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DARTS 2012 - Illinois Department of Human Services

1. Procedure Code Patient s Unique Client ID Internal Client ID Recipient No Where would you like this report sent Printer C Screen Exit 4 start S 2 D AR T 5 for windows EE DA YANA 038 P 802m DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 57 PC Reports DEMOGRAPHIC REPORTS What are the Types of Demographic Reports That Can Be Printed W D A R T S for Windows lel x Client Patient Demographics Services Unit Program File Reports Utilities DARTS Information Exit 35 pa CEP an amp Service Reports b 4 Division of Alcoholism and M Demographic Reports Demographic Master File A a Demographic Demo Transactions D A R T S for Windows PROVIDER Mp IN PASSWORD A After entering your Provider Number and Password use your mouse to choose one of the selections from the Menu Bar ee a RC M a arde 4 Start 180 9 Novel 65 cut sc 85 cur se DAR SOS SU YJaAmN GP ssa DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 58 July2011 PC Reports There are three choices for demographic reports as follows Demographic Master File Report This report lists all clients patients who have an admission record in DARTS Sin
2. Source of Income Support fi Can the patient speak English v Prior Treatment Episodes fi Criminal Justice Referral O Continue _ Previous Self Help Group y Screen Supportive Interaction NC Ext Employment Status NOMs Describes the current employment status start S AA gt me Cos E Mic sere Doa i S XR OO GANE F 11 31 am 1 Full time working 35 hours or more each week includes members of the uniformed services 2 Part time working fewer than 35 hours each week 3 Unemployed looking for work in the past 30 days or on layoff from a job 4 Not in Labor Force NILF not looking for work in the last 30 days or homemaker student disabled retired or an inmate of an institution Not in Labor Force NILF Detail NOMs This field is required when the Employment Status 4 Not in Labor Force 1 Homemaker 4 Disabled 7 Not Applicable 2 Student 5 Inmate of Institution 8 Volunteer Work 3 Retired 6 Other 9 Not Looking for Work DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 11 Demographics School Job Training Enrollment For incarcerated persons this field must be Not Enrolled Not Enrolled 2 Enrolled Full Time 3 Enrolled Part Time Educational Level NOMs The highest school grade level completed Enter 12 fo
3. 2 July 2011 How to Get Started FS As applicable is used to go backwards to the previous data input screen Tab 79 moves to the next field Shift tab moves to the previous field What are National Outcome Measures NOMs and How Do They Relate to DARTS National Outcome Measures are domains established by the federal government to embody meaningful real life outcomes for people who are striving to attain and sustain recovery from addiction related disorders DARTS collects information about these domains at admission and discharge from most levels of care within an episode of care This data is submitted in aggregate to the federal government and also used by DASA for analysis and process improvement Outcome measures that are used to analyze change from admission to discharge are identified in DARTS as NOMs Unit Program Each service is entered into DARTS using a unit number and program code Therefore before initially entering any data and whenever corrected or updated software is received all provider unit number and program codes should be verified to reduce the incidence of data rejection The Unit and Program number s are displayed in the Provider Unit Program File If services are delivered at multiple sites using the same unit number and program code additional screens will be displayed listing the unique addresses procedure codes and dedicated funding categories for each individual site It is especially importan
4. Funding Code DM are checked against the established fiscal year allocation for each provider prior to processing Solution There are two possible solutions to this problem If the Medicaid allocation is reached and contract funds remain the service can be rebilled to contract using funding code DC An increase in the Medicaid allocation may be requested and may be granted if funds remain in the total appropriation Neither of these scenarios is a sure thing and fund balances should be checked prior to re submission Error Code 930 No Matching Unit Program The unit program number used for the service billing must match one that is contained within the facility file at DASA When this error occurs it is held in suspense for the next five submissions in anticipation of a correction to the submission If this does not occur the service will have to be resubmitted Solution Verify that you using the most current update to your software This is particularly important if you have relocated a facility or ended or started a new funded service Often when this occurs reporting numbers change or are given new begin and end dates If you determine that you are using the most current unit and program file it will be necessary to contact the DASA Help Desk as the error may be in our files Error Code 931 Service not within the contract date range begin and end date for the associated unit program number A submitted service cannot hav
5. Microsoft Internet Explorer provided by IDHS M Fie Edt View Favorites Tools Help Ei Ow O i2 757 Seach ig Favores eds 3 A Address la https JIreports ilinois gov dhs servetJddrintes 2 Le 5x x i enterprise View Enys Reports BE Topic oum Expanded report list HMgiMo446083 CRS REMITTANCE RPT DUP Hgiso446084 COC REMITTANCE RPT SIMP HMigino44608499 TEST 00C REMITTANCE RPT SIMP B ginos46085 MULTIPLE PAGE PROVIDERS HMgiMo44609I LABEL FOR ISSA PROVIDER Efnmoaaso9 LABEL FOR PRIMARY PROVIDER HrgiMo446091 GRON COPY OF GRDN RPT e giino446092 PRIMARY PROV COPY GRDM RPT EigiMo446093 ISSA PROV COPY OF GRDN RPT Ggimo446094 MH COPY OF GUARDIAN RPT E mosa610L DISKETTE LABELS Ph moas6101 RESULTS SUMMARY miimo44e121 CPV VOUCHER SUMMARY REPORT E 0446131 SPV VOUCHER SUMMARY REPORT mgiMo446221 NEGATIVE VOUCHER AMOUNT Egimo446222 NON PAYMENT VOUCHERS AMOUNT mgiMo446223 SUSPENDED VOUCHER AMOUNT 2 fmos46224 RECOUPMENT VOUCHER AMOUNT mimosepola BOGARD CLIENT LISTING mgimoscpoiB ACTIVE BOGARD CLASS mMgimoscpolc SUMMARY BOGARD CLASS Ef moseBolD BOGARD CLNT LIST IN CILA 4H 0800361 DETAIL SUMM BAL SHEET LAPSE Ef 800365 DETAIL SUMM BAL SHEET LAPSE Ls D Arne icon can be used to search locate a specific report When this icon is selected the following window will appear Enter the Report ID in the correct space then click on the icon at the bottom of the window to locate the report E Ej Report E
6. Topic Document server mvs Reports yl Report ID aae Version ID AAA M D YY H MM SS A Example 5 10 07 8 24 27 AM Section ID Page DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 8l Mobius User Manual After the report is found the left side Enterprise View will be populated with the date time the report was moved to Mobius for multiple production schedules Click on the disk icon and the report will be displayed in the window on the right side of the screen If an error message is received indicating that The requested list is empty this means no data was submitted by the community agency for that particular production schedule If another date is selected and data was submitted for that production schedule the report will appear Bie haa Ha birmi es ried beakers es be EA p 3 E w iit mA gr ld ee dme ut A eme ETE WOE ea 3 ND mESS NONITORIEE AT FOE aT br bist mW Pid ciii ie br LIT bh BR fixa Pul te ELI BERGBT ELINE IT db MAHET PST EAST FRG EEF I FTTOET ALOT FREE EMEF 21 DETAIL GSS PEPUFT Hihihi o PBEPER BCT ST TE t SMART DUISE REAT EF DT DETAIL ERROR BIST 3 EPA MELET ERROR CRT fob CLEENT BTL REMET FAC CLEPNT DpiT4lL BEFOPT CES REEITTAMKE EFT Mr EMT TA TH SC A A I o SIME d PET a FR imm DASA HELP E MAIL DHS DASAHELP G
7. Used to view unit number and program codes funding codes and procedure codes Reports Used to print and view reports Utilities Used to submit service data to DASA change passwords and load updates DARTS Information Verifies the software version QNA de Da O What are the Keyboard Functions Enter Selected to save data and move forward through the screens DATA IS NOT SAVED UNLESS THE MESSAGE TRANSACTION SUCCESSFUL IS DISPLAYED Escape Selected to escape from any data input screen and back to the Menu Screen In the process of entering data on a screen selection of ESCAPE will display a message ARE YOU SURE Y N Responding Y will lose data entered on the most recent entry only Responding N will allow continuation with the transaction F1 If selected data in the demographic or service screens is displayed regarding the individual fields F2 If selected will allow duplication of all the data for the same client patient entered from the previous transaction except for the day the service was provided F3 This option is available on all service reporting screens except Level III It will allow duplication of all the data entered from the previous transaction except for the client patient identification This is particularly helpful when entering group services DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747
8. When removing a large number of discharged clients patients the rollover procedure is ideal Two dates are entered during this process First the current date and second the date for deletion of discharged clients patients 1 e if 07 01 06 is selected as the date to use to delete records only discharged records which were opened before 07 01 06 will be deleted The system will not allow a date to be selected within the fiscal year DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 69 SECTION VIII Backing Up DARTS Files Computers have hard disk crashes or users can delete files by accident Backing up the system is a quick and painless experience and COULD SAVE DAYS OR WEEKS OF WORK Computers come equipped with several different options for back up Depending on the type of computer the command on how to back up computer data files varies The Client Patient Admission Master File DASA CLNT CLNTMAST FIL is located on the hard drive or network drive and contains all of the information about admissions and discharges If the computer crashes there are only two ways to reinstall all admissions and discharges 1 restore the data from the most current back up OR 2 re enter all admission discharge records If there is no back up all records must be re entered Decide on the best way to back up files but it is suggested this process
9. enter the service NOTE Ifthe TPL Information is entered on any Service Screen the admission record for this patient must have completed all TPL demographic information DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 35 Service Reporting Information Revision Code This field is to add revise or void a service The default is A Add and is used with all funding codes The R Revise or V Void codes are used as follows R REVISE a record which was previously submitted and accepted by DASA Only for use with funding code DC This code corrects information on a previously submitted DC claim which was accepted by DASA Use of this code will not allow a billing to be changed from one unit program to a different unit program or to make any change to the Unique Client Identifier Staff ID Service Dates Beginning or Ending or Start Time as these fields make a billing unique and allow for matching The only way to change any of these fields is to send in a V Void claim for the original billing and then an A Add claim for the corrected billing V VOID a record which was previously submitted and accepted by DASA Only for use with funding code DC This code voids a record that was submitted and accepted by DASA The V record needs to be entered exactly as it was in t
10. individual site It is especially important to verify all site numbers by address for the current fiscal year as these may vary from to year to year All addresses should match those specified on DASA facility licenses and Medicaid certifications and enrollments Failure to verify this information or to notify DASA immediately if errors are discovered may result in data errors and possible delays or holds in disbursement or reimbursement for rendered services Year Month The year and month of the service Funding Code The funding code is what directs DARTS to the correct payment source for the service The following codes are used DC DARTS Contract A Service which is supported in full or in part by DASA CONTRACT Non Medicaid funding DM DARTS Medicaid A Service which is supported in full or in part by DASA MEDICAID funding Services linked to a DM code are processed and forwarded on to the Department of Healthcare and Family Services HFS for reimbursement HFS produces the Medicaid Remittance Report DS DARTS Split Billing A Service which is supported by both CONTRACT AND MEDICAID funding This funding code is only used to report certain LEVEL III services in which the treatment cost is paid by Medicaid and domiciliary cost is paid by Contract Unique Client Patient Identifier The 9 digit Patient Unique Client Identifier must match an opening in DARTS Billing Begin and End Date The Billing Begin Date through the B
11. Alcohol 2 Drugs 3 Alcohol and Drugs 4 Co Dependence 5 None 6 Alcohol Drugs and Gambling 7 Gambling If the Problem Area is 5 indicating none the only allowable billing is for assessment Also when none is selected the assessment date will default into the discharge date field The primary secondary and tertiary fields of problem code frequency and administration routes will be automatically completed If the Problem Area is 6 Alcohol Drugs and Gambling the problem code must be alcohol or drugs One of the diagnosis codes must indicate an alcohol or drug related problem and the gambling diagnostic code must be 312 31 or 312 30 DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 17 Demographics If the Problem Area is 7 Gambling the diagnosis code must be 312 31 or 312 30 and the primary secondary and tertiary fields of problem code frequency and administration routes will be automatically completed Opioid Maintenance Therapy OMT Identifies whether the use of Methadone or Buprenorphine is part of the patient s treatment Enter Y Yes or N No Primary Problem Code NOMs This field provides additional information relative to the identified Problem Area field For early intervention clients this field identifies the area that precipitated the need for the early intervention
12. DASA Submission Errors MAIN FRAME CROSS EDITS At main frame processing many cross edits are checked to ensure that all demographics fields are correctly completed with the proper values The error messages that result from this checking are generally self explanatory and are mainly the result of keystroke errors or errors in data collection However they must be corrected in the opening record or all services will continue to reject The first step in correcting these types of errors is to obtain the source documentation for the data entry to determine what needs to be fixed Some examples of these types of error messages are Error Code 317 Age of first use cannot be greater than age at admission For example case the age of first use was submitted as 20 and the age at admission was 19 Error Code 044 Invalid Problem Area This error occurs when a problem area is selected that does not match the primary problem code For example if Drugs are selected as the problem area the primary problem code cannot be alcohol Error Code 174 Dually Diagnosed Require Both Diagnosis This error occurs when the patient is identified as MISA in the opening record and there is no mental health diagnosis entered in one of the diagnosis fields SERVICES ACCEPTED REJECTED REPORT Error Code 945 Billed amount exceeds the Medicaid allocation for this Provider This error will cause Medicaid billings to reject as all Medicaid submissions
13. E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 3 How to Get Started Data Submission Errors Specific error messages are displayed on the Client Master File Update and Services Accepted Rejected reports that are posted on Mobius When you receive an error message the first step is READ the message and correct the problem The DASA Help Desk should be contacted only after you have read the report and tried to fix the problem Some of the most common errors and directions on how to correct them and avoid them in the future are specified in Section XI of this manual D A R T S for Windows ME PSI B xi Client Patient Demographics Services Unit Program File Reports Utilities DARTS Information Exit r Division of Alcoholism and Substance Abuse 4 State of Illinois Department of Human Services E D A R T S for Windows PROVIDER IN After entering your Provider Number and Password use your mouse to choose one of the selections from the Menu Bar v cese start 180 Gg Novell Grou Gp GUI Screen DARTS fon ene eJ aie MN 3H P 8 28am DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 4 July 2011 SECTION II Demographics How Do I Enter Information Into DARTS Information is entere
14. Enter Y Yes or N No Answering Yes will require that a mental health diagnosis be entered into one of the diagnosis fields Number of Arrests in the 30 Days Preceding Date of Admission NOMs Identifies the number of arrests in the 30 days preceding the date of admission Social Connectedness NOMs Identifies the client patient s supportive interaction with family and friends and the level of involvement with self help groups and other recovery support organizations Specify if the client patient had in the past 30 days attended any self help groups for recovery that were affiliated with a religious or faith based organization or a peer operated organization devoted to helping individuals with addiction related problems 1 e Alcoholic Anonymous Narcotics Anonymous Oxford House Secular Organization for Sobriety or Women for Sobriety etc Self Help Group Y Yes N No R Refused D Does Not Know Self Help Group Detail If the answer to the Self Help Group question is yes specify how many times or RF Refused DK Does Not Know Specify if the client patient had in the past 30 days interaction with family and or friends that are supportive of his or her recovery Supportive Interaction Y Yes N No R Refused D Does Not Know DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 15 Demographic
15. FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 13 Demographics Prior Treatment Episodes of Care Treatment Episode of Care means the period of service between the beginning of a treatment service admission and the termination of services for the prescribed treatment discharge Indicate the number of previous treatment episodes the patient has received in any addiction treatment program Referral Source The referral source A Individual Includes the client patient a family member friend or any other individual who would not be included in any of the following categories B Addiction Treatment Provider Any program clinic or other health care provider whose principal objective is treating patients with addiction related problems C Early Intervention Provider Any program clinic or other health care provider whose principal objective is the provision of early intervention services to clients with alcohol or drug related problems D DHS SAPP Prevention Provider Any program clinic or other health care provider whose principal objective is the provision of prevention services targeted at preventing alcohol or drug related problems E Other Health Care Provider A physician psychiatrist or other licensed health care professional or general hospital psychiatric hospital mental health program or nursing home F School Educational A school principal
