Detention to Acute Hospitalization with no intent to return at Discharge

An acute hospitalization is typically treated as a service and not a placement, but it will be necessary to reinstate Medical if a youth goes from detention to an acute hospitalization if the intent is not for the youth to return to detention.

Reinstate Medical Coverage for an acute hospitalization when the child will not return to the detention. 

1. Access the case through Person Search or enter the Case Number in the quick search field from Task Navigation and click Go.  The Case Summary page displays.

2. Select Eligibility from Global Navigation and Customer Information from Local Navigation. The Contact Summary page displays.

3. If the Medical program has been discontinued less than 30 days, Rescind the Medical program block.

4. If the Medical Program has been discontinued greater than 30 days, Reapply the Medical program block effective the month of acute hospitalization.  

NOTE: Update Placement Provider information if applicable. 

5. Click the View Details button in the Medical program block.  The Program Detail page displays.

6. Click the Edit button. The Medical Detail page displays in editable mode.

7. Click the Add button in the Administrative Roles section. The Administrative Role Detail page displays.

8. Select the Administrative Role of Facilitator from the drop-down menu. The Resource button displays.

9. Click the Select button under Resource.  The Select Resource page displays.

10. Enter the acute hospital name in the Name field.

11. Click the Search button. The Select Resource page displays with results.

NOTE: If the resource is not found on the first search, try entering a portion of the resource Name. If the resource is still not found or needs to be updated, see Requesting an Addition or Change to the Resource Databank.

12. Click the radio button for the acute hospital name to add to the case then click the Select button. The page displays with selected resource.

13. Select the drop down Facilitator for:.

14. Enter the acute hospital admission date in the Begin Date field using the <mm/dd/yyyy> format or calendar icon.

15. Enter the acute hospital discharge date in the End Date field using the <mm/dd/yyyy> format or calendar icon.

NOTE: If discharge date is not known update the End Date field later. 

16. Click the Save and Return button. The Medical Detail page displays.

17. Click the Save and Return button.  The Case Summary page displays.

18. Select Customer Information from Local Navigation.

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

20. Select the month PPS Medical is to begin from the Benefit Month drop-down menu.

21. Click the Select button.

22. Select the check box for the Medical program.

23. Click the Run EDBC button.  The EDBC List page displays.

24. Click the Medical hyperlink for the benefit month run.  The Medical EDBC Summary page displays.

25. Click the Accept button if the EDBC results are correct. The EDBC List page displays with a Run Status of Accepted-Not Saved. If the results are not correct, click the Cancel button. Correct collected data as needed, then Run EDBC again.

26. Click the Save and Continue button.  The Distributed Documents page displays with the Notice of Action (NOA) generated.

27. Select the check box for the NOA. Click the Delete button. The NOA is removed from the Distributed Documents page.

28. Select Journal from Utility Navigation.  Record all actions taken on the case. See Journal for more information about journaling functionality.

Detention to Acute Hospitalization (Discharge to Foster Home)

An acute hospitalization is typically treated as a service and not a placement, but it will be necessary to reinstate Medical if a youth goes from detention to an acute hospitalization if the intent is not for the youth to return to detention.

Reinstate Medical Coverage after a child in Detention returns to Foster Care Home after an Acute Hospitalization. 

1. Access the case through Person Search or enter the Case Number in the quick search field from Task Navigation and click Go.  The Case Summary page displays.

2. Select Eligibility from Global Navigation and Customer Information from Local Navigation. The Contact Summary page displays.

   • If the Medical program has been discontinued less than 30 days, Rescind the Medical program block.

   • If the Medical Program has been discontinued greater than 30 days, Reapply the Medical program block effective the month of acute hospitalization.  

3. Click the View Details button in the Medical program block.  The Program Detail page displays.

4. Click the Edit button. The Medical Detail page displays in editable mode.

   NOTE: Update Placement Provider information if applicable. 

5. Click the Add button in the Administrative Roles section. The Administrative Role Detail page displays.

6. Select the Administrative Role of Facilitator from the drop-down menu. The Resource button displays.

7. Click the Select button under Resource.  The Select Resource page displays.

8. Enter the acute hospital name in the Name field.

9. Click the Search button. The Select Resource page displays with results.

   NOTE: If the resource is not found on the first search, try entering a portion of the resource Name. If the resource is still not found or needs to be updated, see Requesting an Addition or Change to the Resource Databank.

10. Click the radio button for the acute hospital name to add to the case then click the Select button. The page displays with selected resource.

11. Select the drop down Facilitator for:.

12. Enter the acute hospital admission date in the Begin Date field using the <mm/dd/yyyy> format or calendar icon.

13. Enter the acute hospital discharge date in the End Date field using the <mm/dd/yyyy> format or calendar icon.

    NOTE: If discharge date is not known update the End Date field later. 

14. Click the Save and Return button. The Medical Detail page displays.

15. Click the Save and Return button.  The Case Summary page displays.

16. Select Customer Information from Local Navigation.

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

18. Select the month PPS Medical is to begin from the Benefit Month drop-down menu.

19. Click the Select button.

20. Select the check box for the Medical program.

21. Click the Run EDBC button.  The EDBC List page displays.

22. Click the Medical hyperlink for the benefit month run.  The Medical EDBC Summary page displays.

23. Click the Accept button if the EDBC results are correct. The EDBC List page displays with a Run Status of Accepted-Not Saved. If the results are not correct, click the Cancel button. Correct collected data as needed, then Run EDBC again.

24. Click the Save and Continue button.  The Distributed Documents page displays with the Notice of Action (NOA) generated.

25. Select the check box for the NOA. Click the Delete button. The NOA is removed from the Distributed Documents page.

26. Select Journal from Utility Navigation.  Record all actions taken on the case.  See Journal for more information about journaling functionality.