Over the desk
Ask Mindful
Ask about a client, ask for the draft, or ask what is due. The answer comes from this desk and cites its rules. A person still signs, and a person still records the filing.
Matching primary seed-rule summaries are below. Open the source and check its applicability before using it.
Layers searched that had a match: 3 State Medicaid manual (DMAS).
Layers with no match for this question: 1 Federal law/regulation; 2 State regulation (Virginia); 4 MCO contract / provider manual; 4 MCO contract/manual; 5 Payer clinical criteria; 6-7 Accreditation / case law / guidance. A rule found in one layer can still be changed by another, especially the plan's own contract (layer 4) and the program's policies (layer 7), which are not loaded.
This is deterministic retrieval; a language model is not connected.
Only primary-read records with a local source snapshot can be an answer. Secondary and general-knowledge hits are withheld.
Payer contracts, proprietary criteria, and internal policies are not loaded.
Source snapshots retain their original revision dates; this search does not certify that they are current.
A-014 What the extension form asks for
Existing authorization number and requested end date; last three alcohol/drug screens; ALL medications prescribed by the SUD provider with response; dimension 1-6 ratings with summaries and attachments; how the member is progressing under the current plan; revised treatment goals; a full discharge plan (discharge level of care, receiving agency, transition coordination done; MAT discharge plan incl. scheduled appointments for OUD); projected discharge date.
form pp. 1-6 · rev 7/22/2025 · P