Factors Impacting Medicaid Enrollment

Roles and ResponsibilitiesA Presentation of the Missouri Department of Social Services1User Assistance TeamBrian Kinkade, DirectorTable of ContentsTable of Contents Page 2User Assistance Team Page 3Virtual IVR Process Page 6Submitting Electronic Applications Page 20Submitting Supporting Documentation via emal Page 26Submitting Monthly Reports of Aging and Problem Applications Page 31Are these arrangements permanent? Page 34List of Resource Centers Page 36Monthly Report of Applications Processed Page 41

2User Assistance TeamThe UAT is staffed by employees of the Jefferson City Processing Center MAGIMission provide support to Missouris health care providers (hospitals, clinics, FQHCs, Local Public Health Agencies, physicians offices) as they complete and submit MAGI applicationsFour legs of support:Electronic applicationSubmitting supporting documentation via emailMonthly report of old and problem applicationsVirtual IVR ProcessThe following schematic depicts the various roles and responsibilities of the User Assistance Team3

4What to do if you want to participate?

First, send an email to DSS indicating that your organization will submit applications electronically where possible.

Second, direct the email to dwight.fine@dss.mo.gov

Third, DSS will send you information as to how to take advantage of this process

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Virtual IVR ProcessBackgroundProcess6Background on IVROver the past few years, the Family Support Division (FSD) offered health care providers access to an Interactive Voice Recognition (IVR) service which allowed health care providers to inquire of FSDs eligibility determination computer as to the status of pending Medicaid applications of their patients. This service provided information that was of value to both providers and their patients by Ensuring that applications for patients who appear to be eligible for Medicaid get filed and processed; and,Expediting the completion of pending Medicaid applications.7Background on IVRFSDs IVR system informed providers of the following:Whether a patient had filed a Medicaid application; When the application was filed; Whether supporting documentation was required to complete the application; and, if so, What documentation is required to complete the processing of the patients application?

8Background on IVRAt this point the new Missouri Eligibility Determination and Enrollment System (MEDES) does not provide updates to FSDs IVR system for patients who are determined eligible for Medicaid coverage pursuant to Modified Adjusted Gross Income (MAGI) rules. In order to make access to this information available to providers FSD has formed this Virtual IVR teamProviders are not expected to have executed an IM 6AR in order to take advantage of this service so long as queries are limited to the following:910The following questions will be answered by the Virtual IVR staff:Has the patient filed a MEDES application?What is the status of the application? pending, approved, deniedWhat supporting documentation is required in order to process the application? Income,Identity,CitizenshipHow Virtual IVR WorksDefinitions related to status of the applicationPending ifFound in MEDESFound in VFR, but not in MEDESApproved ifMEDES indicates approved MXIX indicates coverageDenied ifHealth Benefits Case is closed; and,MHN Health Benefits case (Application Case) main-tab has denied status How Virtual IVR Works11Steps for using Virtual IVR?Provide the following information:Name of clientDate of Birth of clientSocial Security Number of client and/or DCN of clientDate of application if availableFor newborns:Mothers nameNewborns nameNewborns date of birth

First, Send an email or place a call to your Virtual IVR contact.12What You Need To Do?

Request for Status of Application You simply want to know whether an application has been filed, and, if so, what is the status of the application.EMERGENCY COVERAGE NEEDED This is used only for those cases where care is needed immediately, inpatient stays or prescriptions are needed immediately.BACKDATING This is to be used when an individuals coverage on MXIX did not go back to the date of application. PQ This is to be used when the individuals regular coverage start date is correct but prior quarter coverage was requested and not reflected on MXIX. HIGH RISK PREGNANCY Patient has risk factors indicating a high risk pregnancy.OLD APPLICATION Application is more than 30 days old.Presumptive Eligibility/TEMP Coverage Applicant has gaps between PE/TEMP coverage and start date for Medicaid coverage.

Second, Triage Your Request as Follows:13In the case of an email, include the following on the subject line:Triage classificationPatient nameSubject line would appear as follows:Subject: PQ for John Doe ApplicationIn the body of the email indicate how the:Application was submitted:Online; or,Paper application submitted:Walk in at Name of County FSD OfficeMailSupporting documentation was submitted:Via email;Fax; or,Mail

What You Need To Do?1415

What Happens Next?Search for an application in MEDES and the worksite and ITRACKR. Answer the basic IVR questions for you either on the phone or via return email.Confirm the Triage status you indicated in the Subject line.In addition two other triage categories are available to the Virtual IVR staff:APPLICATION NOT PROCESSEDVERIFICATION

Third, Your Virtual IVR Contact will:16What Happens Next?Your Virtual IVR contact will send an email to FSD.MEDES@dss.mo.gov sharing the results of their Triage of your request.