16. Institution 8 Volunteer Work 3 Retired 6 Other 9 Not Looking for Work DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 25 Demographics School Job Training Enrollment For incarcerated persons this field must be Not Enrolled 1 Not Enrolled 2 Enrolled Full Time 3 Enrolled Part Time Educational Level NOMs The highest school grade level completed at the time of discharge Enter 12 for a GED Number of Arrests in the 30 Days Preceding the Date of Discharge NOMs The number of times if any that the client patient has been arrested in the thirty days preceding the date of discharge Baby Delivered During Treatment NOMs Indicates if the client patient delivered a baby while receiving treatment If yes indicate if the baby was drug free Social Connectedness NOMs Identifies the client patient s supportive interaction with family and friends and the level of involvement with self help groups and other recovery support organizations at the time of discharge Specify if the client patient had in the past 30 days attended any self help groups for recovery that were affiliated with a religious or faith based organization or a peer operated organization devoted to helping individuals with addiction related problems i e Alcoholic Anonymous Narcotics Anonymous Oxford House Secular Organization for S
17. Jim Ost Elmer Se Re 5 DA e DTS O AAN P 11 39 am Example 3 Discharge Ml D A R 1 S for Windows Screen for Level II Services Unit Program File Reports Exit State of Illinois DHS Division of EOS USO and Substance Abuse Service Setting Code LIENT PATIENT DISCHARGE OUTCOME MEASURES SCREEN PROVIDER 0001 UNIQUE CLIENT PATIENT ID 321321325 OPEN DATE 07 f 01 7 2011 NAME L F MI PUBLIC JAMES K Setting Code OR Start Date 07 rf 11 20 11 End Date OF 22 2011 Reason for Transfer Discharge T Date of Last Contact o7 ip2 i 2011 Living Arrangement a Employment Status E Not in Labor Force NILF Detail fr School Job Training Enrollment 1 Educational Level 11 No of Arrests in 30 days preceding discharge oo Baby delivered during treatment N Drug Free Baby Self Help Group v Self Help Detail for Supportive Interaction y PRIMARY Problem Code 01 Frequency of Use E Continue SECONDARY Problem Code ol Frequency of Use Pi Previous Screen TERTIARY Problem Code 01 Fi f Use 1 roblem Co requency of Use I E Press F1 Key on Data Field for Help y istart DES gt Cin Ose Emo ere Doa o BADIA MANTE usan DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 24 July 2011 Demographics Date of Last Contact NOMs The date of the last contact with the client patient even if this
18. Residence Halfway House Residential Treatment Recovery Home Other Housed momnumounau If the opening date is before 7 1 11 the following FY 2011 codes are used 1 Independent Living 2 Dependent Living 3 Homeless Health Insurance Identifies the primary insurance carrier or the primary coverage of the parent or guardian if the client patient is carried as a dependent on that policy 1 Private Other than Blue Cross Blue Shield 4 Medicaid or an HMO 5 Health Maintenance Organization HMO 2 Blue Cross Blue Shield 6 Other 3 Medicare 7 None DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 10 July 2011 Demographics DEMOGRAPHIC SCREEN 2 D A R T S for Windows Services Unit Program File Reports Exit Client Patient Demographic Screen 2 PROVIDER 0001 UNIQUE CLIENT PATIENT ID 321321325 Educational Level fir Income Eligibility Override Primary Language A Interpreter Type Referral Source c Patient involved with DCFS y Number of Arrests in the 30 days oo preceding Date of Admission ac Self Help Detail State of Illinois DHS Division of Alcoholism and Substance Abuse OPEN DATE 07 01 2011 LAST NAME PUBLIC JAMES K Employment Status fi Not in Labor Force NILF Detail F School Job Training Enrollment 1 Family Annual Income 020000
19. and will not schedule an appointment Program Number 42 Service Type 3 Procedure Code CIH Activity Code 034 A meeting is held with an Employee Assistance Coordinator of a local business Program Number 42 Service Type 3 Procedure Code CIH Activity Code 033 A patient is transported to and from the treatment center Program Number 42 Service Type 3 Procedure Code CIH Activity Code 037 DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 37 Service Reporting Information 38 Outpatient or Intensive Outpatient Individual or Group Client Patient Type T gt The patient meets with a clinician for an individual counseling session Program Number 43 or 44 Service Type 1 Procedure Code OPI or IOI Activity Code 001 gt The patient meets with a clinician for a continued stay review Program Number 43 or 44 Service Type Procedure Code OPI or IOI Activity Code 004 gt Thepatient meets with a physician for medication monitoring Program Number 43 or 44 Service Type 1 Procedure Code OPI or IOI Activity Code 012 gt The clinician meets with a family member to discuss a patient s care Program Number 43 or 44 Service Type 1 Procedure Code OPI or IOI Activity Code 041 gt The patient participates in a counseling group session Program Number 43 or 44
20. date is the same as the discharge date Living Arrangement NOMs Identifies the current living arrangement at the time of discharge A Shelter Safe Havens Transitional Living Center TLC Low Demand Facilities Reception Centers other Temporary Day or Evening Facilities B Street Outdoors Sidewalk Doorway Park Public or Abandoned Building C Institution Hospital Nursing Home Jail Prison D Owned or Rented Apartment Room or House E Someone Else s Apartment Room or House F Dormitory College Residence G Halfway House H Residential Treatment I Recovery Home J Other Housed If the Transfer Discharge Date End Date is before 7 1 11 the following FY 2011 codes are used 1 Independent Living 2 Dependent Living 3 Homeless Employment Status NOMs Describes the current employment status at the time of discharge Full time working 35 hours or more each week includes members of the uniformed services 2 Part time working fewer than 35 hours each week 3 Unemployed looking for work in the past 30 days or on layoff from a job 4 Not in Labor Force NILF not looking for work in the last 30 days or homemaker student disabled retired or an inmate of an institution Not in Labor Force NILF Detail NOMs This field is required when Employment Status at the time of discharge 4 Not in Labor Force 1 Homemaker 4 Disabled 7 Not Applicable 2 Student 5 Inmate of
21. dates entered into the Billing Begin and End Date fields Birth Date The child s date of birth Sex The gender of the child Enter M Male or F Female Parent s Unique Client Patient Identifier The Unique Client Patient Identifier of the child s parent The parent must be have a demographic record and be receiving services in a residential program Revision Code This field is to add revise or void a service The default is A Add and is used with all funding codes The R Revise or V Void codes are used as follows R REVISE a record which was previously submitted and accepted by DASA Only for use with funding code DC This code corrects information on a previously submitted DC claim which was accepted by DASA Use of this code will not allow a billing to be changed from one unit program to a different unit program or to make any change to the Unique Client Identifier Staff ID Service Dates Beginning or Ending or Start Time as these fields make a billing unique and allow for matching The only way to change any of these fields is to send in a V Void claim for the original billing and then an A Add claim for the corrected billing V VOID a record which was previously submitted and accepted by DASA Only for use with funding code DC This code voids a record that was submitted and accepted by DASA The V record needs to be entered exactly as it was
22. detailed information Welcome to the State of Illinois Mobius Report Server If you are having difficulties viewing this site please contact the CMS Service Desk Service Desk support Monday Friday 7 30 a m to 5 00 p m 217 524 4784 800 366 8768 THE DATA CONTAINED HEREIN ARE ASSETS OF THE STATE OF ILLINOIS YOU ARE RESPONSIBLE FOR THEIR SAFEKEEPING AND PROTECTION USE OF THIS SYSTEM IS STRICTLY LIMITED TO STATE OF ILLINOIS BUSINESS Department of Commerce and Economic pi i Department of Environmental Protection Agency I ACCEPT the above agreement and want to Access Reports Department of Human Services I ACCEPT the above agreement and want to Access Reports Department of Public Health I ACCEPT the above agreement and want to Access The following DARTS Mainframe Reports are available on Mobius WEEKLY DARTS REPORTS ran every Monday after 5 00 p m PASDMWRI Client Update Report Accepted Rejected Client Demographic Records PASDMWRQ2 Service Accepted Rejected Update Report PASDMWR3 Service Accepted Rejected Summary Report MONTHLY DARTS REPORTS ran every second Monday after 5 00 p m PASDMRRI YTD Site Report by Month PASDMRR2 Service Report Code Counter by Month PASDMRR3 YTD Activity Report DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 61 PC Reports PASDMRRS Active Cl
23. funded service delivery system and to extract information for fee for service payments and Advance and Reconcile Fee for Service funding reconciliation All payments and reconciliations are based upon funding contained in a contract with DASA The only services that should be entered into DARTS are those that are to be reimbursed by Medicaid or those that are to be reimbursed from or reconciled against DASA non Medicaid currently awarded funding What is the Process for Obtaining Information to Input Into DARTS Hard copy data input forms are provided to use with DARTS software It is strongly suggested that these forms be completed by clinical or other organization staff to document reportable and or billable services prior to any entry into DARTS Additionally all individuals who complete and or enter data from these forms should DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 1 How to Get Started throughly read and understand the definition for each field on every form prior to use of the forms or the software Where do I Start All entry into DARTS begins with the main menu bar and the following six options 1 Client Patient Demographics Openings Closings Used to record opening demographics fix demographic errors and to record closing information and discharge outcomes Services Used to report services Unit Program File
24. funded to deliver HIV early intervention training and to report such training to DARTS 59 Administration 60 Workshop Delivery and Support 61 Training Evaluation Interpreter Referral Only allowed for use with program number 64 62 Interpreter Referral Services Gambling Only allowed for use by providers with funded gambling services Patient type must be T using program number 43 Service Type 2 with an L dedicated funding tag and a problem area of 1 2 or 3 63 Gambling Donated Funds Initiative DFT Use the hours field to enter the number of tokens Numbers must be 1 through 9 Only allowed for use with Program Number 49 and service type 3 66 Case Management Round trip or One Way Public Transportation 67 Round Trip Public Transportation can be bundled up to 9 tokens in the hour field 68 One Way Trip Public Transportation 69 Staff Transportation DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 33 Service Reporting Information Procedure Code This field is not entered by the user When the date unit program funding code and service type are entered DARTS will check to assure that the user has been funded for the type of service entered and will automatically enter the procedure code Procedure codes with their associated funding codes are as follows Funding Co
25. of the first assessment early intervention or treatment service unless that was the actual first contact with the client patient Open Date This is a key field for DARTS It means the first date of service for the episode of care For billing purposes this is the first date that a service can be billed Any bill submitted with a date that precedes the opening date will be rejected Internal ID An optional field to record a second identification number for the client patient that may be used only by the provider DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 6 July 2011 Demographics Client Patient Type In this field the type of client patient is identified T should be selected for an individual who will be receiving a Recovery Home service and or who has completed the assessment has a diagnosis of abuse or dependence and who is recommended for admission to a DASA funded treatment service I should be selected for an individual who has completed the assessment has no diagnosis and who is recommended for admission to a DASA funded early intervention service O should be selected only for closure of patient demographic record opened prior to July 1 2004 for which all demographic discharge information cannot be obtained Assessment Date NOMs This field collected in the client patient demographic record and means the firs
26. or submit a new opening record if the invalid opening relates to a previous treatment episode Once submitted check the Client Master File Update to ensure that the opening was accepted Error Code 955 No Opening Record Pharmacy Patient Every DASA funded patient on the Pharmacy Log must have an open record in the DASA master file This error occurs when the only funded service is OMT and no opening record for the patient has ever been submitted to DASA In order for payment to be processed the patient must be on the pharmacy log and have a valid opening at DASA Solution Complete and submit an opening record for the patient DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 TI ADDENDUMI Mobius User Manual Accessing and Using Mobius Document Direct Use the following Web address to access Mobius Document Direct https reports illinois gov NOTE It is strongly advised that you turn your popup blocker off while using this website Welcome to the State of Illinois Mobius Report Server If you are having difficulties viewing this site please contact the CMS Service Desk Service Desk support Monday Friday 7 30 a m to 5 00 p m 217 524 4784 800 366 8768 THE DATA CONTAINED HEREIN ARE ASSETS OF THE STATE OF ILLINOIS YOU ARE RESPONSIBLE FOR THEIR SAFEKEEPING AND PROTECTION USE OF THIS SYSTEM IS STRICTLY LIMITED TO STA
27. po Exi Third Party Liability Information Status gu Payer Amount poono o Paid Date ae RR ERR Revision Code a Press F1 for Help j Start eG W vasa scree 3 D AR 80 Saal i Client O 99 397019 N BFP 115028 The Residential and Recovery Home Services screen is where all Level III and Recovery Home services reimbursed per diem are reported Additionally psychiatric evaluations for patients receiving these services can also be reported on this screen and are reimbursed per event The following fields are required for completion of this screen DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 39 Service Reporting Information Unit Program The unit and program number of the service that is reported Each service is entered into DARTS using a unit number and program code Therefore before initially entering any data and whenever corrected or updated software is received all provider unit number and program codes should be verified to reduce the incidence of data rejection The Unit and Program number s are displayed in the Provider Unit Program File If services are delivered at multiple sites using the same unit number and program code additional screens will be displayed listing the unique addresses procedure codes and dedicated funding categories for each
28. service NOTE 01 None may only be selected as the primary code if None is selected in the Problem Area field 18 01 None 02 Alcohol 03 Cocaine Crack 04 Marijuana Hashish includes THC and any other Cannabis Sativa preparations 05 Heroin 06 Non Prescription Methadone 07 Other Opiates and Synthetics includes codeine hydrocodone hydromorphone meperidine morphine opium oxycodone pentazocine propoxyphene Tramadol and any other drug with morphine like effects 08 PCP Phencyclidine 09 Other Hallucinogens Includes LSD DMT STP Hallucingoens Mescaline Peyote Psilocybin etc 10 Methamphetamine 11 Other Amphetamines Includes Amphetamines Phenmetrazine and other unspecified amines 12 Other Stimulants Includes Methylphenidate and any other stimulants 13 Benzodiazepines Includes Alprazolam Chlordiazepoxide Clonazepam Clorazepate Diazepam Flunitrazapam Flurazepam Halazepam Lorazepam Oxazepam Prazepam Temazepam Triazolam 14 Other Non Benzodiazepan Tranquilizers Includes Meprobamate Tranquilizers etc 15 Barbiturates Includes Amobarbital Pentobarbital Phenobarbital Secobarbital etc 16 Other Non Barbiturate Sedatives or Hypnotics Includes Chloral Hydrate Ethchlorvynol Glutethimide Methaqualone etc 17 Inhalants Includes chloroform ether gasoline glue nitrous oxide paint thinner etc 18 Over the Counter Includes aspirin cough s
29. service is not within the date range of the opening record When this error occurs the service is held in suspense for the next five submissions in anticipation of a correction to the opening If this does not occur the service will have to be resubmitted Solution Check all copies of the Client Master File Update report to ensure that the associated opening record for the submitted service has been accepted Generally if this error occurs the opening record rejected and has not been corrected All associated services will continue to reject until the opening record is corrected Error Code 935 No Opening Record Services cannot be accepted without an opening record and it should be submitted prior to submission of any service When this error occurs the services are held in suspense for the next five submissions in anticipation of a correction to the opening If this does not occur the service will have to be resubmitted Solution Always ensure that the opening has been accepted on the next Client Master File Update report that is sent after your opening record submission If there is a problem with the opening correct it before submitting any additional services Error Code 944 Incomplete Demographics in the Opening Record This error generally occurs when a new demographic field or value to a field is added and the opening record has not been amended When this error occurs the services are held in suspense for the next five submi
30. should be the last date of service in the bundle Community Intervention CIH Only allowed for use with Program Number 42 and a Service Type of ey 3 In reach 32 Outreach 33 Case Finding 34 Crisis Intervention 35 Training Can only be used by providers who are specifically funded to deliver or obtain training and to report such training to DARTS 37 Client Patient Transportation DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 Service Reporting Information Community Intervention can be bundled and reported in larger increments of time Services should be bundled by staff ID and the date of service entered into DARTS should be the last date of service in the bundle Collateral Only allowed for use with Program Number 42 43 and 44 with a Service Type of oy or 669 4 Family or Significant Other 42 Other Employer Friend Minister etc HIV Early Intervention Only allowed for use with program number 95 51 Test Decision Initial Session 52 Test Decision Follow up Session 53 Post test Session 54 Community Intervention 55 Case Management 56 Phlebotomy Tracking 57 HIV C and T Training 58 Semiannual Training HIV Early Intervention Training Only allowed for use with program number 96 For use only by providers who are specifically
