NC DEPARTMENT OF HEALTH AND HUMAN SERVICES EIS MANUAL

ELIGIBILITY INFORMATION SYSTEM EIS 1061

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X/PTR – REPORT DISTRIBUTION SYSTEM

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EIS 1061 – X/PTR – REPORT DISTRIBUTION SYSTEM


I. GENERAL INFORMATION

II. ACCESS PROCEDURES

III. X/PTR LATEST REPORTS OPTIONS

IV. VIEWING THE REPORTS

V. LOGOFF PROCEDURES

VI. SIGNING ON TO X/PTR FOR THE FIRST TIME

VII. SETTING THE PRINTER DEFAULTS

VIII. MODIFYING YOUR USER PROFILE

IX. REPORT NAMES AND ACCESS CODES-These are the most commonly used reports.


Previous PageTable Of ContentsNext Page

EIS 1061 – X/PTR – REPORT DISTRIBUTION SYSTEM

REVISED 12/01/02 – CHANGE NO. 04-03

Top Of Page

I. GENERAL INFORMATION

Top Of Page

II. ACCESS PROCEDURES

REISSUED 12/01/02 – CHANGE NO. 04-03

II.B. (CONT’D)

REVISED 10/01/01 – CHANGE NO. 05-02

Top Of Page

III. X/PTR LATEST REPORTS OPTIONS

REVISED 10/01/01 – CHANGE NO. 05-02

III.C. (CONT’D)

REVISED 11/01/00 – CHANGE NO. 02-01

III.D. (CONT’D)

Top Of Page

IV. VIEWING THE REPORTS

REVISED 11/01/00 – CHANGE NO. 02-01

IV.(CONT’D)

Top Of Page

V. LOGOFF PROCEDURES

REVISED 12/01/99 – CHANGE NO. 04-00

Top Of Page

VI. SIGNING ON TO X/PTR FOR THE FIRST TIME

REVISED 12/01/99 – CHANGE NO. 04-00

VI. (CONT’D)

REISSUED 10/01/08 – CHANGE NO. 01-09

VI.(CONT’D)

Top Of Page

VII. SETTING THE PRINTER DEFAULTS

REISSUED 10/01/08 – CHANGE NO. 01-09

VI.(CONT’D)

REISSUED 10/01/08 – CHANGE NO. 01-09

VII.(CONT’D)

REISSUED 10/01/08 – CHANGE NO. 01-09

VII.(CONT’D)

REISSUED 10/01/08 – CHANGE NO. 01-09

VII.(CONT’D)

REISSUED 10/01/08– CHANGE NO. 01-09

VII.(CONT’D)

Top Of Page

VIII. MODIFYING YOUR USER PROFILE

REISSUED 02/01/11 – CHANGE NO. 03-11

VIII.(CONT’D)

