dmas mmis quarterly training

DMAS MMIS Quarterly Training

Agenda

Retro-active Cancel Reinstate functionality

TPL-ending and deleting Questions/Comments Contact Information After this Presentation:

Enrollment Issues Q/A on other areas of concern

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Retro-Cancel Reinstate

Accessible from the Enrollment menu

Two cancel reasons 024 moving from limited coverage to greater

limited coverage or full benefit 032 moving between AG and LTC or moving

from FAMIS to Medicaid

Correcting coverage more than a year in the past requires DMAS assistance

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Use cancel reason 024 to move from Plan First to full Medicaid

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Use cancel reason 024 to move from Plan First to full Medicaid continued…

Select row to be canceled Enter cancel reason 024

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Use cancel reason 024 to move from Plan First to full Medicaid continued…

Key new aid category, application date, begin date, and reinstate reason then select ENTER to validate data

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Use cancel reason 024 to move from Plan First to full Medicaid continued…

Select Update to navigate to the Benefits screen

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Use cancel reason 024 to move from Plan First to full Medicaid continued…

Screen shows the shortening of the benefit plans that existed under the previous AC and the newly created benefit plans under the new AC. Use Update to save.

Shortened benefit plans

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Use cancel reason 024 to move from Plan First to full Medicaid continued…

Saved benefit plans under the newly created eligibility segment

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Use cancel reason 024 to move from Plan First to full Medicaid continued…

1. Newly created eligibility segment2. Shortened eligibility segment3. Voided history row showing the coverage prior to the retro cancel reinstate transaction

1.2.3.

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Use cancel reason 032 to move between AG and LTC Medicaid

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Use cancel reason 032 to move between AG and LTC Medicaid cont…

Select row to be canceled Enter cancel reason 032

06/01/2011 12

Use cancel reason 032 to move between AG and LTC Medicaid cont…

Key new aid category, application date, begin date, and reinstate reason then select ENTER to validate data

06/01/2011 13

Use cancel reason 032 to move between AG and LTC Medicaid cont…

Select Update to navigate to the Benefits screen

06/01/2011 14

Use cancel reason 032 to move between AG and LTC Medicaid cont…

Screen shows the shortening of the benefit plans that existed under the previous AC and the newly created benefit plans under the new AC. Use Update to save.

Shortened benefit plans

06/01/2011 15

Use cancel reason 032 to move between AG and LTC Medicaid cont…

Saved benefit plans under the newly created eligibility segment

06/01/2011 16

Use cancel reason 032 to move between AG and LTC Medicaid cont…

1. Newly created eligibility segment2. Shortened eligibility segment3. Voided history row showing the coverage prior to the retro cancel reinstate transaction

1.2.3.

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Use cancel reason 032 to move from FAMIS to Medicaid continued…

06/01/2011 18

Use cancel reason 032 to move from FAMIS to Medicaid

Select row to be canceled Enter cancel reason 032

06/01/2011 19

Use cancel reason 032 to move from FAMIS to Medicaid continued…

Key new aid category, application date, begin date, and reinstate reason and select ENTER to validate data

06/01/2011 20

Use cancel reason 032 to move from FAMIS to Medicaid continued…

Select Update to navigate to the Benefits screen

06/01/2011 21

Use cancel reason 032 to move from FAMIS to Medicaid continued…

Screen shows the shortening of the benefit plan that existed under the previous AC and the newly created benefit plans under the new AC. Use Update to save.

Shortened benefit plan

06/01/2011 22

Use cancel reason 032 to move from FAMIS to Medicaid continued…

Saved benefit plans under the newly created eligibility segment

06/01/2011 23

Use cancel reason 032 to move from FAMIS to Medicaid continued…

1. Newly created eligibility segment2. Shortened eligibility segment3. Voided history row showing the coverage prior to the retro cancel reinstate transaction

1.

3.2.

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TPL Updates

End date any coverage and or policy when no longer valid. When the policy is no longer valid, all coverage lines and the policy must be ended.

Delete any coverage or policy if either was added in error.

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TPL Updates End dating a policy

Select TPL Resource

Select Change

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TPL Updates End dating a policy continued…

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TPL Updates End dating a policy continued…

Key Member ID and select ENTER

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TPL Updates End dating a policy continued…

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TPL Updates End dating a policy continued…

Key policy end dateKey coverage end dates

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TPL Updates End dating a policy continued…

Screen after selecting ENTER to validate data. Select Update to save changes.

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TPL Updates End dating a policy continued…

Screen shot after data is saved.

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TPL Updates End dating a policy continued…

End dated coverage as seen on the TPL Summary screen.

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TPL Updates Deleting a policy

Select TPL Resource

Select Delete

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TPL Updates Deleting a policy continued…

Key Member ID and select ENTER

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TPL Updates Deleting a policy continued…

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TPL Updates Deleting a policy continued…

Key “..” in policy begin dateKey “..” in coverage code

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TPL Updates Deleting a policy continued…

Screen shot after selecting ENTER to validate the data. Use Update to save.

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TPL Updates Deleting a policy continued…

After saving the changes the policy is set to a retired status.

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TPL Updates Deleting a policy continued…

Policy now appears on the TPL Retired Policies screen

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Who to contact… Policy Questions-the VDSS regional

consultants Enrollment issues-

Enrollment@dmas.virginia.gov Patient Pay issues-

PatientPay@dmas.virginia.gov Questions regarding MMIS WebEx or

suggestions for future training- MMISwebex@dmas.virginia.gov

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Questions or Comments

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