31. the bottom of the screen Without this information staff cannot assist with correcting the problem Depress the Print Scan or Print Screen key while both the message and data in error are still displayed on the screen and this will print a copy of what the screen looked like when the error was encountered If the error message concerns a particular field i e Living Arrangement Annual Income Recipient Identification Number etc please refer to that field in this manual to check for the definition and valid field responses DHS assigns User ID s and passwords that are used for FTP processing e RIN requests and Mobius report viewing If you experience problems with this User ID or password contact the Customer Solution Center IT Support for DHS at 1 800 366 8768 Press 1 and then 1 to be connected with a representative If you experience problems with this User ID or password e mail the CMS Customer Solution Center IT Support at cms helpdesk illinois gov and provide the following information gt Full Name gt Organization gt User ID this is the id that begins with HSD gt Telephone number for call back Please note that agents process e mailed password reset requests in the order in which they are received and use the provided telephone number to contact the requester with the new password If the user s information cannot be verified the user will receive an e mail reply suggesting that they resubmit the
32. the client patient has served in the Uniformed Services Enter Y Yes or N No Marital Status 1 Never Married 3 Widowed 5 Separated 2 Married 4 Divorced Number of Dependents for Income Eligibility The number of dependents living in the immediate household as well as any for whom financial responsibility exists Total Number of Children for Whom the Patient is the Primary Care Giver The number of children under the age of 21 living with the client patient and or for whom the client patient is primary care giver Do not include children who have been placed by DCFS temporarily or permanently with others for their care whether relatives or other foster care Pregnant at Assessment Indicates if the client patient is pregnant at the time of the assessment Enter Y Yes or N No DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 9 Demographics Living Arrangement NOMs Describes the current living arrangement A Shelter Safe Havens Transitional Living Centers TLC Low Demand Facilities Reception Centers other Temporary Day or Evening Facilities Street Outdoors Sidewalk Doorway Park Public or Abandoned Building Institutional Hospital Nursing Home Jail Prison Owned or Rented Apartment Room or House Someone Else s Apartment Room or House Dormitory College
33. to recently vewed pages Days to keep pages in history o 24 Clear H story Coloss Fonts Languages Accessibility DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 84 July2011 Mobius User Manual The Settings window will appear Click on View Objects Check for newer versions of stored pages Every visit to the page C Every time you start Internet Explorer Automatically C Never Temporary Internet files folder Current location C Documents and Settings Amount of disk space to use ADHSPA3T OOO Local Settings Temporary Internet Files After the Downloaded Program Files window is displayed PrintEngine ActiveX Control v4 2 will be visible This indicates the print control installed properly and reports from Mobius will be allowed to print F3 Downloaded Program Files File Edit View Favorites Tools Help Q O ome Address 8i C 1wINDOWSiDownloaded Progr v EJ Go he gt feyta Report Viewer Control 18 DDI Print Control Class v2 1 ENU Java Runtime Environment 1 5 0 Java Runtime Environment 1 5 0 4 Java Runtime Environment 1 5 0 Java Runtime Environment 1 5 0 de Java Runtime Environment 1 6 0 Y Java Runtime Environment 1 6 0 Java E E 6 0 i Feroe Activex Control v4 2 J Installed Installed Installed Installed Installed Instal
34. A R T S for Windows EE 2 2 xl Unit Program File Exit FState of Illinois DHS Division of Alcoholism and Substance Abuse 4 SPECIALIZED SERVICES TRANSACTION REPORT Toxicology Childcare Residential PROVIDER 0001 ENTER THE NECESSARY FIELDS BELOW OR LEAVE FIELD S SPACES UNIT PROGRAM PATIENT UNIQUE CLIENT ID INTERNAL PATIENT ID YEAR i MONTH WHAT TYPE OF REPORT DO YOU WANT C Both Records and Totals C Totals Only WHERE WOULD LIKE THIS REPORT SENT C Printer C Screen Exit i esla B ij BOSUPBUNGHF us DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 56 July 2011 PC Reports Medicaid Transaction Report This report lists all of the information about each Medicaid billable service Each billing will print one full page and it is strongly recommended that this report be used to reconcile Medicaid billings The following fields are referenced on this screen gt Unit Program Procedure Code Client Patient Unique Identifier Internal Client Patient ID and Recipient Identification Number D A R T S for Windows Unit Program File Exit State of Illinois DHS Division of Alcoholism and Substance Abuse 1 MEDICAID TRANSACTIONS PRINTING SCREEN PROVIDER 0001 ENTER ONE OR MORE OF THE FIELDS BELOW OR LEAVE SPACES Unit Program
35. AR MONH PATIENT UNIQUE CLIENT ID INTERNAL PATIENTID STAFF ID PROCEDURE CODE __ SITENO DEDICATED FUNDING CHOOSE THE TYPE OF REPORT YOU WOULD LIKE C Report in Order of Patient ID Client Hours C Report in Order of Staff ID Staff Hours C Report in Order of Staff ID with Activity Codes Staff Hours C Group Report WHAT WOULD YOU LIKE PRINTED C Both Records and Totals C Totals Only Generate Report WHERE WOULD YOU LIKE THIS REPORT SENT C Printer C Screen Exit ENTER THE DATA FIELDS ABOVE OR LEAVE ALL FIELDS BLANK TO PRINT ALL RECORDS star i 3 Z D A R T 5 for windows 19905 UMNIECE T soa DASA HELP E MAIL DHS DASAHELP GILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 PC Reports Daily Services Report This report should be printed prior to the submission of any services to DASA to ensure accuracy The printed report can also be used to compare service totals on DARTS Mainframe Reports received from DASA When printing this report the following choices are available gt Unit Program Unique Client Patient Identifier Internal ID Service Year Month etc Leave these fields blank to print all services However to print only a specific unit and program a particular client patient s records or data for a particular service month enter the desired combination gt Clients Patients to be Included T
36. ARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 55 PC Reports Specialized Services Report This report should be printed prior to the submission of any services to DASA to ensure accuracy The printed report can also be used to compare service totals on DARTS Mainframe Reports received from DASA When printing this report the following choices are available gt Unit Program Unique Client Patient Identifier Internal ID Service Year Month etc Leave these fields blank to print all services However to print only a specific unit and program a particular client patient s records or data for a particular service month enter the desired combination gt Client Patients to be Included This allows for tracking of all clients patients or only DCFS clients patients gt Records to be Printed Choose to print 1 Both Records and Totals OR 2 Totals only The first report Records and Totals can be very useful to verify that a client patient has been entered into DARTS for the correct number of hours etc This type of report will also list the date of service which is useful when verifying monthly totals Unit program totals are also printed The second report Totals Only gives one page totals for every unit program entered When printing the Totals Only Report the numbers may reflect service hours for multiple months in case more than one month of data was entered since the last submission W D
37. Alcoholism Substance Automated and Tracking DARTS FISCAL YEAR DARTS Department of Human Services Manual for Abuse Counselors Computer Personnel 2012 Division of Alcoholism and Substance Abuse TROUBLESHOOTING DASA HELP DESK For questions or problems concerning the use of the DARTS software please refer to this manual before contacting the department This is the quickest way to find answers Check also the DASA Web Page at http www dhs state il us page aspx item 29747 as this site contains many reference materials If problems cannot be resolved Section IX of this manual contains guidelines for documentation of the problem and for contacting the DASA Help Desk at DHS DAS AHelp Gillinois gov or faxing to 217 558 4656 Table of Contents SECTIONI How to Get Started siccrscrcorsconci ea da CEA RE ee ee CIE EE CEA ICE EA EE E a 1 What is DARTS and How is it Used euecs hehe LEES S e A a a MP ER RSS RERUMS 1 How and When is Data Sobre ee ee 1 Wher Do TOP arbeitet 1 How DOTES Peau ie A egg Stason AE AA AS AE RRE UD a 1 What Information Should be Entered into DARTS 0 0 0 eee 1 What is the Process for Obtaining Information to Input Into DARTS oooococoocoocoocoocoocooooo 1 Were dol Start de a ru b e LE t rM 2 What are the Keyboard E nctions 2 2 TES 2 What are National Outcome Measures NOMs and How Do They Relate to DARTS 3 Lat PEO STIL A A niet cle coalescere 3 Dedicated Fun
38. DAR e So JU peMNGHF sum DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 44 July 2011 Service Reporting Information SERVICE REPORTING SCREEN CHILDCARE RESIDENTIAL When children accompany their parent in residential care and the child occupies a DASA funded bed the following information is required E D A R T S for Windows E 181x Client Patient Demographics Services Unit Program File Reports Exit State of Illinois DHS Division of Alcoholism and Substance Abuse Childcare Residential Service Reporting Screen Provider 0001 Unit 0100 Program 02 Year 20 08 Month o7 modra dz TW Child s Unique Funding Code DC enano 312323222 Billing Begin Date 07 o 20 08 Billing End Date 07 fos 2u os Number of Days 05 Procedure Code CRD Birth Date i TN i 20 Sex m a 321321325 Exit Duplicate Previous Screen Revision Code A zl stan S G Dovel G cur se B curse Z DAR oU PMN ORF ssa Unit Program Each service is entered into DARTS using a unit number and program code Therefore before initially entering any data and whenever corrected or updated software is received all provider unit number and program codes should be verified to reduce the incidence of data rejection The Unit and Program number s are displayed in th
39. DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 21 Demographics Transfer Discharge Reason NOMs This code was established by DASA to identify the reason for the transfer discharge as follows A Assessment resulted in a finding of none in the problem area field contained within the demographic gs mo record When none is entered into this field the only allowable billing is for an assessment for admission Completion of Intervention or Treatment services This code is used to indicate completion of all planned treatment for the current episode of care Completion of treatment at one level of care within the same provider is not completion of treatment if there is additional treatment planned as part of the treatment episode When this occurs a discharge reason indicating transfer code should be selected Left against staff advice This code should be selected when the client patient chose not to complete services with or without specific advice to continue This includes clients patients who drop out of intervention or treatment for unknown reasons and those who have not received services in three days following completion of residential services and 30 days for outpatient DASA also uses this code every month to close old admission records at DASA that have not had any service in over six months Terminated by facility This code i
40. Date 07 i 1 A 2 Internal ID JKP120146 Patient Type T Assessment Date OF HM oi 20 m Last Name PUBLIC First Name JAMES Middle Initial K Address 123 MAIN ST City KINMUNDY State IL Zip Code 62854 Geocode 100 00 Birth Date 12 01 E 9 61 Press Fl Key on ban Field for Help Race A Ethnicity 1 Sex M Veteran y Marital Status i No of Dependents 05 Previous Screen Primary Care Number po Pregnant at Assessment N Print It Living Arrangement A Health Insurance Pa Exit start S AG gt Wb ser Emer sere Doa SO XP CIO IN BF 11 30 am DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 5 Demographics Unique Client Patient Identifier NOMs This is a key field for DARTS as it holds the number that identifies the client patient as unique in our system and across other systems of care This number is essential to state and federal government for the measurement of outcomes the ability to track clients patients who receive services from multiple agencies and to ensure that duplicate services are not billed for the same client patient For existing clients patients who have been receiving services with no interruption over the past few fiscal years this number might still be the social security number or a generated identification number However the Re
41. E http www dhs state il us page aspx item 29747 42 July 2011 Service Reporting Information Medicaid Spend Down Due from Patient The amount that the patient is responsible for before Medicaid Eligibility can be established If not applicable leave this field blank Third Party Liability TPL Information If applicable enter the following fields TPL Status Enter the adjudication status of the amount in question 01 TPL adjudicated total payment shown 02 TPL adjudicated patient not covered 03 TPL adjudicated services not covered 05 Patient not covered 06 Services not covered 07 Billed insurance not paid TPL Payer Amount Enter the amount of payment received from the third party health resource or the patient TPL Paid Date If the status is 01 02 or 03 enter the Third Party Adjudication Date If the STATUS is 05 06 or 07 enter the service NOTE Ifthe TPL Information is entered on any Service Screen the admission record for this patient must have completed all TPL demographic information Revision Code This field is to add revise or void a service The default is A Add and is used with all funding codes The R Revise or V Void codes are used as follows R REVISE a record which was previously submitted and accepted by DASA Only for use with funding code DC This code corrects information on a previously submitted DC claim which was accep
42. EN E D A R T S for Windows E 7 atx Services Unit Program File Reports Exit State of Illinois DHS Division of Alcoholism and Substance Abuse Aa PROVIDER 0001 3 UNIQUE CLIENT PATIENT ID 321321325 OPENDATE 07 01 2011 NAME L F MD PUBLIC JAMES K Service Setting Code Start Date End Date Transfer Discharge Reason Dx oz for sf 20ft1 gt 07 ff 03 ff 20511 Tt RR o7 04 sf 20f1 o7 10 sf 20i T oR or afi EN oz 22 sf 201 7 o wyatt o EENEN __ o B NE Jd d 39 if NEN SS 39 s NEM 3 d _ if B NEM d d I 83 MN HN J Continue Em CE 8 NEM NJ d Po a S LIEN __ 3 B8 I MEM 3 Jd h Exit Closing Date E HH l 4 gt star S AO gt mme Oso Emer m Re Doa o e E e IO CIN TB seam See examples of corresponding Client Patient Discharge Outcome Measures screens in the next section on pages 21 and 22 Service Setting Code The two digit code established by DASA to identify the service the client patient is receiving OP Level I Outpatient RR Level IIL5 Residential Rehabilitation OR Level II Intensive Outpatient DX Level IIL 2D IIL7D Detoxification HH Level IIL1 Residential Extended Care RH Recovery Home Start Date The date of admission into the specified service setting code End Date The date of discharge from the specified setting code DASA HELP E MAIL DHS
43. ES we od vd wd we EEE AEE i 31 33 36 43 46 48 53 MA e e e o 34 36 43 46 48 Stats pasa is ETE LAT EAT A EEE EEE EE EEE 6 9 11 25 35 43 Supportive Intetactol 2222 2 RRERRRRRRERERRRERURRRRAAGQNRRERNRERRMRIARDQEMRG 15 26 27 Tertiary Problem Code 19 28 Third Party Liability TPL Information oo ooooooororrr e 16 35 43 Total Number of Children 9 is Tals seria at ten eu uetus uiae uuu utut ui cd ad ASN aa hte Aaah stet 48 TPL Codes or sa occ ca hc hates veux A NEN stated 16 TPL Pad Date dd E EE 35 43 TPL Payer AmoUnt a as alar 35 43 TPL Payer Name Ian aia aan me nM a aA 16 TEA aaa 35 43 Transfer Discharge Reason NOMS o 22 Unique Chent Patient Identifier y 9 RH Rem e Re ee 6 31 40 46 48 51 53 55 56 59 Unit Program 0 0 0 0 eee seen 2 3 30 34 36 40 41 43 45 48 51 53 55 57 68 72 75 VOI E 9 be A E 40 O SER 7 DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE 88 July 2011 DARTS 2012 Department of Division of Alcoholism Human Services and Substance Abuse A Users Manual for Substance Abuse Treatment Counselors and Computer Entry Personnel
44. IDER 6001 OLD PASSWORD J kh NEW PASSWORD _ GoBack DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 Utility Functions Diskette File Counter submitted to DASA This utility function will count records in DARTS which have been previously D A R T S for Windows BEE 3 State of Illinois DHS Division of Alcoholism and Substance Abuse Count Records of Transaction Files PROVIDER 0001 This program will count records on DARTS files which have been previously pulled onto a diskette Enter the disk drive which contains your DARTS Transaction Files The default is A Diskette Drive h Exit gt From the Menu Bar click on Utilities then Diskette File Counter gt Insert the diskette containing the records to be recounted gt Identify the drive which contains the diskette The screen will display the file name and the number of records contained on each of the files on the diskette Resubmit a File to DASA This program will copy a DARTS back up file to diskette s to be resubmitted to DHS Enter the date in which the file was originally downloaded The date in which the file s were downloaded can be found through the PC Reports Option from the Main Menu View the report associated with that date to verify the correct back up file DASA HELP E MAIL DHS DASAHEL
45. ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 82 July 2011 Mobius User Manual The icon shown at the top of the screen may be used to search locate specific information Next rene a roro Icons used for right report side web panel Ea Q Page Address https reparte Minos gov drs saa 3 2 go e Va s Gi 2 IE Enterprise View Bms Reports H Topic Provider Name f Report MBURSEMENT SUB Provider FEIN r5 Entry Agent Nane Entry Agent FEIN Ef no246053 0 Page Nunber Bier 12 tum m diank j oem j i i i ee one HE blank i p H T T HE lt blank e Ejovlank H IQGRAM SUMMARY Bp 0 0723 i i VOUCHER EXPND FY o 0761 ICAA 4501 2007 E 043653 HE 046404 Adjust viewable TEES size of report 127404 Download amp E 201436 a H ee save to PDF or Must select this print B2758 other file type icon to allow ActiveX 207136 i Print Controller to de install on 1 use of Mobius web site 1 323 00 ray 5 2 mita 25 Bar 21 aar 15 e men Report MD446003 Version May 12 2007 8 05 58 PM Section 061703157 CARRIES PLACE NFP ls Printing To activate the Mobius print function click on the larger printer icon at the top of the screen in the right panel to allow the print application ActiveX Print Controller to load to the computer
46. P ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 67 Utility Functions D A R T S for Windows State of Illinois DHS Division of Alcoholism and Substance Abuse COPY BACKUP FILE TO RESUBMIT TO DHS PROVIDER 9001 BACKUPFILEDATE f f ls Ext DISKETTE DRIVE This program will copy a DARTS backup file to diskette s to be resubmitted to DHS Enter the date in which the file was originally pulled onto diskette You may find out the date in which the monthly diskette was created thru the PC Reports option from the Main Menu View the report associated ith the date to verify the correct backup file Clear Record Locks Since DARTS provides for use on local area network LAN systems record locking is provided In the event a record cannot be accessed and the message Record is locked by LAN is displayed this option can be used to clear all record locks Update Unit Program File Periodically files are e mailed from DASA which will update the unit program file The provider unit program file contains all of the valid unit program combinations Updates of this file are sent at the beginning of every fiscal year as well as throughout the year if there are any additions or changes After receiving a file please update the provider unit program file in a prompt manner Check the provider unit program file by choosing Unit Program Fi
