When a Pregnant Woman (PW) does not report her pregnancy until she has had the baby and is asking for coverage for both her and her newborn at the same time, an extra step is needed to get the correct Deemed Newborn (DN) coverage approved. KEES is not able to recognize the PW coverage until EDBC is ran and accepted and saved approving the PW. Because of this, the child will not show as a DN with that first run. EDBC must be run again for the same month to update the child correctly.
Follow the steps below to properly approve DN coverage for the child after all required Non-Financial and Financial fields have completed. EDBC has been ran and PW coverage is showing in the Eligible Budgets.
From the Medical EDBC Summary page make sure that the coverage pending approval is PLN/PW for the PA. Child will be showing PLN/NB at this time. Click Accept and Save.
EDBC List page displays. Click Save and Continue.
Delete the NOA that is generated
Navigate back to Run EDBC. Select the same Benefit Month that was just ran and accepted for the PW and Newborn. Checkmark the Medical Program. Click Run EDBC.
EDBC List page displays. Choose the “Not Accepted” Medical Program.
Coverage should now be showing the child with DN coverage now and correcting their CE. If so, click Accept and Save.
Review the notice for accuracy.