NC DEPARTMENT OF HEALTH AND HUMAN SERVICES EIS MANUAL

ELIGIBILITY INFORMATION SYSTEM EIS 3558

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RECIPIENTS IN NON-MEDICAL INSTITUTIONS REPORT

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EIS 3558 – RECIPIENTS IN NON-MEDICAL INSTITUTIONS REPORTS


I. GENERAL INFORMATION

II. THE FOLLOWING CODES display on the report:

III. THE REPORT IS SORTED BY county:

IV. THE FOLLOWING INFORMATION is listed on the report:

V. X/PTR REPORT DISTRIBUTION SYSTEM


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EIS 3558 – RECIPIENTS IN NON-MEDICAL INSTITUTIONS REPORTS

ISSUED 07/01/05 - CHANGE NO. 01-06

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I. GENERAL INFORMATION

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II. THE FOLLOWING CODES display on the report:

ACTION

REASON

ADEQUATE

TIMELY

       

Delete an individual

The individual is a resident of a public institution.

77

N/A

       

Denial

You are living in a public non-medical institution.

C5

N/A

       

Termination

You cannot get Medicaid in your current living arrangement.

64

N/A

ACTION

REASON

ADEQUATE

TIMELY

       

Delete an individual

The individual is a resident of a public institution.

77

16

       

Denial

The child(ren) for whom you applied is living in a public non-medical institution.

C5

N/A

       

Termination

Residents of a non-medical institution cannot receive NCHC.

64

N/A

ACTION

REASON

ADEQUATE

TIMELY

       

Denial

You are living in a public, non-medical institution.

G8

N/A

ISSUED 07/01/05 - CHANGE NO. 01-06

II. (CONT’D)

ACTION

REASON

ADEQUATE

TIMELY

       

Termination

The individual(s) in the case is/are incarcerated or a resident of a public institution.

6G

1G

ACTION

REASON

ADEQUATE

TIMELY

       

Termination

Became a resident of public institution.

41

N/A

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III. THE REPORT IS SORTED BY county:

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IV. THE FOLLOWING INFORMATION is listed on the report:

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V. X/PTR REPORT DISTRIBUTION SYSTEM

REVISED 03/01/08 - CHANGE NO. 05-08

V. (CONT’D)

EXAMPLE OF THE RECIPIENTS IN NON-MEDICAL INSTITUTIONS REPORT

10/1/05

NORTH CAROLINA ELIGIBILITY INFORMATION

RECIPIENTS IN NON-MEDICAL INSTITUTIONS (ACCUMULATIVE)

00 YANCEY

POS DT CASE ID CO CASE WKR NO INDIV ID APP NO AID NOTICE

xxxxxxxx xxxxxxxx xxxxxx xxx xxxxxxxxxx xxxxxxx xxx xx

COUNTY TOTAL xxxx

STATE TOTAL xxxx

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