47. SARY FIELDS AND PRESS ENTER start S A O gt Wind Ose Emer sere Doa i SRO LOO GaN FB FP inseam Example 1 Discharge Screen for Detox Service Setting Code DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 23 Demographics Wil D A R T S for Windows Services Unit Program File Reports Exit State of Illinois DHS Division of SADIPS ex Substance Abuse Example 2 Discharge Screen for Level III Service Setting Code CLIE NT DISCHARGE OUTCOME ME PROVIDER 0001 UNIQUE CLIENT PATIENT ID 321321325 OPEN DATE 07 f 01 2011 NAME L F MI PUBLIC x JAMES K Setting Code RR Start Date 07 04 20 11 End Date 07 510 2011 Reason for Transfer Discharge T Date of Last Contact o7 10 i 2011 Living Arrangement a Employment Status i Not in Labor Force NILF Detail fr School Job Training Enrollment u Educational Level 11 No of Arrests in 30 days preceding discharge 01 Baby delivered during treatment N Drug Free Baby Self Help Group y Self Help Detail Supportive Interaction y PRIMARY Problem Code 02 Frequency of Use i Continue SECONDARY Problem Code 05 Frequency of Use 1 s TERTIARY Problem Code 07 Freq f Use 1 roblem Co requency of Use ES T Press F1 Key on Data Field for Help X start amp B
48. Service Type 2 Procedure Code OPG or IOG Activity Code 002 gt The patient participates in a didactic group session Program Number 43 or 44 Service Type 2 Procedure Code OPG or IOG Activity Code 006 gt The patient participates in a recreational activity Program Number 43 or 44 Service Type 2 Procedure Code OPG or IOG Activity Code 007 Case Management A Discussion with other providers regarding supportive services to the patient e g child care Medicaid needs public assistance etc Program Number 41 Service Type 3 Procedure Code CMH Activity Code 023 gt The Provider contacts another staff member within the same organization to discuss the patient s treatment or discharge planning Program Number 41 Service Type 3 Procedure Code CMH Activity Code 022 gt The organization has a weekly meeting to staff treatment patients Program Number 41 Service Type 3 Procedure Code CMH Activity Code 022 Psychiatric Evaluation An early intervention client receives a psychiatric evaluation Program Number 42 Service Type 1 Procedure Code PEV Activity Code 011 gt A treatment client receives a psychiatric evaluation Program Number 43 or 44 Service Type 1 Procedure Code PEV Activity Code 011 Discharge Assessment The discharge assessment is a distinctly reported and separately billed service Billing for a discharge assessment will be rejected u
49. TE OF ILLINOIS BUSINESS Department of Commerce and Economic Opportunity I ACCEPT the above agreement and want to Access Department of Environmental Protection Agency I ACCEPT the above agreement and want to Access Reports y Reports y Department of Central Manazement Services Department of Human Services I ACCEPT the above agreement and want to Access I ACCEPT the above agreement and want to Access J J c2 Reports Reports gt Department of Employment Securities Department of Public Health I ACCEPT the above agreement and want to Access I ACCEPT the above agreement and want to Access Click the printer icon Department of Human Services on the Mobius Report Server screen to enter the site DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 78 July 2011 Mobius User Manual Select Yes on the Security Information Window to continue Security Information The following window will appear Enter your DHS User ID and password then click on the green circle with the check mark DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 79 Mobius User Manual The following screen appears after successful log on NOTE This website does not allow you to update or change your password If your password is re
50. This only needs to be done once and takes just a few seconds The popup blocker must be turned off for this application to download DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 83 Mobius User Manual Verifying that the ActiveX Print Controller has been successfully installed On the Document Direct screen select Tools from the menu bar then select Internet Options from the drop down list 3 DocumentDirect for the Internet Microsoft Internet Exp File Edit View Favorites Tools Help S Mail and News Back gt F Y gt ix t Synchronize Address E https J reports illina Show Related Links Sun Java Consolc Internet Options gEnterprise View igam Reports EHE Topic report The Internet Options window will appear with the General tab displayed Click on Settings under Temporary Internet files section of the screen Internet Options General Security Privacy Content Connections Programs Advanced Home page You can change which page to use for your home pags Addess II Use Curent Use Detaut Use Blank C Temporary Internet files P T view on the Internet are stored in a special loldes EV for quick viewing later Delete Cookies Delete Fies a D PE History The History folder contains links to pages you ve visited for quick access
51. V FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 Demographics CLIENT PATIENT DISCHARGE OUTCOME MEASURES SCREEN The following three examples of Discharge Screens are for the Example Discharges on the Client Patient Service Setting Screen on page 19 of this manual The examples demonstrate how the collection of outcomes should be documented for each service setting code D A R T S for Windows Services Unit Program File Reports Exit State of Illinois DHS Division of Alcoholism and Substance Abuse CLIENT PATIENT DISCHARGE OUTCOME MEASURES SCREEN PROVIDER 0001 dows UNIQUE CLIENT PATIENT ID 321321325 OPEN DATE 07 01 2011 NAME L F MI PUBLIC JAMES K Setting Code Dx Start Date o7 ors 20 11 End Date 07 Jo 2011 Reason for Transfer Discharge T Date of Last Contact o7 os 2011 Living Arrangement E Employment Status E Not in Labor Force NILF Detail fr School Job Training Enrollment I Educational Level 11 No of Arrests in 30 days preceding discharge 00 Baby delivered during treatment N Drug Free Baby Self Help Group y Self Help Detail Supportive Interaction y PRIMARY Problem Code 02 Frequency of Use 1 SECONDARY Problem Code 05 Frequency of Use 1 ae creen TERTIARY Problem Code 01 Fi fUse 1 roblem Code requency of Use h Est Press Fl Key on Data Field for Help X CHANGE NECES
52. ang g usse eek un er NR TR RUE TRO ER RENE OR CR RU ER ELENA MERE RE RE NOR RC ICA COR OR ORA 13 Primary Problem Code NOMS is were eru ud C RH ADR DR EEE AC RU PR 18 27 Prior Treatment Episodes of Care iuusaeueausueox ee ROCA RON ROCATCA a ae wale a ee ae OR wae UR 14 PFODAUOH e M MM MM M deca 14 a UE Lt Lt EE 7 17 19 22 27 33 60 75 Procedure Code us 34 37 39 41 42 51 52 57 Program Nu nber ici a ia ei ena ean TES 3 30 32 33 36 40 44 45 47 75 Provider Number cid ia mia ea a a e a aa iia e iio M 1 71 Psychiatric Evaluation a lada e 32 34 38 42 en M 9 Recipient Identification Number RIN o oo oocoooooo eh ra 6 ReferralSource srserscese t TEETE E E TEPE EERTE EEE EEEE hh aha hrs 14 Revision Code E ESET A E eee A AAA 36 43 46 48 74 School Job Training Enrollment o oooooooorrr ehh 12 26 secondary Problem Code 22229 9 RPRRRRRAG GG RR RRRRRRPRRRRPRRRRPRRRTRRRRPRMERPRERPRERPRRRS 19 28 sel HEIP OUP Geceeer sede sashes rro E E E E EE EE a DERDE ENERE RE DIORA 15 26 a le ol BELO NO NU dud UA a a a aaa a aaa 31 48 74 77 Sage duo RIA 31 34 36 39 OO de Me RO e e TE 9 46 Site N mber unir a 31 DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 87 Index Social Connectedness NOMS esee eee re e e e re y a teense 15 26 Source of Income Support AA O emn 13 Staff d occa te co ee cose Wo Ew
53. ce there may be thousands of patients who have been entered view the report on the screen before printing Choices are given to customize the report These choices include 1 printing in order of the Unique Client Patient Identifier or Name AND 2 printing all records only admission records or only discharge records State of Illinois DHS Division of Alcoholism and Substance Abuse PATIENT DEMOGRAPHIC 1 TER REPORT SCREEN IN WHAT ORDER WOULD YOU LIKE THE PATIENT MASTER PRINTED C Print in order of Patient Unique Client ID C Print in order of Name C Print in order of Recipient ID RIN WHAT TYPE OF RECORDS DO YOU WANT TO SEE C All Records C Opened Records Only C Closed Records Only WHICH TYPE OF PATIENTS WOULD YOU LIKE TO INCLUDE N C Both Treatment and Intervention Patients C Treatment Patients Only C Intervention Patients Only WHERE WOULD YOU LIKE TO SEE THE REPORT C Screen Exit DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 59 PC Reports Client Patient Demographic Transaction Report Choosing this option will print all one or all client patient demographic records that have been submitted to DASA Every time a client patient s record is added to changed or deleted that data is written onto the hard drive This report will show these changes and print demographic problem area and dis
54. charge data input form The information contained on this form is then used to input the data into DARTS Discharge in DARTS is critical to reduce the incidence of submission errors and to ensure correct reporting of national outcome measures Discharge means the termination of all services for the prescribed intervention or treatment by some action initiated by the organization and or the client patient Any change in service within the same Provider during an episode of care is considered a discharge with a transfer code selected as the reason The prescribed intervention treatment should be assumed to have ended if the client patient has not received a service in three days in the case of residential services and 30 days in the case of intervention or outpatient services All discharge questions should be completed relative to the client patient s condition at last known contact and submitted to DASA Billing for a discharge assessment is not allowed unless the client patient is discharged in DARTS through completion and submission of information required on the following screens When a discharge reason is entered on the Client Patient Service Setting Screen this then requires completion of the Client Patient Discharge Outcome Measures Screen DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 20 July 2011 Demographics CLIENT PATIENT SERVICE SETTING SCRE
55. charge information This date reflects information entered on this date not admitted on this date i e a review of all admission records entered into the PC today In most cases it is not necessary to print or view this report every month Each client patient record takes up one printed page therefore only refer to the report when necessary for error reconciliation The date range feature allows the date range to be chosen so that only demographic records added or changed within that data range are printed D A R T S for Windows L 8 x Unit Program File Reports DARTS Online Manual Exit State of Illinois DHS Division of Alcoholism and Substance Abuse y PATIENT DEMOGRAPHIC TRANSACTION REPORT SCREEN er WHAT DATE RANGE WOULD YOU LIKE TO USE FOR THIS REPORT Either fll in the date fields or you may leave one or both of the fields blank STARTDATE A v N END DATE AA TJ ENTER THE PATIENT SSN or leave blank for all records WHERE WOULD YOU LIKE TO SEE THE REPORT C Printer C Screen Generate Report Exit DONA IA AAA Re TEE Am mro TrA Anne DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 60 July2011 PC Reports Mobius Document Direct Choosing this option will allow providers to view DARTS mainframe reports online See Mobius User Manual Addendum I for more
56. cipient Identification Number RIN assigned by DASA is the preferred unique identifier and must be used for any new admission Identifier Status This field contains additional information concerning the status of the unique identifier The SSN is the identifier The service recipient does not have a SSN The SSN was not obtained before termination of service The RIN is being used as the unique identifier For clients opened after 6 30 07 Identifier Status must be D Ow Recipient Identification Number RIN Enter the 9 digit number assigned to the individual by DHS or as indicated on the Medical Eligibility Card This recipient number is comprised of a mathematical computation and is required for all clients patients Entering any of the nine digits incorrectly will display the error message Invalid RIN Computed Note If the RIN is used as the unique identifier it will automatically default to this field Initial Date of Contact NOMs The date of the initial contact means the first request for an early intervention or treatment service for the current episode of care in which an appointment is made by the client patient or someone on behalf of the client patient NOTE This date keys to a critical outcome measure related to the amount of time elapsed between the initial contact the assessment and the first intervention or treatment service Please ensure that this date is entered correctly This date SHOULD NOT be the date
57. code do not complete these fields Tertiary Problem Code NOMs The same code choices as those designated under primary If there is no tertiary problem code do not complete these fields DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 28 July 2011 SECTION III Service Reporting How Do I Enter Delivered Services Into DARTS Service delivery information is collected and recorded on DARTS data input forms The information contained on these forms is then used to input data into DARTS through the Service Reporting Menu which contains three sections for data entry To enter services choose Service from the main menu bar The following screen will be displayed D A R T S for Windows E la xl Client Patient Demographics Services pUnit Program File Reports Utilities DARTS Information Exit AS Hourl gt a Division of A HeY ance Abuse 4 Residential Recovery Home gt State of Ilis EM f Human Services D A R T S for Windows PROVIDER MA PASSWORD After entering your Provider Number and Password use your mouse to choose one of the selections from the Menu Bar v 4 start a SB novel 85 cur sc 85 curse DAR e JogU3mNOEST 8 51am What Types of Services Can Be Entered Services are entered onto specific data entry screens that relate to how the service pa
58. code corrects information on a previously submitted DC claim which was accepted by DASA Use of this code will not allow a billing to be changed from one unit program to a different unit program or to make any change to the Unique Client Identifier Staff ID Service Dates Beginning or Ending or Start Time as these fields make a billing unique and allow for matching The only way to change any of these fields is to send in a V Void claim for the original billing and then an A Add claim for the corrected billing V VOID a record which was previously submitted and accepted by DASA Only for use with funding code DC This code voids a record that was submitted and accepted by DASA The V record needs to be entered exactly as it was in the original submission so that a match can be made by DASA and the void can be made to the record DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 48 July 2011 SECTION VI PC Reports Main Menu What are PC Reports and How Do I Use Them PC reports are produced from your computer and are very important for reconciling and verifying data that is sent to DASA against DARTS Mainframe Reports and Medicaid billings All PC reports should be printed and reviewed prior to data submissions to ensure that accurate data is submitted These reports are simple to use and may either be printed or disp
59. counselor or teacher or a Student Assistance Program the school system or an educational agency G Employer EAP A supervisor or an employee counselor H Other Community Referral Community or religious organization or any Federal State or local agency that provides aid in the areas of poverty relief shelter unemployment child welfare or other social services Self help groups are included in this category Defense attorneys are also included in this category E l Criminal Justice Referral Any police official judge prosecutor probation officer or other person affiliated with a federal state or county judicial system Includes referral for DUI and clients referred in lieu of or for deferred prosecution Criminal Justice Referral Detail Required when Referral Source I Criminal Justice Referral 1 State Federal Court 4 Other Recognized Legal Entity 7 DUI 2 Other Court 5 Diversionary Program 8 Other 3 Probation Parole 6 Prison DCFS Involved Identifies if the client patient is involved with DCFS Enter Y Yes or N No DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 14 July 2011 Demographics Mentally Ill Substance Abuser MISA Identifies if the patient is an individual with a co occurring substance use disorder and any mental health Axis I or Axis II disorder as identified in the DSM IV
60. d no assessment service submission can be accepted if it occurred after the treatment or intervention service This error may occur because the wrong activity code is used for a discharge assessment vs an admission assessment Solution Adopt internal practice to ensure that all clinicians know that submission of an admission assessment service cannot occur after submissions for intervention or treatment services have been accepted The billing for assessment is for admission pre treatment and discharge post treatment purposes only Ensure that the correct activity code is used for admission assessment 70 and discharge assessment 71 Error Code 954 No Valid Opening Record Pharmacy Patient This error occurs when a DASA funded Opioid Maintenance Therapy OMT patient has a submitted service on the Pharmacy Log but no valid opening in the DASA master file A valid opening is one with complete and correct demographic fields that has not been rejected as an error Generally when this error occurs with an OMT patient it is because there may be an old opening record on the Master file that does not match the date range for the OMT service No payment for the pharmacy service can be authorized by DASA until there is a match to a valid opening record in DARTS Solution Check all copies of the Client Master File Update report to determine the error This may involve checking source documentation related to demographic fields Correct the error
61. d into DARTS using the main menu and any of its data entry options All early intervention and treatment services require a client patient demographic record and this must be completed before any services can be entered Community Intervention and HIV Early Intervention are the only two reportable services that do not require demographics OPENING How is a Client Patient Opened into DARTS Demographics are required for each episode of care Episode of care means the period of service between the beginning of a service for an alcohol or drug problem and the termination of services for the prescribed intervention or treatment plan The first event in this episode is an admission and the last event is a discharge Any change in service within the same Provider during a treatment episode is considered a discharge with a transfer code selected as the reason Demographics required for opening are initially collected and recorded on the Client Patient Opening data input form The information contained on this form is then used to input the data into DARTS The fields contained on each demographic screen are identified and defined as follows DEMOGRAPHIC SCREEN 1 D A R T S for Windows Services Unit Program File Reports Exit State of Illinois DHS Division of Alcoholism and Substance Abuse atient PROVIDER 0001 Unique z xev PIU ID TUN Identifier Status D Ks ID Number 32132 Initial Contact 06 7 11 2011 Open
