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NC DEPARTMENT OF HEALTH AND HUMAN SERVICES EIS MANUAL

ELIGIBILITY INFORMATION SYSTEM EIS 2240

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AUTHORIZED REPRESENTATIVE

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EIS 2240 – AUTHORIZED REPRESENTATIVE


I. GENERAL INFORMATION

II. EIS KEYING INSTRUCTIONS

III. EIS AUTOMATED NOTICES

IV. REPORTS

V. Client Service Data Warehouse (CSDW)


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EIS 2240 – AUTHORIZED REPRESENTATIVE

ISSUED 02/01/11 – CHANGE NO. 03-11

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I. GENERAL INFORMATION

Hierarchy

Relationship Type

EIS Relationship Code

first

Legal Guardian (includes DSS with custody or guardianship)

A

second

Power of Attorney

B

third

Health Care Power of Attorney

C

fourth

Department of Social Services (placement responsibility only)

D

fifth

Spouse (Not separated)

E

sixth

Parent (for children under 21, a parent who is not the casehead but who lives in the home).

F

seventh

Authorized Representative (An individual designated in writing by the applicant/recipient to assist with eligibility issues and who can have access to the information in the case file.)

G

eighth

Authorized Representative as designated by SSA on SDX

H

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II. EIS KEYING INSTRUCTIONS

Authorized Representative/CAP Manager/PACE Agency data is entered on either the DSS-8124 at application entry, or on the DSS-8125. This data is displayed on the Notice Register in NCXPTR. The data updates in the EIS overnight in batch process.

ISSUED 02/01/11 – CHANGE NO. 03-11

II. (CONT’D)

2. If you entered “Y”, you will get an option to use the PF12 key to access the “Auth Rep - PACE/CAP Agency Data Screen.”

ISSUED 02/01/11 – CHANGE NO. 03-11

II. A.2. (CONT’D)

ISSUED 02/01/11 – CHANGE NO. 03-11

II. A. (CONT’D)

4. For the Authorized Representative, required fields are the name, address, relationship code of the representative to the applicant, and the language preference of the representative. Use the language codes in EIS-4000.

ISSUED 02/01/11 – CHANGE NO. 03-11

II. B.1. (CONT’D)

ISSUED 02/01/11 – CHANGE NO. 03-11

II. (CONT’D)

ISSUED 02/01/11 – CHANGE NO. 03-11

II. C.2. (CONT’D)

D. Deleting or Changing Authorized Representative/PACE/CAP Applications

ISSUED 02/01/11 – CHANGE NO. 03-11

II. D.2. (CONT’D)

ISSUED 02/01/11 – CHANGE NO. 03-11

II. (CONT’D)

ISSUED 02/01/11 – CHANGE NO. 03-11

II. E.4. (CONT’D)

Agency name, and address. Up to thirty characters may be keyed for the name field.

ISSUED 02/01/11 – CHANGE NO. 03-11

II. (CONT’D)

When transferring from MAF to AAF Payment Type 1, EIS automatically deletes all authorized representative and/or PACE/CAP data.

When transferring from SAA/SAD to Medicaid, Authorized Representative information can be added, modified or deleted. If Authorized Representative information is already on the case, EIS will retain that information unless it is modified.

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III. EIS AUTOMATED NOTICES

Unless overridden, EIS sends two automated notices: one to the casehead at the case address and one to the Authorized Representative at the address on the Authorized Representative screen.

If PACE or CAP information is available, EIS will also send a notice addressed to the PACE agency or CAP Case Manager at the address keyed for that agency.

Two notices are sent; one to the casehead and one to the Authorized Representative if there is one.

ISSUED 02/01/11 – CHANGE NO. 03-11

III. (CONT’D)

Two notices are sent; one to the casehead and one to the Authorized Representative if there is one. (See EIS-3520, Medicare Entitlement and Enrollment).

For new SSI Medicaid recipients not active in EIS, EIS will read the SDX file for Representative Payee and address information. If the data is there, EIS sets the Authorized Representative indicator to Y, and moves the data to the Authorized Representative fields. EIS currently uses the Authorized Representative address as the EIS case address, therefore one notice will be sent to the casehead name at the Authorized Representative address.

NOTE: For SSI cases, the caseworker is able to change the Authorized Representative name and address on the DSS-8125 for PLA, LTC and Special Assistance Cases.

If there is no Authorized Representative in EIS, EIS will load the information from the SDX. If Authorized Representative information is in EIS, it will not overlay it as we want to keep the data the worker has keyed previously. The Authorized Representative data from the SDX is written to a report in NCXPTR. See Reports below.

If the individual is in LTC or AAF pay type 4, 5, or SAA, SAD, or HSF, notice will be sent to the address in EIS, and will also go to the Authorized Representative if there is one. Otherwise, the notice will be sent to the address from the SDX which would be the Authorized Representative address if there is one.

If the individual is in LTC or AAF pay type 4, 5, or SAA, SAD, or HSF, a notice is sent to the address in EIS, and will also go to the Authorized Representative if there is one. Otherwise the notice is sent to the address from the SDX which would be the Authorized Representative address if there is one.

REISSUED 08/01/11 – CHANGE NO. 01-12

III. (CONT’D)

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IV. REPORTS

REVISED 08/01/11 – CHANGE NO. 01-12

IV. (CONT’D)

    B. Authorized Representative and/or the PACE Agency/CAP Manager is displayed on the Case Management Report, if there is one on the case.

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V. Client Service Data Warehouse (CSDW)

    Current and historical Authorized Representative/PACE/CAP data is stored in the CSDW.

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