Assign your request to a queue so that the underlying application will be processed;Process electronic applications and supporting documents within 5 7 working days if appropriateResolve any technical issues that may be impacting a pending application; and,Provide feedback if you have submitted an IM 6 AR with the patients application or supporting documentation

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Fourth, User Assistance Team in Jefferson City will:Support Staff for Virtual IVR ProcessHospital and Hospital Systems Danny Evans Danny.J.Evans@dss.mo.gov (573) 751-9023

Federally Qualified Health Centers and Clinics Amber Gonzales - Amber.M.Gonzales@dss.mo.gov (573) 751-9007

Local Public Health Agencies and Physicians Offices Dwight Fine dwight.fine@dss.mo.gov (573) 526-3288

Kim Evans, County Manager, Jefferson City Processing Center - Kim.R.Evans@dss.mo.gov

18Additional Services Available to PartnersThe User Assistance Team provides the following additional services to Partners:Expedited processing of electronic applications;Expedited processing of supporting documentation submitted via email; and,Reviewing and processing applications, as appropriate, submitted on your Monthly List of Aging Applications.The following schematic depicts the various roles and responsibilities of the User Assistance Team19Submitting Electronic ApplicationsSign and SubmitTips for using MEDES

20www.mydss.mo.gov 21Applications entered electronically are in the MEDES system once Sign and Submit is completedNo faxing, no scanning, no dropping the application off at the nearest officeQuicker processing fewer opportunities for delay in processingTips for Using MEDES22If applicants have lost their Medicaid coverage do not answer YES to the question that asks if the applicant lost insurance coverage. Answering YES to that question will cause the individual to be required to provide proof of loss of insurance. That question is intended to be used to determine whether the applicant has lost private or group health insurance coverage. If female applicants do not mark YES on the Family Planning question the MEDES system will not evaluate such applicants for Extended Womens Health Service coverage.

23Make sure to answer YES to the question that asks whether the applicant wants coverage for the children and the other parent even though they may already have active Medicaid coverage. Answering YES to this question on the on-line application allows MEDES to move the whole family over to MEDES from the FAMIS legacy system.If someone in the household is being claimed on taxes by another person who does not live with the family, please capture as much information about that tax filer as possible. This facilitates the correct computation of household income.

Tips for Using MEDES24It is helpful if you list all individuals living in the tax filing household even if coverage is not being requested for such individuals. Again, this facilitates the correct computation of household income. Please do not submit applications for Emergency Medical Care for Ineligible Aliens (EMCIA) before the month of the babys birth. Applications submitted prior to the birth month will be rejected. Simply, you cant apply for EMCIA coverage until the month of birth.

Tips for Using MEDES25Make sure that applicants who answer YES to the question Are you a state employee? are in fact state employees. Some people read this question to mean that they currently hold a job or are employed within the boundaries of the State of Missouri. This question is not designed to determine whether you hold a job or are employed with the boundaries of the state. This question is designed to determine whether the applicant is on the payroll of the State of Missouri.

Tips for Using MEDESSubmitting Supporting Documentation via emailProcessEmail Cover Sheet2627We are pleased that you are committed to using our new electronic application process for submitting Medicaid applications to the Family Support Division. As you know we are establishing an email portal that you can use to submit supporting documentation for the applications that you submit electronically.When submitting supporting documentation through FSD.MEDESHOSPITALS@dss.mo.gov we suggest that you:Submit supporting documentation for only one application per emailInclude the applicants last name and DCN and/or SSN on the subject lineInclude FSDs standardized cover sheet as a part of the supporting documentationEncrypt the application when submitted by email Submitting Supporting Documentation via Email28You may use the Department of Social Services encryption service when submitting encrypted emails. There are directions on the DSS web site about how to send us an encrypted email. The link is http://dss.mo.gov/encrypt.htm. You will need to follow the third set of instructions on the page. Commonly required supporting documentation includes:Proof of identity which can be documented by submitting a copy of the applicants drivers license.Proof of income which can be documented by submitting a copy of the applicants pay stubs. (5 pay stubs required when paid weekly and 3 pay stubs required when paid every two weeks.)