62. de DM or DC AAS Assessment OPI Outpatient Individual IOI Intensive Outpatient Individual OPG Outpatient Group IOG Intensive Outpatient Group PEV Psychiatric Evaluation Funding Code DC Only EH Intervention Individual EIG Intervention Group CMH Case Management CIH Community Intervention HIV HIV Service INT Interpreter Referral DFC DFI Case Management DFF DFI Round Trip Public Transportation DFH DFI One Way Trip Public Transportation DFS DFI Staff Transportation Group ID The group ID should be a unique five digit combination of numbers and or letters that will distinguish the treatment counseling group from other such groups on the same date of service This Group ID is used by DASA for auditing purposes to determine the number of patients per counseling group DASA will only reimburse for up to 16 patients Medicaid or Contract funds per counseling group Start Time The time of day in which the service began including A for AM or P for PM Length of Service Hours of Service The number of hours the service was provided Hours must be entered as whole numbers For DFI use this field to enter the number of transportation tokens DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 34 July 2011 Service Reporting Information Minutes of Service Minutes of s
63. ding Category Window Non Medicaid 0 eee 3 SECTION II Demographics ronn oL ocosete sebet de dara QURE RR MERE ERE M OMA FARE V RE FR E a i ri RU RT aja 5 How Do I Enter Information Into DARTS 0 0 00 er 5 OPENING How is a Client Patient Opened into DARTS 0 eee eee eee 5 Demographic SOLE CINE arnis hs Sec Ok doe SUME Usus ee ee Mh at Mat at Rha ina a ce M gus 5 Demographic Screen 2 2 tedew eee ded ied A te eae ee 11 Medicaid CMO STAD MIC Screen ASE 16 Demographic Problem Area Screen sotano se see ne NER eS BS PTAA AAA RT voces 17 DISCHARGE How is a Client Patient Closed from DARTS 0 000002 ee eee 20 Client Patient Service Setting Screen oooooooooorrrrr tenet eee n eens 21 Client Patient Discharge Outcome Measures Screen 23 SECTION III Service Reporting sve ere 9 RES a rau Recepta 29 How Do I Enter Delivered Services Into DARTS 0 0 cece eee eee eee eens 29 What Types of Services Can Be Entered 20 00 00 cceccaececececes ct ateersecaerereeeeteaee es 29 Service Reporting Screen Hourly essen e eH SNA VEEN OMIA MSRM RACIAL 30 REVISION ODE ous qd acho Sal oett dte hase e Le CHOSE I eae 36 What are Some Examples of Types of Hourly Services and How They Would Be Entered 36 Service Reporting Screen Residential and Recovery Home Services oooooooooo o 39 Medicaid Spend Down Due from Patient 0 0c cee lees 43 Service Reporting Screen Specialized S
64. dresses procedure codes and dedicated funding categories for each individual site It is especially important to verify all site numbers by address for the current fiscal year as these may vary from to year to year All addresses should match those specified on DASA facility licenses and Medicaid certifications and enrollments Failure to verify this information or to notify DASA immediately if errors are discovered may result in data errors and possible delays or holds in disbursement or reimbursement for rendered services DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 47 Service Reporting Information Unique Client Patient Identifier The 9 digit Unique Client Patient Identifier must match a patient with an open demographic record in DARTS and the service date entered must fall between the admission assessment and closing dates Billing Begin and End Date Record the time period in which the toxicology tests were administered Toxicology Tests The number of toxicology tests on and between the Billing Begin and End Dates Revision Code This field is to add revise or void a service The default is A Add and is used with all funding codes The R Revise or V Void codes are used as follows R REVISE a record which was previously submitted and accepted by DASA Only for use with funding code DC This
65. e Provider Unit Program File If services are delivered at multiple sites using the same unit number and program code additional screens will be displayed listing the unique addresses procedure codes and dedicated funding categories for each individual site It is especially important to verify all site numbers by address for the current fiscal year as these may vary from to year to year All addresses should match those specified on DASA facility licenses and Medicaid certifications and enrollments Failure to verify this information or to notify DASA immediately if errors are discovered may result in data errors and possible delays or holds in disbursement or reimbursement for rendered services DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 45 Service Reporting Information Child s Unique Number The child s unique 9 digit identifier Billing Begin and End Date The Billing Begin Date through the Billing End Date reports the time period for which the provider is seeking payment When a Level III service spans two months enter the service as two separate transactions Example There would be two entries for a patient who receives a Level III service from 07 15 2010 through 08 04 2010 The first would be 07 15 2010 07 31 2010 and the second would be 08 01 2010 08 04 2010 Number of Days This number is automatically computed by the
66. e activity code field for monitoring special services Hours accumulated are referred to as Staff Hours 4 Group Report This report will print all of the clients patients in each group and will print in the order of Group ID Clients Patients to be Included This allows for tracking of all clients patients or only DCFS clients patients Records to be Printed Choose to print 1 Both Records and Totals OR 2 Totals only The first report Records and Totals can be very useful to verify that a client patient has been entered into DARTS for the correct number of hours etc This type of report will also list the date of service which is useful when verifying monthly totals Unit program totals are also printed The second report Totals Only gives one page totals for every unit program entered When printing the Totals Only Report the numbers may reflect service hours for multiple months in case more than one month of data was entered since the last submission DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 53 PC Reports 54 Wl D A R T S for Windows Unit Program File Exit State of Illinois DHS Division du Alcoholism and Substance Abuse ASS SMENT INTERVENTION iO AGEMENT LEVEL I LEVEL II E port PROVIDER 0001 ENTER THE NECESSARY FIELDS BELOW OR LEAVE FIELD S SPACES UNIT PROGRAM YE
67. e been delivered on a date that in not within the begin and end date for the associated reporting unit program number When this error occurs it is held in suspense for the next five submissions in anticipation of a correction to the submission If this does not occur the service will have to be resubmitted DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 75 DASA Submission Errors Solution Verify that you using the most current update to your software This is particularly important if you have relocated a facility or ended or started a new funded service Often when this occurs reporting numbers change or are given new begin and end dates If you determine that you are using the most current unit and program file it will be necessary to contact the DASA Help Desk as the error may be in our files Error Code 934 No Valid Opening Record Resubmit Record There must be a valid opening for any reported service except community intervention and HIV early intervention which is not linked to a specific client patient A valid opening is one with complete and correct demographic fields that has not been rejected as an error This error frequently occurs when the opening record identifies the patient as a client patient type T for intervention and a treatment service is submitted against that opening or vice versa It also occurs when a submitted
68. e e s 1 3 10 12 16 17 30 31 34 36 38 40 45 47 49 57 72 75 Medicaid Spend Down Due from Patient o ooooooooororo en 35 43 Mentally Ill Substance Abuser MISA ooo ooooooo hr hr hs 15 Minutes OF ServICe es eee esee p tse viov b aep ep de S RE 44 0 4 44 0 0 04 0 0 a 44 0 ee 35 National Outcome Measures eeeeeeeeee ee es 3 20 Not in Labor Force NILF Detail NOMS 0 00 00 cee han 11 25 Numb riol Arrests corrotte ttit trt ttr rtr rr eMe 15 26 Number of Days R 41 46 Number ot Dependents for Income Eligibility i iedesesesusese e ewe eR eRe OE RW RENE A ERE NE 9 Open Date s nia toot tatto tecti tete det dada 6 Opioid Maintenance Therapy OMT ssseeeeeee eee he 18 77 Parents Unique Client Patient Identifier usas Rx EX REDE A ee A 46 hong gp 14 ougnalbme c 32 53 57 Patient l Yp6 scada ade ede edu Qe eu due dede dedu dedans s 7 33 37 39 74 76 PG Reports ar e us 49 67 O ois acta RE O M ee ee EE IIR CERE 16 Presnant e T ER 9 13 Pregnant at JA SSOSSITIOIIE usar ee E TAURUM TM ARMIN MEME E 9 Primary Administration or 19 Primary Ase Ot First se ET 19 Primary Care Giver c ccceee eee 86 dedu edad uuu EEE EEE EEE EEE EEE EEE AEMN TENE DD DERE RE REDD 9 Primary Frequency NOMS i RRRRRRRRRRRRRRRRRRPRRRERBRBA BB BSPRRERRRRRRRRRRRRBRBRABRBRRRES 19 28 Primary L
69. e he a t e a td c a we 7 60 Educational Level NOMS 0 0 000 eh hr ars 12 26 Employment Status NOM S 5 iie tin unita dei de Urin ux SR UR uS UR A a UU Un ut gut up ce esas de estet aset e n 11 25 English M 13 Ethnicity AF H 9 Family Annual Income 0 0 ehh rr a han 12 13 E rndins Code eoe r o a 3 31 34 36 40 44 46 48 74 75 GeOCOde lou es e e a ee O benc oe odd ue 8 Group ID 2 25 ocio poe redeo e eventa dexeve e du eor du eine te eoru te e denuo R ete dot teen 34 53 Gat TS WAN CG eoru eun MA A A EM MM EM UE 10 HEIP qe m 2 4 71 75 76 Homeless E m m m ma E mU E T RITE 10 25 Hours Of SERVICE isa EEE A A AAA AEE CEA EAE 34 MHS TACT TRS Ee Status careto rre E 6 Income Eligibility Override 24 55 55555595565552535053535295529555959 29959559950 50000000004 12 Initial Date of Contact NOMS lssleeeeeeeeeee ehh rra raras 6 A otha AA aa aut attache ahr ahaha OEE 6 53 55 56 a CEU 13 Keyboard FUNCHONS o ded deus E hehehehehe ahh e 2 Length of SPEI eee ee IN 34 Living Arrangement NOMS AAA AN AAA AAA 10 25 Location Codes A A A A titi 31 METAS AAA N d eque toria eia me ee v ed qe dans 9 DASA HELP E MAIL DHS DASAHELPOGILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 86 July 2011 Index Medicaid tt dd e
70. e is mailed place the diskette in a mailer and mail it to the following address When data is successfully transmitted to DHS a back up copy of those files on the diskette is automatically Illinois Department of Human Services DASA Harris Building Harris II 100 South Grand Avenue East 2nd Floor Springfield Illinois 62762 copied into the DASA CLNT subdirectory These files are named in the following format D1080707 FCT In the above example the name of the file is comprised of three parts 1 2 3 Change DARTS Password A password is required on the DARTS Main Menu for entry into the system The default password is DARTS however a new password can be entered into DARTS From the Menu Bar click on Utilities then Change Password Enter both the old password and new password and click on Process D1 represents the number of diskettes used to complete the extract process If it took two diskettes to extract there would be one file named D1080707 and another named D2080707 The second component of this name is 080707 This is the extract date year month day In this example the extract was done July 7 2008 The last part of this name is the extension or the part that follows the period In this case the file represents the FCT file which is the patient admission file or press enter 66 D A A T S fos Windows RAE State of Illinois DHS Division of Alcoholism and Substance Abuse PROV
71. e your mouse to choose one of the selections from the Menu Bar v s start 180 S Novell 6j cut sc 85 curse DAR ene eU EMEN 3E P 2204m The following information will be helpful in using utility functions Create Submission Files This option extracts service data entered into DARTS File Transfer Protocol FTP is the required method of submission However this section contains information on FTP and diskette submission in the event that diskette submission is necessary FTP Submission Once the organization has successfully registered with DHS files may be transmitted via FTP If a fire wall is utilized then port 2021 must be open for connectivity A connection to the Internet is required Before the first FTP submission click on Agency Information from the DARTS Menu Bar This screen allows the setup of your FTP Provider ID and e mail addresses Information on this screen needs to be entered only one time DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 63 Utility Functions State of Illinois DHS Division of Alcoholism and Substance Abuse Pull Transaction Files for DASA PROVIDER This program will transfer all DART System transaction files to diskette or Internet FTP for processing by DASA It will also make backup copies of the transfer files and the I
72. ention service delivery patterns for budgetary purposes measure outcomes and assist with long term planning It is critically important that data is submitted correctly and in accordance with submission time frames How and When is Data Submitted All DARTS data must be submitted electronically using the DHS Intranet At a minimum data must be submitted monthly but can be submitted daily if desired All data is processed weekly as of 5 00 p m on Monday of each week When Do I Get Paid Payments are authorized monthly by DASA Fee for service payments are based upon actual data received and accepted by DASA as of 5 00 p m of every second Monday of each month Submissions not received in this time frame are used to authorize payment in the following month Pre approved Advance and Reconcile Fee for Service payments are authorized monthly and are reconciled to service submissions periodically and at the end of the fiscal year How Do I Get Started Directions for loading and updating software are provided with the software The four digit provider number and initial password DARTS are also provided and are needed to begin using DARTS Once the provider number is entered it will automatically appear on any other screen where the number is required Upon entry into DARTS the password can be changed to identify a unique password for the organization What Information Should be Entered into DARTS DASA uses DARTS information to analyze its
73. ervice should be rounded to the nearest quarter hour increment based upon the actual number of minutes of delivered service i e 1 hour 45 minutes 30 minutes etc This field may be left blank if there were 00 minutes EXAMPLES OF ROUNDING 11 minutes Rounded 15 minutes 34 minutes Rounded 30 minutes 20 minutes Rounded 15 minutes 40 minutes Rounded 45 minutes 29 minutes Rounded 30 minutes 52 minutes Rounded 45 minutes Collateral ID When an activity code of 041 or 141 the collateral is a family member or significant other a unique identifier shall be entered There must be a demographic record in DARTS for client patient in order to serve a collateral Medicaid Spend Down Due from Patient The amount that the patient is responsible for before Medicaid Eligibility can be established If not applicable leave this field blank Third Party Liability TPL Information If applicable enter the following fields TPL Status Enter the adjudication status of the amount in question 01 TPL adjudicated total payment shown 02 TPL adjudicated patient not covered 03 TPL adjudicated services not covered 05 Patient not covered 06 Services not covered 07 Billed insurance not paid TPL Payer Amount Enter the amount of payment received from the third party health resource or the patient TPL Paid Date If the status is 01 02 or 03 enter the Third Party Adjudication Date If the STATUS is 05 06 or 07
74. ervices dle 44 Service Reporting Screen Childcare Residential o oooooooooooonor o 45 Service Reporting Screen Toxicology 22 co ber Ee Uere Ee eReRUEes9bek 9 hePE VES 47 SECTION VI PC Reports Main Menu cc ccc ccc ccc cece ee eee cece eee ee hh hh hn n 49 What are PC Reports and How Do I Use Them 0 0 0 eee ec eee eens 49 SERVICE REPORTS What are the Types of Service Reports That Can Be Printed 51 Biling REpOrt s ag ar hl at ht te eae ao a nt CA E E ER ERE eae E ac dada nn ann 31 Hours S dd AA A O 53 Daily S rvic s RODOH rege sene cancer aos 55 Specialized Services Report A chek shud stoi nias 56 Table of Contents Medicaid Transaction Report RARA 57 DEMOGRAPHIC REPORTS What are the Types of Demographic Reports That Can Be Printed 58 Demographic Master File Report Si rm Eb OLDER YAA A Lt A 59 Client Patient Demographic Transaction Report ceces eer e er e eC E I UY Reg 60 Mobius Document Direct oooooooooororrr ehh rra 61 SECTION VII Utility Functions Main Menu ccc cc ccc ccc cece ccc e hh hh n hi ri nr nnn 63 What are Utd Functions cessctecckve sere cere oterotere CR cba trates 63 Create SUBMISSION FILES ooo otto trot atero AA AS 63 PUP SUBMISSION ua ori pe eu pe vate Ra vu Ag ed Cul ed au e ee viu A 63 Diskette Submission Hs uat a D du ua 66 Change DARTS PassWord x aet ses cleat A A 66 Diskette File Counter oL ate fa ee EE SUC e gos 67 R submi
75. ete the opening Error Code 987 Cannot Change Closing Date Due To An Accepted Discharge Assessment Service This error occurs when there is an attempt to change the closing date after a discharge assessment has already been accepted The error message will specify the date of the discharge assessment The discharge assessment is the final service submission that can be accepted against an open record and this service will not be accepted unless a closing is also submitted Solution No service can be accepted after payment for a discharge assessment If the closing date needs to be changed the discharge assessment must be voided first Error Code 986 This Opening Has Treatment Services Cannot Change To An Intervention Opening The opening record in DARTS specifies the client patient type This is identified through selection of T for treatment and T for Intervention and only one can be selected The service billed against the opening record must match the client patient type If a treatment service is accepted against an opening record identified as a T a subsequent attempt to change the client patient type to T will be rejected Solution If the client patient type needs to be changed void the accepted services prior to submitting the change against the opening record DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 74 July 2011
76. file to assure that the agency has been funded for the type of service entered and will complete the procedure code automatically The following procedure codes linked to the funding code are used for LEVEL III service If the program is MEDICAID CERTIFIED and ENROLLED for DAY TREATMENT or MEDICALLY MONITORED DETOXIFICATION and also has other CONTRACT funding Funding DCY Youth Residential Day Treatment treatment portion of bill paid by Medicaid AND Code ps RBD Residential Domiciliary room and board portion of bill paid by Contract DCA Adult Residential Day Treatment treatment portion of bill paid by Medicaid AND RBD Residential Domiciliary room and board portion of bill paid by Contract DXT Medically Monitored Detoxification Treatment treatment portion of bill paid by Medicaid AND DXB Medically Monitored Detoxification Domiciliary room and board portion of bill paid by Contract DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 41 Service Reporting Information If the program is MEDICAID CERTIFIED and ENROLLED for DAY TREATMENT or MEDICALLY MONITORED DETOXIFICATION BUT has no other CONTRACT funding or is billed after the final submission date when contract funds for the previous fiscal year can no longer be accessed the following procedure codes will be used for billing Funding DCY Y
