Write Successful LON Increase Requests
Having accurate Levels of Need for the individuals you serve has never been more important than right now. As the wages rise, day hab transitions to “Individual Services and Supports (ISS),” and ISS becomes licensed in 2023 with its own set of regulations that include specific ratios and reimbursement rates for specific LON combination, it will become more critical than ever to capture the true costs associated with meeting the needs of the individuals we serve.
Many of the individuals we serve presently are not scored properly because someone outside your agency completed the ICAP, and no one since then has taken the initiative to request a change. Of course, getting LONs changed is a very challenging process, and denials are common because request packets are frequent missing necessary documentation to support the request. LON packets are also frequently denied because behavior support services provided are insufficient to justify the change.
Yet, without the right LON, provider agencies cannot afford the resources necessary to maintain safety for individuals, their peers, and staff. And the documentary requirements for LON increase request packets are daunting, especially for professional staff who may be new to what we do and are usually juggling many high priority tasks. Even the most experienced professional staff are frequently denied LON increases based on minor technicalities that are unforeseen by almost anyone other than the most experienced professionals who have years of experience in the utilization review process, and the many steps leading up to gathering the documentation necessary to succeed in getting LON increases approved.