Submitting Supporting Documentation via Email29The email address will be continuously monitored by the User Assistance Team staff. Staff will:Open emails as they arriveIdentify the applications associated with the emailsAffix the supporting documentation to the appropriate applicationDetermine whether all required supporting documentation has been providedRequest any additional supporting documentation that is required:Acknowledge receipt of the emailSend notices to the applicantSend copies of the notices to the provider submitting the application when supported by the Curam softwareAdjudicate applications as appropriate within 5 business days

Submitting Supporting Documentation via Email30Submitting Supporting Documentation via Email

Submitting Monthly Reports of Aging and Problem ApplicationsFormatProcess3132Submitting Monthly Reports of Aging Applications

33Submit Monthly Reports via email to FSD.MEDES@dss.mo.govSubmit Monthly Reports on a spreadsheet

Submitting Monthly Reports of Aging ApplicationsAre these arrangements permanent?Back to IVRAdditional functionalities should eliminate need to:Submit Supporting Documentation via emailSubmit Monthly Reports of Aging and Problem applications (backdating, PQ, etc.)

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35FSD Resource CentersList of locations

3637CountyOffice NameAddressCityZip CodeAdairKirksville Customer Service Center1612 N. OsteopathyKirksville63501AndrewSavannah Resource Center106 N 5th StSavannah64485AtchisonRock Port Resource Center101 Grant StRock Port64482AudrainMexico Resource Center4690 S Clark StMexico65265BarryBarry County FSD208 East 8th StreetCassville65625BartonLamar Resource Center501 W 13th StLamar64759BatesBates County FSD4 West Ohio StreetButler64730-0032BentonHarbor VillageTruman Dam Access RdWarsaw65355Warsaw Resource Center1661 Hilltop DrWarsaw65355BollingerBollinger County FSD602 Highway 34 WestMarble Hill63764BooneColumbia Customer Service Center1500 Vandiver Drive, Suite 103Columbia65205-1227BuchananSt Joseph Resource Center301 S Seventh StSt Joseph64501St. Joseph Customer Service Center525 Jules StreetSt Joseph64501ButlerButler County FSD1903 NorthwoodPoplar Bluff63902CaldwellCaldwell County FSD400 West BerryHamilton64644CallawayFulton Resource Center108 N Hospital DrFulton65251CamdenCamden County FSD146 Rodeo RoadCamdenton65020Cape GirardeauCape Girardeau Customer Service Center220 N. FountainCape Girardeau63701CarrollCarroll County FSD1303 North 65 HighwayCarrollton6463338CarterCarter County FSDHCR 2 Box 2270Van Buren63965CassCass County FSD2500 East MechanicHarrisonville64701CedarCedar County FSD112 RB RoadStockton65785CharitonChariton County FSD121 East JacksonKeytesville65261ChristianChristian County FSD4715 N Towne Center DriveOzark65721ClarkClark County FSD320 West MainKahoka63445ClayClay County FSD7000 Liberty DriveLiberty64068ClintonPlattsburg Resource Center108 Bush StPlattsburg64477ColeJefferson City Customer Service Center1716 Four Seasons Dr., Suite 104Jefferson City65101CooperCooper County FSD409 High StreetBoonville65233CrawfordCrawford County FSD272 Cushing RoadSteelville65565DadeEverton City Hall116 W CommercialEverton65646Greenfield Resource Center150 S Main StGreenfield65661Lockwood Library721 Main StLockwood65682DallasBuffalo Resource Center719 N Ash StBuffalo65622DaviessDaviess County FSD201 AshGallatin64640DeKalbCameron Resource Center207 E McElwainCameron64429DentDent County FSD800 West Scenic Rivers BlvdSalem65560DouglasDouglas County FSD603 NW 12th Ave, Bldg EAva65608DunklinDunklin County FSD1100 Hwy 25 S Bypass Ste 1Kennett6385739FranklinFranklin County FSD1 Liberty PlazaUnion63084Washington Resource Center1108 Washington Square Shopping CenterWashington63090GasconadeGasconade County FSD1008 