77. fingham 060 Mason 095 Washington 026 Fayette 061 Massac 096 Wayne 027 Ford 062 McDonough 097 White 028 Franklin 063 McHenry 098 Whiteside 029 Fulton 064 McLean 099 Will 030 Gallatin 065 Menard 100 Williamson 031 Greene 066 Mercer 101 Winnebago 032 Grundy 067 Monroe 102 Woodford 033 Hamilton 068 Montgomery 103 Out of State 034 Hancock 069 Morgan 104 Unknown 035 Hardin 070 Moultrie 105 CHICAGO City DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE 8 July 2011 Demographics Birth Date The numeric equivalent of month day and year MM DD Y Y Y Y Race A American Indian E Black or African American B Alaska Native F White C Asian L Other Single Race D Native Hawaiian or other Pacific Islander Ethnicity 1 Puerto Rican of Puerto Rican origin regardless of race 2 Mexican of Mexican origin regardless of race 3 Cuban of Cuban origin regardless of race 4 Other Specific Hispanic Latino of known Central or South American or any other Spanish cultural origin including Spain other than Puerto Rican Mexican or Cuban regardless of race 5 Not of Hispanic Latino Origin 6 Hispanic Latino Specific Origin Not Specified of Hispanic Latino origin but specific origin not known or not specified Sex Identifies the gender of the client patient Enter M Male or F Female Veteran Indicates whether
78. he original submission so that a match can be made by DASA and the void can be made to the record Dedicated Funding Category Window Non Medicaid Dedicated funding is contained in many DASA contracts to ensure that a specific portion of the funding is earned by delivery of services to special populations regardless of whether such funding is contained in a global cost center Dedicated funding is applicable only to non Medicaid earnings Therefore only services with a funding code of DC or DS can be tagged as dedicated funding These specific dedicated funding amounts are contained in contract Exhibit 1 and only those categories which are funded will display on the software as follows D DCFS G OMT Toxicology L Gambling N None Not all contracts will have dedicated funding obligations If the contract has no dedicated funding no window will be displayed If the contract has dedicated funding but the service being reported does not apply to the patient select N for none It is very important that dedicated funding is reported correctly This is how DASA measures compliance with the contract and these amounts are reflected on special dedicated funding reports What are Some Examples of Types of Hourly Services and How They Would Be Entered The following information provides some examples of specific combinations of client patient types program number service type procedure and activity codes and may be helpful
79. her stimulants 13 Benzodiazepines Includes Alprazolam Chlordiazepoxide Clonazepam Clorazepate Diazepam Flunitrazapam Flurazepam Halazepam Lorazepam Oxazepam Prazepam Temazepam Triazolam 14 Other Non Benzodiazepan Tranquilizers Includes Meprobamate Tranquilizers etc 15 Barbiturates Includes Amobarbital Pentobarbital Phenobarbital Secobarbital etc 16 Other Non Barbiturate Sedatives or Hypnotics Includes Chloral Hydrate Ethchlorvynol Glutethimide Methaqualone etc 17 Inhalants Includes chloroform ether gasoline glue nitrous oxide paint thinner etc 18 Over the Counter Includes Aspirin cough syrup Diphenhydramine and other antihistamines sleep aids and any other legally obtained non prescription medication 19 Nicotine Only available to use as a secondary or tertiary choice 20 Other Includes Diphenylhydantoin Phenytoin GHB GBL Ketamine 2 Gambling 22 Ecstasy 23 Rohypnol 24 Steroids 25 Ephedrine Psuedoephedrine DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 27 Demographics Primary Frequency NOMs 1 0 within one month prior to discharge 2 3 times in the past month 3 1 2 times in the past week 4 3 6 times per week 5 Daily Secondary Problem Code NOMs The same code choices as those designated under primary If there is no secondary problem
80. his allows for tracking of all clients patients or only DCFS clients patients gt Records to be Printed Choose to print 1 Both Records and Totals OR 2 Totals only The first report Records and Totals can be very useful to verify that a client patient has been entered into DARTS for the correct number of hours etc This type of report will also list the date of service which is useful when verifying monthly totals Unit program totals are also printed The second report Totals Only gives one page totals for every unit program entered When printing the Totals Only Report the numbers may reflect service hours for multiple months in case more than one month of data was entered since the last submission i D A R T S for Windows EE lel x Unit Program File Exit State of Illinois DHS Division of Alcoholism and Substance Abuse Residential and Recovery Home Transaction Report PROVIDER 0001 ENTER THE NECESSARY FIELDS BELOW OR LEAVE FIELD S SPACES UNIT PROGRAM PATIENT UNIQUE CLIENT ID INTERNAL PATIENT ID YEAR i MONTH R WHAT TYPE OF REPORT DO YOU WANT C Both Records and Totals C Totals Only WHERE WOULD YOU LIKE THIS REPORT SENT C Prnter C Screen Exit ENTER THE DATA FIELDS ABOVE OR LEAVE ALL FIELDS BLANK TO PRINT ALL RECORDS start i 3 gs c v OOS JU JamN O 1 53am DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTW
81. ices as those designated under primary If there is no tertiary problem code do not complete these fields Diagnosis No entry will be made in this field for early intervention clients For treatment patients an entry must be made in at least one field and an alcohol or drug abuse dependence diagnosis is required as one of these fields unless Problem Area 4 5 or 7 is selected The diagnosis code must be a valid DSM IV or ICD 9 code If Problem Area 4 Co Dependence is selected the diagnosis code must be V61 9 will be automatically entered by DARTS and only PEV Level I and CM can be entered If Problem Area 5 None is selected the diagnosis code V71 09 will be automatically entered in DARTS If Problem Area 7 Gambling is selected the diagnosis must be 312 30 or 312 31 Use ofthe second field and third fields are optional unless the patient is identified as MISA in which case at least one of the diagnosis fields must contain a mental health diagnosis or unless Problem Area 6 Alcohol Drugs and Gambling is selected in which case at least one of the diagnosis fields must contain the diagnostic code 312 31 or 312 30 DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 19 Demographics DISCHARGE How is a Client Patient Closed from DARTS Demographics required for discharge are collected on the Client Patient Dis
82. id either hourly per event or per diem The hourly services that can be reported are Assessment Early Intervention Community Intervention Level I II Individual and Group Counseling Case Management HIV Counseling and Testing and Interpreter Referral services These services are paid with an hourly rate that can be reported in quarter hour increments DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 29 Service Reporting Information SERVICE REPORTING SCREEN HOURLY D A R T S for Windows Client Patient Demographics Services Unit Program File Reports Exit State of Illinois DHS Division of Alcoholism and Substance Abuse SERVICE REPORTING SCREEN Hourly Assessment Intervention Case Mat Level I Level IL HIV Interpreter PROVIDER 0001 UNIT 0001 PROGRAM 43 SITE 0l 123 MAIN STAFF ID 312312322 SERVICE DATE 09 12 20 09 Funding Code DC Unique Client Patient ID 321321325 Service Type 1 Activity Code 001 Group ID s Start Time 09 Jo la Length of Service Hrs 1 Mins 00 Collateral ID MEDICAID BILLING DATA Spenddown Previous Screen Due from Patient 00000 b TPL Status Exit TPL Payer Amount 00000 D 0 TPL Paid Date D i Duplicate Individual Revision Code Al Recipient Code A Procedure Code OPI Duplicate Last Gr
83. ient Listing PASDMRR6 All Client Listing PASDMCR7 All Service Setting Codes PASDMCRS Services and the Opening Dates They are Tied to PASDMXR1 Warning Report of Openings with No Service Activity Within the Last Three Months PASDMXR2 Openings with No Service Activity Within the Last Four Months that have been Administratively Closed QUARTERLY DARTS REPORTS ran after the completion of each quarter within a fiscal year These reports will begin with letters PASDMQ Pharmacy OMT reports begin with the letters PASPH DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 62 July 2011 SECTION VII Utility Functions Main Menu What are Utility Functions Utility functions are used to submit service data to DASA change passwords and load software updates and remove out of date discharge records from the client patient admission master file D A R T S for Windows Ziel X Client Patient Demographics Services Unit Program File Reports Utilities DARTS Information Exit Create Submission Files 4 Change Password TU T11 TA Diskette File Counter State of Illinois Department of a aan s Clear Record Locks D A R T IS for Windd Update Unit Pgm File Client Master Rollover File Reindexing Agency InFormation PROVIDER Mz A PASSWORD After entering your Provider Number and Password us
84. illing End Date reports the time period for which the provider is seeking payment If billing Medicaid DM or DS the patient must be eligible for Medicaid during this date If the patient is not Medicaid eligible for the continuous stay each continuous segment must be billed separately Example A patient enters a program on the 5th of the month and he stays through the 25th of that month however the patient is NOT Medicaid eligible on the 10th and 11th Two DM or DS billing records would be created The first record would be for the 5th through the 9th The second record would be the 12th through the 25th DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 40 July 2011 Service Reporting Information Additionally when a Level III or Recovery Home service spans two months the service must be entered as two separate transactions Example There would be two entries for a patient who receives a Level III or Recovery Home service from 07 15 2011 through 08 04 2011 The first would be 07 15 2011 07 31 2011 and the second would be 08 01 2011 08 04 2011 Number of Days This number is automatically computed by the dates entered into the Billing Begin and End Date fields Procedure Code This field is not entered by the user When the date unit program funding code and billing type are entered DARTS will check the Unit Program
85. in determining how to enter services Assessment The assessment is a distinctly reported and separately billed service and the assessment date is entered in the demographic record DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 36 July 2011 Service Reporting Information The client patient receives an assessment and is recommended for a treatment service Client Patient Type is T Program Number 48 Service Type 1 Procedure Code AAS Activity Code 070 The client patient receives an assessment and is recommended for an early intervention service Client Patient Type is L Program Number 48 Service Type 1 Procedure Code AAS Activity Code 070 The client patient receives an assessment and is not recommended for any service Client Patient Type is I Program Number 48 Service Type 1 Procedure Code AAS Activity Code 070 A closing for the demographic record is also completed and submitted Early Intervention Individual or Group Client Patient Type T The client meets with a staff member for an individual session to discuss the content and structure of the early intervention services that the client will receive Program Number 42 Service Type 1 Procedure Code EII Activity Code 001 A staff member meets with the parents of an adolescent who is receiving early intervent
86. in one of three different ways 1 in order of Unit Program 2 in order of Procedure Code or 3 in the order of Unique Client Patient Identifier gt Type of Report This option allows printing of 1 Both Records and Totals OR 2 Totals Only The first report Records and Totals is useful to verify that a client patient has billings for the correct number of hours etc This type of report will also list the date of service and procedure code which is useful when verifying monthly totals Unit Program Totals are also printed The second report Totals Only provides one page totals for every unit program entered D A R T S for Windows Unit Program File Exit State of Illinois DHS Division of Alcoholism and Substance Abuse SERVICE FUNDING REPORT PROVIDER 0001 ENTER THE NECESSARY FIELDS BELOW OR LEAVE FIELD 8 SPACES UNIT PROGRAM PROCEDURE CODE SITE PATIENTS UNIQUE CLIENT ID INTERNAL CLIENTID YEAR MONTH DEDICATED FUNDING WHICH FUNDING DO YOU WANT TO INCLUDE Choose one or more Medicaid l Contract I Split Funds WHAT TOTALS WOULD YOU LIKE C Umt Program C Procedure Code C Client WHAT TYPE OF REPORT WOULD YOU LIKE C All Records and Totals C Totals Only PRINT THIS REPORT WHERE C Printer C Screen Exit 4 gt start a 3 aic 7 v OOO SU PMN GFF 1218m DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE ht
87. in the original submission so that a match can be made by DASA and the void can be made to the record DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 46 July 2011 Service Reporting Information SERVICE REPORTING SCREEN TOXICOLOGY D A R T S for Windows Client Patient Demographics Services Unit Program File Reports Exit State of Illinois DHS Division of Alcoholism and Substance Abuse service Reporting Screen Provider 0001 Unit 0100 Program 52 Year 20 08 Month 07 Funding Code DC reca 521321325 Billing Begin Date 07 pz 20 08 Billing End Date 07 07 20 08 Toxicology Tests li N Exit Revision Code A Procedure Code TXD Duplicate Previous Screen A OO O O U d A Start 180 novel 85 aur sc 85 curse DAR bao eX IU JAMN BP o6an Unit Program Each service is entered into DARTS using a unit number and program code Therefore before initially entering any data and whenever corrected or updated software is received all provider unit number and program codes should be verified to reduce the incidence of data rejection The Unit and Program number s are displayed in the Provider Unit Program File If services are delivered at multiple sites using the same unit number and program code additional screens will be displayed listing the unique ad
88. ining E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 SECTION XI Data Submission Errors How to Correct Them and Prevent Future Errors CLIENT MASTER FILE UPDATE REPORT Error Code 984 A Previous Opening Has Not Been Closed The DASA master file holds multiple openings for the same client patient if they contain both an opening and a closing date However this file will only allow one open record with no associated closing DARTS contains PC edits that will not allow a new opening for the same client patient until the previous open record is closed However this error can still occur when the client patient is closed in DARTS at the PC level especially in organizations that submit data from multiple sites but a closing is never submitted to DASA or when data is lost at the provider level and thus the provider was unable to send in a discharge or with a third party system Solution The Client Master File Update report will display ALL accepted and rejected openings and closings and any demographic updates Always check to ensure that openings have been accepted before submitting any additional services This will help to avoid many errors of this type When this error does occur the message will specify the opening date of the record that must be closed All transactions are processed in date and time order Therefore to correct this error yo
89. insurance company name TPL Insured s Name The name of the person on the policy DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 16 July 2011 Demographics TPL Insured s ID The ID of the person on the policy i e insurance company s ID Medicaid ID etc DEMOGRAPHIC PROBLEM AREA SCREEN D A R T S for Windows Services Unit Program File Reports Exit State of Illinois Chent Pa JAMES DHS Division of Alcoholism and Substance Abuse PROVIDER 0001 UNIQUE CLIENT PATIENT ID 321321325 OPEN DATE O7 01 2011 NAME L F MI PUBLIC K Problem Area E OMT Client Patient N PRIMARY INFORMATION Frequency 5 Problem Code 02 Administration Route ul Age of First Use 15 SECONDARY INFORMATION Frequency 3 Problem Code 03 Administration Route 3 Age of First Use 19 ERTIARY INFORMATION Problem Code 01 Frequency 1 Administration Route 5 Age of First Use Previous 8 Diagnosis ICD DSM 303 00 296 Bs W h creen Exit Press F1 Key on Data Field for Help X ii start 1836 gt scr E Mir s Re gt DA Vi Sel Dos jo Gat NB FP 11 34am Problem Area The area that is the suspected or confirmed major reason that the client patient requires Intervention or Treatment services 1
90. ion services Program Number 42 Service Type 1 Procedure Code EIG Activity Code 041 The client participates in a group didactic session Program Number 42 Service Type 2 Procedure Code EIG Activity Code 006 The client is participating in an individual session because of a Moderate Risk classification resulting from an arrest for Driving Under the Influence of Alcohol or Other Drugs DUI Program Number 42 Service Type 1 Procedure Code EIL Activity Code 001 The client participates in a recreational activity Program Number 42 Service Type 2 Procedure Code EIG Activity Code 007 The client meets with a physician for medication monitoring Program Number 42 Service Type 1 Procedure Code EII Activity Code 012 Community Intervention Client Patient Type T A meeting is held with a group of local DHS office workers to discuss screenings and referrals for addiction related services Program Number 42 Service Type 3 Procedure Code CIH Activity Code 031 A meeting is held with a group of high school teachers and administrators to discuss how to intervene with and refer students who are caught with alcohol or other drugs as school Program Number 42 Service Type 3 Procedure Code CIH Activity Code 032 A staff member speaks with a person on the phone who is unsure if they have an addiction related problem or uncertain if they want to come to the facility
91. layed on the screen As many types of reports as needed may be viewed or printed To access the PC Report section choose the Reports option from the Menu Bar No data will be damaged or destroyed when utilizing these reports D A R T S for Windows Client Patient Demographics Services Unit Program File Reports m DARTS Information Exit Service onm e mum x Division of Alcoholism and 77 gt 4 State of Illinois Departm BEEN vices D A R T S for Windows PROVIDER Mp A IN PASSWORD After entering your Provider Number and Password use your mouse to choose one of the selections from the Menu Bar v Bn pe Fe ee Start EJE 69 Novell 6j cut sc 85 curse DAR Men eJ ade EN B 9174M Reports can be printed from data contained in the following two file types 1 Services includes service data entered into DARTS which will be submitted via FTP 2 Demographics this includes reports generated from the client patient master file and transaction files which are sent via File Transfer Protocol FTP DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 49 PC Reports The first screen displayed provides a choice for the type of transaction file that will be printed gt data not yet submitted via FTP to DASA OR gt aback up file that contains data previously
