When processing a prior medical request that was received after initial eligibility is established, and initial eligibility was CHIP only, and the CHIP start date caused the application month, or any subsequent months to be fully denied.
Change the View Month to the month of application.
Click the View Details button in the Medical Programs block.
Click the Edit button to make the Medical Program Detail page editable.
Click the Rescind button in the Program Persons block. The Rescind Detail page displays.
Click the radio button for the CHIP child with the ‘Future CHIP Start Date’ Role Reason.
Select Rescind Disc/Deny in the drop-down menu and click the Save and Return button. The Rescind Confirmation page displays.
Verify that the child is Pending from application month to the last day of the month prior to where CHIP started. If something is incorrect, click the Cancel button to navigate to the Rescind Detail page; otherwise click the Save and Return button.
The Medical Program Detail page displays.
Click the Edit button for the child with the prior medical request in the Program Persons block.
Add the appropriate prior medical months and click the Save and Return button. The Medical Program Detail page displays.
Click the Save and Return button.
Select Run EDBC from Task Navigation. The Run EDBC page displays.
Select the first prior medical month from the drop-down menu and click the Select button.
Select the check box for the Medical Program EDBC is being run for, and then click the Run EDBC button. The EDBC List page displays.
Click the hyperlink for the Medical Program. The Medicaid EDBC Summary page displays.
Verify that the outcome looks correct.
NOTE: If Medicaid eligibility is found, the continuous eligibility period is established from the first eligible prior medical month.
Click the Accept button. The EDBC List page displays.
Click the Save and Continue button.
Continue running EDBC until all of the prior medical months have been run.
Was Medicaid approved in any of the prior medical months?
If Yes, proceed to STEP 20.
If No, proceed to STEP 24.
Continue running EDBC for the application month through the come-up month (this allows Medicaid to fill in any months where no eligibility or partial eligibility existed as well as updating former CHIP coverage to Medicaid).
NOTE: No NOA is produced after the application month EDBC has been Accepted/Saved. Workers should send the General Notice of Approval from the Standard Text for Copy Paste document. This should be sent using the V008 form as well as the KC5720 form.
Navigate to the Case Summary page. Click the View Details button in the Medical Programs block. The Medical Program Detail page displays.
Click the Edit button to edit the page.
Update the Review Due Month to match the shortest of the CE End Dates. Click the Save and Return button.
Continue running EDBC for the application month through the month prior to where CHIP eligibility begins.
NOTE: Since these months were rescinded, they need to be denied again to get them out of Pending status.
No NOAs are required for this step.
When processing a prior medical request that was received after initial eligibility is established and the CHIP start date DID NOT cause the application month or any subsequent months to be fully denied.
Click the View Details button in the Medical Programs block.
Click the Edit button to make the Medical Program Detail page editable.
Click the Edit button for the person with the prior medical request in the Program Persons block.
Add the requested prior medical months on the Medical Person Detail page by adding each month and the corresponding Requested Medical Type then clicking the Add button.
When all requested prior medical months have been added, click the Save and Return button. The Medical Program Detail page displays.
Click the Save and Return button. The Case Summary page displays.
Select Eligibility from Global Navigation. Select Customer Information from Local Navigation.
Select Run EDBC from Task Navigation. The Run EDBC page displays.
Select the first prior medical month from the drop-down menu and click the Select button.
Select the check box for the Medical Program EDBC is being run for, and then click the Run EDBC button. The EDBC List page displays.
Click the hyperlink for the Medical Program. The Medicaid EDBC Summary page displays.
Verify that the outcome is correct.
NOTE: If Medicaid eligibility is found, the continuous eligibility period will be established from the first eligible prior medical month.
Click the Accept button. The EDBC List page displays.
Click the Save and Continue button.
Continue running EDBC until all of the prior medical months have been run. If there was no Medicaid eligibility in any of the prior medical months, then the process is complete; otherwise, proceed to STEP 16.
Continue running EDBC for the application month through the come-up month (this allows Medicaid to fill in any months where no eligibility or partial eligibility existed as well as updating former CHIP coverage to Medicaid).
NOTE: No NOA is produced after the application month EDBC has been Accepted/Saved. Workers need to send the General Notice of Approval from the Standard Text for Copy Paste document. This should be sent using the V008 form as well as the KC5720 form.
Navigate to the Case Summary page. Click the View Details button in the Medical Programs block. The Medical Program Detail page displays.
Click the Edit button to edit the page.
Update the Review Due Month to match the shortest of the CE End Dates. Click the Save and Return button.