Review Processing

 

To Process a Review:

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

  2. Select Eligibility from Global Navigation. Select Reporting from Local Navigation. The Review and IR/12 Month Reporting List page displays.

  3. Check the Document Status to verify it is in Received status and make sure the Date Received is populated correctly.

NOTE: It’s important that this is set correctly. If marked No, the Program Block will be picked up by the Review Discontinuance batch and coverage Discontinued. This field is defaulting to “No”. Click the Save and Return button.

  1. Update any relevant data collection pages.  See Non-Financial Data Collection and Financial Data Collection for detailed instructions. See Interfaces/Adding a Verification for steps on requesting information.

NOTE: If the consumer has a Pre-Populated review it is necessary for the user to complete a Reasonable Compatibility Determination.

  1. Proceed to STEP 6 if the review can be processed same day. If not, follow these steps:

NOTE: This step is only to be completed when the review is ready for a final determination.

 

Run EDBC with a Run Reason of RE. See Running EDBC for detailed steps.

  1. Verify the Review and IR/12 Month Reporting Detail List page Report Status has been automatically updated to Complete-EDBC Accepted after running EDBC.

NOTE:  If a review is received early and a positive change can be made prior to the review month, add any new information on the appropriate data collection page(s) with a Begin Date of the first day of the month the change should take place and Run EDBC for the appropriate month to adjust the eligibility determination. Run EDBC for the review month using the Run Reason of RE to reset the review date.