzo Provider Portal - How to Complete a Saved Request
- Atrezzo Provider Portal - How to Submit a New Request
Job Aid
Consumer Education Goals
KEPRO staff are available for training and technical assistance and to receive complaints about TBI Waiver service provision.
- Empowering persons receiving services with information about their rights and responsibilities in communicating with providers and a utilization management contractor
- Informing people of their rights and responsibilities within the TBI Waiver program
- Informing people of their role/choice in accessing services through Waiver versus an institution, choice in service delivery model, and service providers
- Serving as a resource to assist consumers, families, providers and stakeholders with information about alternative resources, advocacy, transitional living homes, food pantries and more.
- Resources:
- Disability Rights of West Virginia
- Center for Excellence in Disabilities at West Virginia University
- West Virginia Parent Training and Information
- West Virginia 211
- US Department of Justice and Civil Rights Division Americans with Disabilities Act
- US Department of Education Individuals with Disabilities Education Act
- West Virginia Department of Health and Human Resources
- Brainline
- National Resource Center for Traumatic Brain Injury
- Brain Injury Association of America
- The Society for Cognitive Rehabilitation
Provider Education Goals
KEPRO Provider Educators and other UMC staff are available for training and technical assistance to TBI Waiver providers.
- Educating providers about their duties to consumers, families and other stakeholders
- Completing on-site utilization management and quality outcomes reviews to gather data and provide training/technical assistance to improve the quality of service documentation, services provided and consumer outcomes
- Assisting providers with proper submission of requests for prior authorization
- Educating providers about TBI Waiver policy
TBI Waiver Department Contacts
Phone: 866.385.8920
Fax: 866.607.9903
General Email: WVTBIWaiver@kepro.com
Additional Resources
Bureau for Medical Services
Website: http://www.dhhr.wv.gov/bms/Programs/WaiverPrograms/TBIW/Pages/default.aspx
350 Capitol Street, Room 251
Charleston, WV 25301
Phone: 304.558.1700
Fax: 304.558.4398
Fiscal Employer Agent (Personal Options)
Public Partnerships, LLC (PPL)
Website: http://www.publicpartnerships.com/programs/westvirginia/WVTBI/index.html
Phone: 877.908.1757
EFax: 877-567-0071
Claims Processing
Molina Medicaid Solutions
Website: https://www.wvmmis.com/default.aspx
For Providers: 888.483.0793
For Members: 304.343.3380
Fax: 304.348.3380
West Virginia Adult and Child Protective Services
Phone: 800.352.6513
Website: http://www.dhhr.wv.gov/bcf/Services/Pages/default.aspx
WV CARES
Website: https://www.wvdhhr.org/oig/wvcares.html
Phone: 304.558.2018
WV CARES Helpful Tips