Highway 28 WestOwensville65066GentryAlbany Resource Center809 N 13th StAlbany64402GreeneAPO (Aids Project of the Ozarks)1901 E BennettSpringfield65804Bill's Place424 E CommercialSpringfield65803Burrell/Transitions323 E Grand StSpringfield65807Greene County FSD101 Park Central SquareSpringfield65806Harbor House636 N BoonvilleSpringfield65806NAMI (National Alliance on Mental Illness)1701 S CampbellSpringfield65807Neighborhood Center/Community Partnership330 N Jefferson AveSpringfield65806Rare Breed Youth Drop In Center301 N MainSpringfield65806Salvation Army1707 W Chestnut ExwySpringfield65802Southwest Missouri Office on Aging1735 S Fort AveSpringfield65807Springfield Affordable Housing Center300 E CentralSpringfield65802Victory Square1610 N BroadwaySpringfield65803GrundyTrenton Customer Service Center2926 Oklahoma AvenueTrenton64683HarrisonHarrison County FSD2403 Vandivert StreetBethany64424HenryHenry County FSD1661 North 2ndClinton64735HickoryHickory County FSDDallas & Oak StreetsHermitage65668HoltMound City Resource Center514 State StMound City6447040HowardHoward County FSD103 Furr StreetFayette65248-1069HowellHowell County FSD3415 Division DriveWest Plains65775IronIron County FSD202 Park DriveIronton63650JacksonJackson County East Jackson Office201 East Partridge StreetIndependence64055Jackson County Fletcher Daniels Office615 East 13th StreetKansas City64106Jackson County Fletcher Daniels Office615 East 13th StreetKansas City64106Jackson County Midtown Office4309 East 50th TerraceKansas City64130Kansas City-Midtown Resource Center4309 E 50th TerraceKansas City64130Operation Breakthrough3039 TroostKansas City64109JasperJoplin Customer Service Center601 CommercialJoplin64802-1353JeffersonJefferson County FSD10325 Business 21 Suite 100Hillsboro63050-3587Jefferson County FSD-Arnold Office3675 W. Outer Road Arnold63010-5232JohnsonJohnson County FSD505-B N RidgeviewWarrensburg64093KnoxEdina Resource CenterJim Sears Technical Bldg, Hwy 6East Edina63537LacledeLaclede County FSD2639 South JeffersonLebanon65536LafayetteKC Region Nursing Home Office736 S Business Highway 13Lexington64067LawrenceLawrence County FSD1419 East Church StreetAurora65605LewisMonticello Resource Center500 South Washington, PO Box 66Monticello63457LincolnLincoln County FSD384 North Lincoln DriveTroy63379LinnLinn County FSD103 Forest DriveBrookfield6462841LivingstonNorth Region Nursing Home Office601 W. Mohawk Road, Suite BChillicothe64601MaconMacon County FSD1716-B Prospect DriveMacon63552MadisonSt Louis Region Nursing Home Office413 BurrisFredericktown63645MariesVienna Resource Center205 Hwy 63 SVienna65582MarionHannibal Customer Service Center3055 Holman DriveHannibal63401McDonaldAnderson Resource Center929 N Highway 71Anderson64831MercerPrinceton Resource Center501 W MainPrinceton64673MillerSpecialized Nursing Home Pro. Unit#6 Industrial DriveEldon65026MississippiMississippi County FSD718 North MartinEast Prairie63845MoniteauCalifornia Resource Center104 N Gerhart RdCalifornia65018MonroeParis Resource Center315 N Washington StParis65275MontgomeryMontgomery Resource Center501 Niedergerke DrMontgomery City63361MorganMorgan County FSD703 North MonroeVersailles65084New MadridNew Madrid County FSD350 US Highway 61 Ste BNew Madrid63869NewtonNeosho Customer Service Center201 North WashingtonNeosho64850NodawayMaryville Customer Service Center301 East Summit Drive Maryville64468OregonOregon County FSDHighway 19 SouthAlton65606OsageLinn Resource Center63 Progress LaneLinn65051OzarkSo Region Nursing Home OfficeHighway 160 WestGainesville65655PemiscotPemiscot County FSD911 Highway 84Caruthersville63830PerryPerryville Resource Center12 E Wichern RdPerryville6377542PettisPettis County FSD808 WestwoodSedalia65301PhelpsRolla Customer Service Center1111 