92. le from the Menu Bar To update the Unit Program File copy the unit program attachment file directly to your dasa fdb folder OR copy the e mailed file to a diskette and update using the following steps gt From the Menu Bar click on Utilities then Update Unit Program File gt Load the update diskette gt Identify the drive which contains this update diskette gt After successfully updating the screen will display a successful message DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 68 July 2011 Utility Functions D A R T S for Windows State of Illinois DHS Division of Alcoholism and Substance Abuse Load Unit Program File PROVIDER 0001 Enter the Disk Drive which contains your Provider Unit Program Update diskette The default is A Diskette Drive a Is Exit Client Patient Master Rollover This option allows for removal of out of date discharged records from the Client Patient Admission Master file Each year as more and more clients patients are admitted the Admission Master file may become quite large and can slow down the system or fill up the hard drive It may become necessary and or desirable to clean off some of these old records First view or print the Client Patient Admission Master file report from the PC to see what the client patient database looks like
93. led Installed Installed Installed Installed Installed DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX SOFTWARE WEBSITE 217 558 4656 http www dhs state il us page aspx item 29747 July 2011 85 Index Activity COde i i seciecteciectebcresdle i bes 4e Rev rede eee REG RREGS 31 35 37 39 53 T7 Assessment Date NOMS 00 lerra 7 Baby Delivered During Treatment ae RSS RR ERAN 26 Billing Begin and End Date 0 0 0 0 eee e nee n ene 40 41 46 48 Billie Type A ued eue dde 41 Birth Dat kezeBUPuRREVREPUREPURERURECUEERUEERRULNECDEREDEDEDLEREDEDRELEDRELERELDPERIS 9 46 Child s UNOS NUmbet AAA AA AAA AAA AAA 46 Client Patient Type a A ea PY ERU CR RE ER e CE oU 7 37 39 74 76 Closing Dit e REY A ERR RR RW teen Seen eee eRe ene es 22 73 74 Collateral IO ese aac tl ui a Ci e Lo dE 35 Criminal Justice Referral Detail ehh 14 Date of Last Contact NOMS A a nS 25 DCES Involved ooooooooooorrr e e a A 14 Dedic t d Funding Category 545464 540451444 EIN RAGE RAEE AREA RARA AGA 3 36 44 Demostapite Uf EmiallOll 4 1 udo io ee ee ERA RIRS ICH UE RECUERDE RU RU EEE Re ERREUR 35 43 Di gnosis 2232 RRRRRRRRRRRRRRARMRRRRRRRRRRRRRRRRRRERRRRRRRRERRRERRRERRRRR 7 15 17 19 75 Disabled cz dic borvcie lese doshas we PPRRYRRRPRRRPRRBRRRERRRRRRRRRRRRRRRRERRRRERPERBAB RQgS 11 25 Discharge Date eee ec E gn d dog ol wr an tea ee o a OR o RU RR VR e 7 17 25 Discharge Information ii e e s e sd e
94. lution Center IT Support for DHS at 1 800 366 8768 Press 2 and then 11 to be connected with a representative DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 64 July2011 Utility Functions FTP Transfer Lx Connect File Settings Transaction History View Result Backups Help Transfer Data to DHS via FTP Connected Transaction 000000000 09 26 2005 08 59 Click OK to begin File Verification and Transfer Click Ok on the screen below to begin the transfer to DHS The FTP Transfer dialog box will display information about the transfer process To verify a successful transfer scroll to the bottom of the dialog box to view the transfer results FTP Transfer x Connect File Settings Transaction History iew Result Backups Help Transfer Data to DHS via FTP Connected Transferring Demographic file to DHS Transfer Successful 19KiB to DHS 3KiB sec Transferring Service file to DHS Transfer Successful 17KiB to DHS OKiB sec Transfer Completed Successfully Click Exit DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 65 Utility Functions Diskette Submission Providers can ONLY submit data via diskettes due to extreme circumstances and must obtain prior permission from DASA If a diskett
95. mission nothing needs to be done DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 73 DASA Submission Errors Error Code 980 Cannot Change Due To A Service Date Outside of the Opening Date Range This error occurs when a change is sent for the opening date and a service has already been accepted that would then fall outside of the new date range The message will specify what type of service and on what date Solution Examine the error report and source documentation to determine the cause of the error If the opening date is incorrect it cannot be changed until the accepted service is voided The only accepted and paid services that can be voided in DARTS are those with a funding code of DC contract funds To void a service in DARTS the submission must match identically to the original submission with the exception of the Revision Code field which must be completed with a V Error Code 981 Cannot Delete Opening Record Due To An Accepted Service Against That Opening No opening record can be deleted from the DASA Master File if there is an accepted service associated with that admission Solution If the opening record needs to be deleted any accepted DC service will have to voided prior to the submission of the opening record deletion Remember the processing order of date and time Void the service first and then del
96. nless the client patient discharge demographic record has been submitted gt The treatment episode of care has ended for the patient The demographic record in DARTS is closed and submitted and a discharge assessment is reported Client Patient Type is T Program Number 48 Service Type 1 Procedure Code AAS Activity Code 071 DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 Service Reporting Information gt The early intervention episode of care has ended for the client The demographic record in DARTS is closed and submitted and a discharge assessment is reported Client Patient Type is L Program Number 48 Service Type 1 Procedure Code AAS Activity Code 071 SERVICE REPORTING SCREEN RESIDENTIAL AND RECOVERY HOME SERVICES D A R T S for Windows Client Patient Demographics Services Unit Program File Reports Exit State of Illinois DHS Division of Alcoholism and Substance Abuse 4 RESIDENTIAL AND RECOVERY HOME SERVICES SCREEN E PROVIDER 0001 UNIT 0004 PROGRAM 46 _ YEAR 2009 MONTH 07 N Funding Code pc Unique Client Patient ID 321321325 Billing Begin Date 07 i02 f 2d 09 Billing End Date 07 oa 20 09 Number of Days Billed for Month 03 Procedure Code DXD Psychiatric Eval Bil y Previous Screen Duplicate Spenddown Due from Patient a0000
97. nternet FTP transmission log file and place them in your IDASA CLNT subdirectory There are two choices of destination in which to save files 1 The Internet FTP option can only be used by providers who have completed and submitted the Provider and User registrations for electronic file transfer to DASA 2 Providers can ONLY submit v a diskette due to extreme circumstances and must obtain PRIOR PERMISSION from DASA I Diskette is selected please enter that disk drive letter below The default is A Destination C Diskette Internet FTP Transfer Data Now Diskette Drive View Internet FTP Log Exit To submit your DARTS data to DHS select Create Submission File from the Utilities drop down menu Click Transfer File Now to continue or Exit to abort the transfer Next the Login window will be displayed Enter your FTP User ID and Password then click Ok to continue If an error box is displayed check that the FTP User ID and Password are correct Note The first time you log into the system enter your FTP User ID as the password and then you will be prompted to change your password The password is case sensitive and must be changed every 30 days loon FTP User ID DHS9018 Password Change Password Dk Cancel The above screen appears after successfully connecting to the FTP server If your password needs to be reset due to inactivity or other problems contact the Customer So
98. obriety or Women for Sobriety etc Self Help Group Y Yes N No R Refused D Does Not Know Self Help Group Detail If the answer to the Self Help Group question is yes specify how many times or RF Refused DK Does Not Know DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 26 July 2011 Demographics Specify if the client patient had in the past 30 days interaction with family and or friends that are supportive of his or her recovery Supportive Interaction Y Yes N No R Refused D Does Not Know Primary Problem Code NOMs This field provides additional information relative to the identified Problem Area field at the time of discharge 01 None 02 Alcohol 03 Cocaine Crack 04 Marijuana Hashish includes THC and any other Cannabis Sativa preparations 05 Heroin 06 Non Prescription Methadone 07 Other Opiates and Synthetics includes codeine hydrocodone hydromorphone meperidine morphine opium oxycodone pentazocine propoxyphene Tramadol and any other drug with Morphine like effects 08 PCP Phencyclidine 09 Other Hallucinogens Includes LSD DMT STP Hallucingoens Mescaline Peyote Psilocybin etc 10 Methamphetamine 11 Other Amphetamines Includes Amphetamines Phenmetrazine and other unspecified amines 12 Other Stimulants Includes Methylphenidate and any ot
99. occur at least weekly This will not only prevent loss of DARTS data but also Word Processing files Spreadsheet data etc All data files for DASA are resident in the DASA CLNT subdirectory on the computer DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 70 July 2011 SECTION IX Help Desk Guidelines The DASA Help Desk can be reached through e mail at DHS DASAHELP G9 ILLINOIS GOV or through fax at 217 558 4656 All questions to the Help Desk should specify the problem and include examples if appropriate Be sure to include the Provider name and four digit Provider number and the name number and e mail address of the contact person so the Help Desk staff can respond Most Help Desk requests are answered by DASA staff within three working days However questions that must be referred to other DHS offices may take longer For questions regarding DASA reports on Mobius please specify the name of the report Itis very important to be familiar with the drive in which DARTS resides Most systems use the C drive to keep DARTS but others may use D E etc For LAN users it is important to know what Login ID was used when the problem occurred Different login ID s are given different rights on LAN systems and this could be the basis of the problem When a problem occurs entering data into DARTS write down the COMPLETE error message which is displayed on
100. oup AAA nl ii start 180 p DasaHelp No C REALWORK 5 DARTS for OAZ J 39 C 8 2E IN BF 10 56 am The following fields are required for completion of this screen Unit Program The valid unit and program number for the service that is reported Each service is entered into DARTS using a unit number and program code Therefore before initially entering any data and whenever corrected or updated software is received all provider unit number and program codes should be verified to reduce the incidence of data rejection The Unit and Program number s are displayed in the Provider Unit Program File If services are delivered at multiple sites using the same unit number and program code additional screens will be displayed listing the unique addresses procedure codes and dedicated funding categories for each individual site Itis especially important to verify all site numbers by address for the current fiscal year as these may vary from to year to year All addresses should match those specified on DASA facility licenses and Medicaid certifications and enrollments Failure to verify this information or to notify DASA immediately if errors are discovered may result in data errors and possible delays or holds in disbursement or reimbursement for rendered services DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 30 July2011 Ser
101. outh Residential Day Treatment treatment portion only will be billed Code pM DCA Adult Residential Day Treatment treatment portion only will be billed DXT Medically Monitored Detoxification Treatment treatment portion only will be billed If the program is JCAHO accredited and Medicaid CERTIFIED for Residential Rehabilitation Youth or enrolled for Medially Monitored Detoxification in a hospital subacute setting the following procedure codes may be used for billing Funding RHY Residential Rehabilitation Youth Code pM DXD Medically Monitored Detoxification Funding RHB Adult Residential Rehabilitation Code Contract funding is billed for the entire treatment episode treatment and DC domiciliary RHY Youth Residential Rehabilitation Contract Funding is billed for the entire treatment episode treatment and domiciliary DXD Detoxification HHD Halfway House Residential Extended Care RHD Recovery Home Psychiatric Evaluation If the service is for a Psychiatric Evaluation enter a Y If not enter a N in this field Entering a Y in this field will link to the established rate for this service which pays for one event per day regardless of the hours and minutes entered in the time field and PEV will be automatically displayed in the Procedure Code field DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSIT
102. phic screens in DSRS A specific code 103 is also given for out of state Geocode for Chicago begins with 105 and the Community Area is to be looked up in the Geocode Manual Geocode for Suburban Cook begins with 016 and the Township is to be looked up in the Geocode Manual Also please spell Chicago CHICAGO Do not use CHGO CGO etc Code County Code County Code County 001 Adams 036 Henderson 071 Ogle 002 Alexander 037 Henry 072 Peoria 003 Bond 038 Iroquois 073 Perry 004 Boone 039 Jackson 074 Piatt 005 Brown 040 Jasper 075 Pike 006 Bureau 041 Jefferson 076 Pope 007 Calhoun 042 Jersey 077 Pulaski 008 Carroll 043 Jo Daviess 078 Putnam 009 Cass 044 Johnson 079 Randolph 010 Champaign 045 Kane 080 Richland 011 Christian 046 Kankakee 081 Rock Island 012 Clark 047 Kendall 082 Saline 013 Clay 048 Knox 083 Sangamon 014 Clinton 049 Lake 084 Schuyler 015 Coles 050 LaSalle 085 Scott 016 Cook Suburb 051 Lawrence 086 Shelby 017 Crawford 052 Lee 087 Stark 018 Cumberland 053 Livingston 088 St Clair 019 DeKalb 054 Logan 089 Stephenson 020 DeWitt 055 Macon 090 Tazewell 021 Douglas 056 Macoupin 091 Union 022 DuPage 057 Madison 092 Vermilion 023 Edgar 058 Marion 093 Wabash 024 Edwards 059 Marshall 094 Warren 025 Ef
103. r a GED Family Annual Income Enter all projected gross income per calendar year A total family annual income eligibility criteria is utilized to determine the appropriateness of DASA contract dollars to pay for addiction early intervention or treatment as follows FAMILY INCOME ELIGIBILITY CRITERIA CONTRACT REIMBURSED NON MEDICAID FY 2012 FAMILY INCOME ELIGIBILITY Number of Dependents Annual Income 1 21 780 29 420 37 060 44 700 52 340 59 980 67 620 75 260 CO Oo 0 ADN For each additional person add 7 640 Income Eligibility Override This field is required if the client patient income exceeds the eligibility requirements Select 1 7 from the following reasons to override the criteria 1 adependent adult whose spouse or other responsible party is unwilling to assume financial responsibility for the cost of treatment and the dependent adult would as a result be denied access to treatment services or 2 a dependent minor who is not Medical Benefits All Kids and Family Care eligible and or whose parent s or legal guardian is unwilling to assume financial responsibility for the cost of treatment or DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 12 July 2011 Demographics intervention and the dependent minor would as a result be denied access to treatment or intervention se
104. re contained in contract Exhibit 1 and only those categories which are funded will display on the software as follows D DCFS G OMT Toxicology L Gambling N None Not all contracts will have dedicated funding obligations If the contract has no dedicated funding no window will be displayed If the contract has dedicated funding but the service being reported does not apply to the patient select N for none Itis very important that dedicated funding is reported correctly This is how DASA measures compliance with the contract and these amounts are reflected on special dedicated funding reports SERVICE REPORTING SCREEN SPECIALIZED SERVICES This screen allows for the reporting of toxicology services or services to children in residential care with their parent and is only used by agencies that are specifically funded by DASA to provide these services The correct report screen will be displayed when the appropriate unit and program number is entered E D A R T S for Windows E lel xj Client Patient Demographics Services Unit Program File Reports Utilities DARTS Information Exit y I eet Hourly x Division of AE tance Abuse E State of Illi 4 D A R T S for Wir PROVIDER PASSWORD poes After entering your Provider Number and Password use your mouse to choose one of the selections from the Menu Bar HE Start 180 Novel Gp cur sc Gp cur sc
105. request with the correct information A requester will never receive a return e mail or voice mail that includes a password Should there be questions regarding the e RIN process please call the RIN Call Center Help Desk number 1 800 385 0872 DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 71 Tables of Commonly Used Data Elements AS OP OR DX HH 02 05 27 40 41 42 43 45 72 SECTION X Tables of Commonly Used Data Elements Setting Codes Identified in Provider Unit Program File and Mainframe Reports Assessment IN Level I Outpatient Level II Intensive Outpatient Level III Residential Rehabilitation ntervention TX Toxicology CM Case Management CR Childcare Residential Detoxification UR HIV Halfway House Residential Extended SH Staff Hour Care DF Donated Funds Initiative DFI Recovery Home Program Numbers Childcare Residential 46 Level I Methadone 47 Level III Rehabilitation Adult Medicaid 48 only programs 49 Recovery Home 52 Case Management 64 Intervention 78 Level I Adult or Adult Y outh 95 Level II Adult or Adult Youth 96 Halfway House DASA HELP Detoxification Level III Rehabilitation Adult Assessment Donated Funds Initiative DFI Toxicology Interpreter Referral Services Level III Rehabilitation Youth HIV HIV Early Intervention Tra
106. rvices or 3 apregnant woman who is not Medical Benefits All Kids and Family Care eligible and has no insurance benefit that covers the cost of treatment or 4 amember of a family unit whose combined debt for prior medical expenses not covered by insurance exceeds 7 596 of the total gross family annual income and the individual would be denied access to treatment due to the unwillingness or inability of the family to assume further debt or 5 apatient with an extenuating circumstance that meets any additional hardship guidelines adopted by the provider s governing body or 6 anindividual for whom the fee is the sole inhibitor to accept treatment or 7 other approved governing body criteria Source of Income Support The primary source of family income 1 Wages Salary 4 Disability 2 Public Assistance 6 None 3 Retirement Pension Primary Language Specify the primary language spoken by the client patient A English G Korean B Arabic H Polish C Chinese I Russian D French J Spanish E German K Urdu F Hindi English Proficiency vozzt Vietnamese Other Asian Other African Other Indian Other Indicates if the client patient can speak English Enter Y Yes or N No Interpreter Type Will interpreter services be needed Select the type or enter none 1 Foreign Language 2 Hearing Impaired 3 None DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV
