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DMA ADMINISTRATIVE LETTER NO. 18-03, NEW MEDICAID PROFILE INDICATOR AND FOLLOW-UP CASE MANAGEMENT REPORT

(EPICS)

TO: County Directors of Social Services

DATE: January 23, 2003

RE: New Medicaid Profile Indicator and Follow-up Case Management Report

EFFECTIVE

DATE: February 10, 2003

EPICS created a new Medicaid Profile Indicator field on the Claim Detail screen that program integrity investigators can use to trigger a monthly case management report to notify them when it is time to request a follow-up Medicaid Recipient Profile. Prior to this change, investigators had to rely on a manual process to remind them to reorder recipient profiles.

I. REQUESTING FOLLOW-UP MEDICAID RECIPIENT PROFILES

II. MEDICAID PROFILE INDICATOR

III. MEDICAID PROFILE FOLLOW-UP CASE MANAGEMENT REPORT

IV. IMPLEMENTATION INSTRUCTIONS

If you have system questions, please contact Economic Independence Automation Staff at (919) 733-7831. If you have Medicaid policy questions, please contact a DMA Recipient Investigations Coordinator in the Quality Assurance Section at (919) 733-3590.

PB/NY/BA/bh

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