Kingshighway, Suite ARolla65401-2922PikePike County FSD1610 Business Hwy 54 WestBowling Green63334PlattePlatte County FSD233 Marshall RoadPlatte City64079PolkPolk County FSD2110 South Springfield Building 1Bolivar65613PulaskiPulaski County FSD712 Historic 66WWaynesville65583PutnamPutnam County FSD702 South 27th StreetUnionville63565RallsMonroe City Resource Center1110 Hwy 24, Ste 16Monroe City63456RandolphRandolph County FSD1715 South Morley #BMoberly65270RayRay County FSD901 East LexingtonRichmond64085ReynoldsReynolds County FSD2394 Highway 21Centerville63633RipleyRipley County FSDRt. 2 Box 1143Doniphan63935SalineSaline County FSD1239 Santa Fe Trail, Suite 100Marshall65340-9115SchuylerLancaster Resource Center209 E Washington StLancaster63548ScotlandScotland County FSD#2 Child Support LaneMemphis63555ScottScott County FSD106 Arthur, Suite ASikeston63801ShannonShannon County FSDHwy 19 S & Route FEminence65466ShelbyShelby County FSD306 East MainShelbyville63469St CharlesCrider Health Center1032 Crosswinds CtWentzville63385St. Joachim and Ann Care Services4116 McClay RdSt Charles63304St. Charles County FSD3737 Harry S Truman Blvd, Suite 100St Charles6330143St. ClairOsceola Resource Center285 SE 467 Rd, PO Box 574Osceola64476St. FrancoisPark Hills Customer Service Center140 Staples DrivePark Hills63601St. GenevieveSte Genevieve Resource Center583-B Ste Genevieve DrSte Genevieve63670St. LouisSouth Lindbergh Resource Center7545 South Lindbergh, Ste 110St Louis63125St Louis County FSD9900 Page AvenueSt Louis63132St Louis County Jennings Service Center8501 Lucas & HuntSt. Louis63136St Louis County North Service Center4040 Seven Hills DriveFlorissant63033St Louis County South Service Center7545 South Lindbergh Suite 110St. Louis63125St. Louis CitySt Louis City Chouteau Midtown3101 ChouteauSt Louis63103-2926St Louis City Prince Hall Family4411 N Newstead Avenue St Louis63115StoddardStoddard County FSD401 ShawneeBloomfield63825StoneStone County FSD30832 State Highway 413Galena65656SullivanSullivan County FSD309 East 3rd StreetMilan63556TaneyTaney County FSD2720 Shepherd of the Hills Expressway D-1Branson65616TexasTexas County FSD16798 Oak Hill Drive, Suite 600Houston65483VernonNevada Customer Service Center621 East Highland, Suite 1Nevada64772WarrenWarren County FSD513 West Booneslick RoadWarrenton63383WashingtonWashington County FSD10235 West State Highway EPotosi63664WayneWayne County FSDRT 2, Box 26351Piedmont63957WebsterWebster County FSD222 CommercialMarshfield65706WorthGrant City Resource Center108 E 1st StGrant City64456WrightWright County FSD1801 North TalcottMtn Grove65711Updated Monthly Report of Applications ProcessedJuly

4445MEDICAID Applications ProcessedApps AppsAppsTotalPendingDATEReceivedApprovedRejectedProcessedMHNMEDES (MAGI)Jan/Feb 2014 32,853 7,4563,21510,67122,182Mar, 2014 23,454 8,3844,11312,49721,669April, 2014 17,680 9,9994,50914,50824,841May, 2017 12,018 8,7724,50813,28018,081June, 2014 12,634 9,6035,20414,80713,818July, 2014 16,618 10,2436,95117,19413,242FFM TransfersJan, 2014000Feb, 2014000Mar, 20144,510483,5403,5884,510April, 201414,4232695,8896,15821,404May, 20142,9088423,6484,49017,259June, 20141,6221,4785,3126,79013,957July, 20141,5831,4944,1905,68410,543FSD.MEDESHOSPITALS@dss.mo.govVERIFICATI0N COVER SHEET

Date: ______________________________Facility: ____________________________Contact Name: ______________________Contact Number: ____________________

Applicants Name: ___________________Date of Birth: _______________________Social Security Number:_______________DCN (if available):____________________

Immediate Medical Emergency? ________ 30-Day Report Format*Head of Household NameDCN and/or SSNDOBApplication Date (If available)Comments

*For newborns: Parent name, newborns name and date of birth