107. s MEDICAID DEMOGRAPHIC SCREEN Completion of these fields is required if Medicaid is the payment source for the service To avoid service rejections ensure that the patient is Medicaid eligible on the dates of service prior to billing by gt Checking the patient s Medicaid card or gt Calling 1 800 842 1461 Bill D A R T S for Windows BE 2i xi Services Unit Program File Reports Exit State of Illinois DHS Division of Alcoholism and Substance Abuse Chent Patie sessme PROVIDER ID 0001 UNIQUE CLIENT PATIENT ID 321321325 OPEN DATE 07 01 2011 MEDICAID CLIENT FIELDS Physician ID 14234324333 THIRD PARTY LIABILITY Payer Name TPL Cade poc Insured s Name L F MI m 3 Insured s ID rc Continue Duplicate Last Physician ID Previous Screen Exit Press F1 Key on Data Field for Help il PRESS F3 TO DUPLICATE LAST PHYSICIAN ID ENTERED jstart 6 aG gt Do emu ge caMNTST sm Physician ID The nine digit all numeric ID of the Organization s Medical Director or physician authorized to oversee medical procedures Third Party Liability TPL Information If APPLICABLE enter the following fields TPL Payer Name The name of the paying organization from which the provider might expect some payment for treatment service i e private insurance company Medicare Medicaid etc TPL Code The corresponding Healthcare and Family Services code for the
108. s used when services are terminated by action of the provider generally because of client patient noncompliance or violation of rules laws or procedures not because client patient dropped out of treatment was incarcerated or some other client patient motivated reason Incarcerated This code is to be used for all clients patients whose intervention or treatment is terminated due to incarceration through jail prison or house confinement Death Discharged to another Provider Utilization Management decision External Transfer to another Provider Non completion of the current level of care treatment plan transferred to another provider External Transfer to another Provider Completion of the current level of care treatment plan transferred to another provider Internal Transfer within the same Provider Completion of the current level of care treatment plan transferred to a different level of care Internal Transfer within the same Provider Non completion of the current level of care treatment plan transferred to a different level of care Internal Transfer within the same Provider Transferred to another level of care Utilization Management decision Closing Date The last date of service for the episode of care For billing purposes this is the last date that a service can be billed Any bill submitted with a date after that of the closing date will be rejected as an error 22 DASA HELP E MAIL DHS DASAHELP ILLINOIS GO
109. ssions in anticipation of a correction to the opening Solution Generally these types of enhancements are only made by DASA at the beginning of the fiscal year However whenever they are made notifications are sent indicating that the change will have to be made for any new openings or to existing open records for clients patients who continue to receive services Be sure to make all demographic changes as soon as they are required Error Code 921 Duplicate Service This error occurs when an exact duplicate of the service has already been accepted or where service dates times conflict Solution Determine what caused the duplicate submission If the most recent submission was sent in error no correction to the submission is necessary as it will not be resubmitted However examination is needed to determine why duplicates were submitted and corrective action should be implemented to prevent such submissions in the future DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 76 July 2011 DASA Submission Errors If there is a service date time conflict determine which submission is correct If the second submission is correct the first submission will have to be voided before the second submission can be accepted Error Code 962 Assessment Is After Another Service Date Once a treatment or an intervention service is delivered submitted and accepte
110. start 180 BD novel 6j cut sc 85 curse DAR eao AUJAMN ET 217M There are five choices for service reports as follows Billing Report This report should be printed prior to the submission of any services to DASA to ensure accuracy The printed report can also be used to compare service totals on DARTS Mainframe Reports received from DASA When printing this report the following choices are available gt Field Specific Information Unit Program Procedure Code Unique Client Patient Identifier etc By entering data into one or more of these fields only the records which match the criteria entered will be printed i e entering RHY in procedure code will print only patients billed to Level III Youth entering the patient s Unique Client Patient Identifier will print only that client patient s billings Any or all of the above fields can be left blank Funding Codes DM DC or DS Enter an X next to each of the funding codes to be included in the report One or more funding codes may be chosen gt Clients Patients to be included This allows for tracking of all clients patients or only DCFS clients patients DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 PC Reports gt Unit Program Procedure Code or Unique Client Patient Identifier Order This option will allow sorting of the report
111. submitted via FTP to DASA When choosing a back up file the resident drive must be entered The resident drive is usually hard drive C or the network drive IE D A R T S for Windows o 28x Unit Program File Exit State of Illinois DHS Division of Alcoholism and Subsl nce Abuse H TYPE OF TRANSACTION FILE SCREEN WHAT KIND OF FILE DO YOU WANT PRINTED Data not yet submitted via FTP to DASA C Data previously submitted via FTP to DASA Exit IF YOU WANT A BACKUP FILE WHICH DISK DRIVE IS IT ON NA AA AO EE start 3 3 gii c 5 v ZI e do XU iN GFF 1217M DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 50 July2011 PC Reports SERVICE REPORTS What are the Types of Service Reports That Can Be Printed D A R T S for Windows Client Patient Demographics Services Unit Program File Reports Utilities DARTS Information Exit Division of Alcoholism and EMERGE _ Bilira reports Demographic Reports gt Hourly Services Rpt a 22 i Mobius Document Direct Daily Services Rpt State of Illinois Departm ia Specialized Services Rpt Medicaid Services Rpt D A R T S for Windows PROVIDER Mp A h PASSWORD After entering your Provider Number and Password use your mouse to choose one of the selections from the Menu Bar v m po
112. t Filesto DASA 222 bude bade leds cede ele bade edes 67 Clear Record Locks cao ce hades ke eek CeCe ROR BORER Ee SCRE RE eee EE EERE RE LE eno 68 Wpdate Unit Pro cram Pes V esteso bane hens eee eese ohare oues Whee ee evel 68 Client Patient Master Rollover 2 1 0 0 0 ccc ce eee nee ra 69 SECTION VIII Backing Up DARTS Files eeeeeeeeeeeeeee ehh hr 70 SECTION IX Help Desk Guidelines 0c cece cece cece cece eee e rere eee e EEE EE EEEE 71 SECTION X Tables of Commonly Used Data Elements 0 cc ccc ccc cece wee weet hh hh mr nnn 72 SEMI odas aeos AEA dad di ATREA AAA 72 Program Numbers eue aoa ected GaGa quee EGE PEGE a 72 SECTION XI Data Submission Errors How to Correct Them and Prevent Future Errors 0 c cece cece cree eee een nnn 73 ADDENDUM I Mobius User Min al oer eocnocrceehveoecreeeeoeceecrveveceoveoeopeoceve eee ed 78 SECTIONI How to Get Started What is DARTS and How is it Used The Department s Automated Reporting and Tracking System DARTS is a software program used to report funded and or Medicaid certified addiction intervention and treatment services as authorized by the Division of Alcoholism and Substance Abuse DASA Information extracted from DARTS is used to reconcile grant disbursements authorize fee for service payments and determine compliance with State and Federal reporting requirements Additionally data extracted from DARTS is used to determine treatment and interv
113. t date of the process required by Administrative Rule Part 2060 to collect and interpret information from a client patient to make an initial determination of alcohol abuse or dependence and to make a recommendation for placement into intervention or treatment services For DASA this date is used as a process improvement measurement to determine the time elapsed between the start of the assessment and the first clinical service For data collection purposes this date can precede the opening date For billing purposes it cannot If the assessment is billed to DASA through DARTS this date should match the first assessment billing date Additionally this date will default to the discharge date for any admission assessment that results in a problem area of 5 None Name L F MI Street Address City State Zip Code DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 7 Demographics Geocode County Code Quick Reference Geocode is a five digit number which correctly identifies the county and township community area The first three positions identify the county and the next two identify the township community area Refer to the current Directory of Geographic Information published by the State of Illinois to find a geocode The corresponding three digit code is specified for each county in Illinois and is a required field on the demogra
114. t to verify all site numbers by address for the current fiscal year as these may vary from to year to year All addresses should match those specified on DASA facility licenses and Medicaid certifications and enrollments Failure to verify this information or to notify DASA immediately if errors are discovered may result in data errors and possible delays or holds in disbursement or reimbursement for rendered services Dedicated Funding Category Window Non Medicaid Dedicated funding is contained in many DASA contracts to ensure that a specific portion of the funding is earned by delivery of services to special populations Dedicated funding is applicable only to non Medicaid earnings Therefore only services with a funding code of DC or DS can be tagged as dedicated funding These specific dedicated funding amounts are contained in contract Exhibit 1 and only those categories which are funded will display on the software as follows D DCFS G OMT Toxicology L Gambling N None Not all contracts will have dedicated funding obligations If the contract has no dedicated funding no window will be displayed If the contract has dedicated funding but the service being reported does not apply to the patient select N for none It is very important that dedicated funding is reported correctly This is how DASA measures compliance with the contract and these amounts are reflected on special dedicated funding reports DASA HELP
115. ted by DASA Use of this code will not allow a billing to be changed from one unit program to a different unit program or to make any change to the Unique Client Identifier Staff ID Service Dates Beginning or Ending or Start Time as these fields make a billing unique and allow for matching The only way to change any of these fields is to send in a V Void claim for the original billing and then an A Add claim for the corrected billing V VOID a record which was previously submitted and accepted by DASA Only for use with funding code DC This code voids a record that was submitted and accepted by DASA The V record needs to be entered exactly as it was in the original submission so that a match can be made by DASA the void can be made to the record DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 43 Service Reporting Information Dedicated Funding Category Window Non Medicaid Dedicated funding is contained in many DASA contracts to ensure that a specific portion of the funding is earned by delivery of services to special populations regardless of whether such funding is contained in a global cost center Dedicated funding is applicable only to non Medicaid earnings Therefore only services with a funding code of DC or DS can be tagged as dedicated funding These specific dedicated funding amounts a
116. three digits comprised of the specific type of service activity that was performed and the location as follows Location Codes O Service at Provider Location 1 Off Site DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 31 Service Reporting Information 32 Assessment Only allowed for use with Program Number 48 70 Admission 7l Discharge 72 Gambling Assessment only for use by providers with specific funding for gambling services Treatment or Early Intervention Service Only allowed for use with Program Number 42 43 and 44 01 Individual Counseling 02 Counseling Group 04 Continued Stay Review and Discharge Planning 05 Treatment Planning 06 Didactic Group 07 Recreation 08 Telephonic Psychiatric Review 11 Psychiatric Evaluation 12 Medication Monitoring Case Management Only allowed for use with Program Number 41 22 Intra Agency Staffings 23 Case Coordination Case management services can be bundled and reported in larger increments of time For example atreatment patient s case is staffed 10 minutes each day on 24 different days during one month These minutes can be bundled into hour increments and reported once as four hours of case management Services should be bundled by staff ID linked to each patient ID and the date of service entered into DARTS
117. tp www dhs state il us page aspx item 29747 52 July2011 PC Reports Hourly Services Report This report should be printed prior to the submission of any services to DASA to ensure accuracy The printed report can also be used to compare service totals on DARTS Mainframe Reports received from DASA When printing this report the following choices are available Unit Program Unique Client Patient Identifier Internal ID Service Year Month etc Leave these fields blank to print all services However to print only a specific unit and program a particular client patient s records or data for a particular service month enter the desired combination Type of Report 1 Report in Order of Client Patient ID client patient hours This will print a service report in order of client patient ID s and will total the hours entered for every client patient Hours accumulated are referred to as Client Patient Hours 2 Report in Order of Staff ID staff hours This will print the report that may monitor the activity of each staff Totals of hours and events will also be printed for each staff member Hours accumulated are referred to as Staff Hours 3 Report in Order of Staff ID with Activity Codes staff hours This report will print in an order that allows monitoring of the hours of each staff while also totaling hours for each of the activity codes entered for that staff member This is especially useful when using th
118. u must first close the previous opening before submission of the new opening Otherwise the same error will reoccur Additionally if the opening record is not correct all services reported against that opening will also reject To help reduce this type of error providers should always check the Client Master File Update report to make sure that openings are not in error and submit closing records for any client patient in early intervention or outpatient who has not received services other than case management in over 30 days or any residential patient who has not received services other than case management in over 3 days DASA also routinely deletes any opening record off the master file that has not had any reported services for over 6 months Error Code 982 Duplicate Opening This error message means that an exact duplicate of the opening is already on the master file This error occurs most often with third party users because there is no connection to the master file to alert the user that the opening is a duplicate Also if a change is made to the demographic record and it is marked as an add instead of change the system will reject it as a new opening Solution Examine the error report and source documentation to determine the cause of the error If it relates to a demographic change that was erroneously submitted as an add the record should be resubmitted as a change If it was simply a duplicate opening sub
119. vice Reporting Information Site Number This field is required ONLY for billing of Assessment Case Management Early Intervention or Community Intervention at more than one site Staff ID The unique nine digit identification number for the staff member providing services Service Date The date of service Funding Code The funding code is what directs DARTS to the correct payment source for the service The following codes are used DC DARTS Contract A Service which is supported in full or in part by DASA CONTRACT Non Medicaid funding DM DARTS Medicaid A Service which is supported in full or in part by DASA MEDICAID funding Services linked to a DM code are processed and forwarded on to the Department of Healthcare and Family Services HFS for reimbursement HFS produces the Medicaid Remittance Report Unique Client Patient Identifier The 9 digit Unique Client Patient Identifier must match the demographic record for the client patient Service Type There are three service types that can be used to report services that are paid hourly 1 Individual 2 Group Service 3 Support Includes Case Management Community Intervention HIV Counseling and Testing Activity HIV Early Intervention Training and Interpreter Referral Donated Funds Initiative DFD Activity Code Activity codes are mandatory and are used for identification of specific types of activity that relate to a general service The activity code is
120. voked you will need to contact the CMS Service Desk for assistance 1 800 366 8768 first menu option will be 2 second menu option will be 11 DocumentDirect for the Internet Microsoft Internet Explorer provided by IDHS File Edit View Favorites Tools Help Qe Ix a PD JO Search 5 2 Favorites A Media vo gt a Address e hitps reports illinois gov dhs servlet ddrintee Be altri a e A i E a EHSMVS Reports e Topic Mi Report Use the plus sign tofexpand the list of available reports The left side of the web site is used to navigate or locate reports to be viewed Applet Enterprise xplorerApplet started Click on the plus sign to the left of Reports to display the list of reports generated by the DHS MIS Unified Health Systems Section on the left side of the screen The reports are listed in alphabetic order by report ID If your community agency does not submit data for all UHS Systems some reports may not contain information There are also reports generated for Mobius e g EXITRAP that can be ignored Below are the report prefixes and corresponding system PASDM DARTS CR ECR CRS ffs PDLAS DLA M020 DD Waiver PROCS ROCS M044 CRS ffs PPUNS PUNS DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 80 July 2011 Mobius User Manual 3 DocumentDirect for the Internet
121. yrup Diphenhydramine and other antihistamines sleep aids and any other legally obtained non prescription medication 19 Nicotine Only available to use as a secondary or tertiary choice 20 Other Includes Diphenylhydantoin Phenytoin GHB GBL Ketamine 21 Gambling 22 Ecstasy 23 Rohypnol 24 Steroids 25 Ephedrine Psuedoephedrine DASA HELP E MAIL DHS DASAHELP ILLINOIS GOV FAX 217 558 4656 SOFTWARE WEBSITE http www dhs state il us page aspx item 29747 July 2011 Demographics Primary Frequency NOMs 1 O within one month prior to admission 4 3 6 times per week 2 1 3 times in the past month 5 Daily 3 1 2 times in the past week Primary Administration Route 1 Oral 4 Injection IV or intramuscular 2 Smoking 5 Not Applicable 3 Inhalation Primary Age of First Use For drugs this field identifies the age at which the client patient first used the identified drug For alcohol this field records the age of first intoxication for treatment patients For early intervention clients and patients with gambling as a primary diagnosis this field is not required Secondary Problem Code NOMs Frequency NOMs Administration Route and Age of First Use The same code choices as those designated under primary If there is no secondary problem code do not complete these fields Tertiary Problem Code NOMs Frequency NOMs Administration Route and Age of First Use The same code cho

DARTS 2012 - Illinois Department of Human Services

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