CHIP Approval

CHIP Approval

NOTE: The steps below assume the user has completed all data collection pages first.

• When the current benefit month is referenced below, it refers to the current calendar month.

• Workers will need to always run EDBC months in order. If EDBC is not run in order, the CE Date and the Review Due date will not set correctly.

CHIP Starts in Month of Application

PM months should have already been run

1. Select Run EDBC from Task Navigation. The Run EDBC page displays.

2. Select the application month from the drop-down menu and click the Select button.

3. Select the check box for the Medical Program you are running EDBC, and then click the Run EDBC button. The EDBC List page displays.

4. Click the hyperlink for the Medical Program. The Medical EDBC Summary page displays.

5. Verify that the coverage is correct.

6. Click the Accept button.

   NOTE: If a validation message is received stating CHIP Start Date is before the Application Date. Add a MAGI Requested Medical Type Retro Month record and Run EDBC. the user should Cancel the EDBC and process the retro months first. Rules have identified a child that meets the requirements for retro eligibility in a prior month. CHIP - Prior Medical.

   NOTE: If this is not done, and the EDBC is accepted anyway, then CHIP eligibility WILL NOT backdate to the newborn’s date of birth even though the CHIP Start Date displays the newborn’s date of birth. Instead, eligibility will start on the first day of the month of application.

   The EDBC List page displays.

7. Click the Save and Continue button.

8. If this was a request to add coverage to an already open program, the worker should continue to run EDBC until the come-up month is reached.

CHIP Starts After the Month of Application

PM months should have already been run

Opt 1:

Blended application that contains both Medicaid approved and CHIP approved individuals. Also applicable to situations where a CHIP child is being added to an already open program.

1. Select Run EDBC from Task Navigation. The Run EDBC page displays.

2. Select the application month from the drop-down menu and click the Select button.

3. Select the check box for the Medical Program you are running EDBC for then click the Run EDBC button. The EDBC List page displays.

4. Click the hyperlink for the Medical Program. The Medicaid EDBC Summary page displays.

5. Verify that the coverage is correct (CHIP child is Denied).

6. Repeat process for all

7. Click the Accept button. The EDBC List page displays. Click the Save and Continue button.

NOTE: If this was a request to add coverage to an already open program, the worker should continue to run EDBC until the current benefit month is reached. Repeat steps 1-6.

Opt 2:

CHIP only approval (program is not currently open for any other individuals).

1. Select Run EDBC from Task Navigation. The Run EDBC page displays.

2. Select the application month from the drop-down menu and click the Select button.

3. Select the check box for the Medical Program EDBC is being run for then click the Run EDBC button. The EDBC List page displays.

4. Click the hyperlink for the Medical Program. The Medical EDBC Summary page displays.

5. Verify that the CHIP child is Denied.

6. Click the Accept button. The EDBC List page displays. Click the Save and Continue button. The Case Summary page displays.

7. Expand the newly Denied program block. Click the View Details button. The Medical Program Detail page displays. Click the Edit button.

8. Click the Rescind button in the Program Persons block. The Rescind Detail page displays. Select the radio button for the CHIP child with the Future CHIP Start Date Role Reason. Select CHIP Start in Future from the Rescind Reason drop-down menu.

9. Click the Save and Return button. The Rescind Confirmation page displays.

10. Verify in the Program Status Change block that the program is changing from Denied to Pending. The Begin Date listed next to Pending should be the first day of the current benefit month.

11. Click the Save and Return button. The Medical Program Detail page displays. Click the Save and Return button. The Case Summary page displays.

12. The CHIP child is now in Pending status in the current benefit month.

13. Repeat steps 1-4.

14. Verify that the coverage is correct.

15. Click the Accept button. The EDBC List page displays. Click the Save and Continue button.