How do I make a referral for ADvantage services?
If the person applying for services has an active Medicaid number, refer the person to their local DHS County Office. If the person does not have an active Medicaid number, call 1-800-435-4711 or fill out an IS01 LTCA Referral Fax Form. Include the name, agency, telephone and fax numbers of the referring party. It is important to provide all the information requested to prevent a delay in the process while the missing information is obtained. Fax only the completed referral form to the number listed on the form. Due to confidentiality, other information should NOT be provided until requested by a signed release. Due to confidentiality, LTCA cannot respond to follow-up inquiries regarding the status of a referral. Please direct all status questions to the individual that you referred to the ADvantage Program. Back to Top What do I do when I have a Member that may not meet ADvantage Program appropriateness or Level of Care? Written documentation is essential to facilitate timely follow-u