REVISED 02/01/11 – CHANGE NO. 03-11

Top Of Page

IX. REPORT NAMES AND ACCESS CODES-These are the most commonly used reports.

XPTR Access Code

English Report Name

DHREHC CAR ACC ENROLL RPT NCHC

CAROLINA ACCESS ENROLLMENT REPORT NCHC

DHREHC CAROLINA ACCESS CNTY NCHC

CAROLINA ACCESS COUNTY NCHC

DHREHC HLTH CHOICE ELIG TOTALS

HEALTH CHOICE ELIGIBILITY TOTALS

DHREHC MONTHLY NCHC ACT APPS EXC

MONTHLY NCHC ACTUAL APPLICATIONS EXCLUDED

DHREHC MONTHLY NCHC ACT APPS INC

MONTHLY NCHC ACTUAL APPLICATIONS INCLUDED

DHREHC MONTHLY NCHC ACT REP CARD

MONTHLY NCHC ACTUAL REPORT CARD

DHREHC MONTHLY NCHC ADJ APPS INC

MONTHLY NCHC ADJUSTED APPLICATIONS INCLUDED

DHREHC MONTHLY NCHC ADJ REP CARD

MONTHLY NCHC ADJUSTED REPORT CARD

DHREHC MONTHLY NCHC ADJ REP SUM

MONTHLY NCHC ADJUSTED REPORT SUMMARY

DHREHC NCHC ACTIVE RECIPIENTS

NCHC ACTIVE RECIPIENTS

DHREHC NCHC APPLICATIONS REACTIV

NCHC APPLICATIONS REACTIVATED

DHREHC NCHC APPS DENIED/WITHDRAWN

NCHC APPLICATIONS DENIED/WITHDRAWN

DHREHC NCHC/BCCM TPR COUNTY REP

NCHC/BCCM TPR COUNTY REPORT

DHREHC NCHC/BCCM TPR STATE REP

NCHC/BCCM TPR STATE REPORT

DHREHC NCHC BY FAM AGE SEX RACE

NCHC BY FAMILY AGE SEX AND RACE

DHREHC NCHC CWKR/SUPERVISOR RPT

NCHC CASEWORKER/SUPERVISOR REPORT

DHREHC NCHC CWKR/SUPERVISOR SUMM

NCHC CASEWORKER/SUPERVISOR SUMMARY RPT

DHREHC NCHC DETAIL PREMIUM RECON

NCHC DETAIL PREMIUN RECON

DHREHC NCHC EXTENDED COVERAGE

NCHC EXTENDED COVERAGE

DHREHC NCHC INDIV WITH MEDICARE

NCHC INDIVIDUAL WITH MEDICARE

DHREHC NCHC-INSURANCE DROPPED

NCHC-INSURANCE DROPPED

DHREHC NCHC INTERFACE

NCHC INTERFACE

DHREHC NCHC LIMITED FUNDING

NCHC LIMITED FUNDING

REVISED 05/01/09 – CHANGE NO. 03-09

IX. (CONT’D)

XPTR Access Code

English Report Name

DHREHC NCHC APPR APPS BY SOUR

NCHC/MEDICAID APPROVAL APPLICATIONS BY SOUR

DHREHC NCHC APPS APPR 10/1/98

NCHC/MEDICAID APPLICATIONS APPROVAL 10/1/98

DHREHC NCHC OUTCOME OF REACTIVAT

NCHC OUTCOME OF REACTIVIATION

DHREHC NCHC PREMIUM RECON

NCHC PREMIUM RECON

DHREHC NCHC PULL ERRORS

NCHC PULL ERRORS

DHREHC NCHC RECON CERT NONMATCH

NCHC RECON CERTIFICATION NON MATCHING

DHREHC NCHC RECON DEMOGRAPH DATA

NCHC RECON DEOMGRAPHIC DATA

DHREHC NCHC RECON GRP/INC NONMAT

NCHC RECON GRP/INC NON MATCHING

DHREHC NCHC RE-ENROLLMENT

NCHC RE-ENROLLMENT

DHREHC RE-ENROLL NCHC RPT SUM -1

RE-ENROLLMENT NCHC REPORT SUMMARY-1

DHREHC RE-ENROLL NCHC RPT SUM -2

RE-ENROLLMENT NCHC REPORT SUMMARY-2

DHREHC WEEKLY NCHC ACT APPS EXC

WEEKLY NCHC ACTUAL APPLICATIONS EXCLUDED

DHREHC WEEKLY NCHC ACT APPS INC

WEEKLY NCHC ACTUAL APPLICATIONS INCLUDED

DHREHC WEEKLY NCHC ACT REP CARD

WEEKLY NCHC ACTUAL REPORT CARD

DHREHC WEEKLY NCHC ADJ APPS INC

WEEKLY NCHC ADJUSTED APPLICATIONS INCLUDED

DHREHC WEEKLY NCHC ADJ REP CARD

WEEKLY NCHC ADJUSTED REPORT CARD

DHREHC WEEKLY NCHC ADJ REP SUM

WEEKLY NCHC AJDUSTED REPORT SUMMARY

DHREJ $50 PENALTY REGISTER

$50 Penalty Register

DHREJ AAF AUTO TRANSFERS TO MAF

AAF Automatic Transfers to MAF

DHREJ AAF CASES UPDATED TO PAY TYPE S

AAF Cases Updated to Payment Type S

DHREJ ACT APPS EXCLUDED REPORT

Actual Applications Excluded Report

DHREJ ACT APPS INCLUDED REPORT

Actual Applications Included Report

REISSUED 05/01/09 – CHANGE NO. 03-09

IX. (CONT’D)

XPTR Access Code

English Report Name

DHREJ ACT DDS REPORT CARD SUM

Actual DDS Report Card Summary

DHREJ ACT TIME REPORT CARD SUM

Actual Time Report Card Summary

DHREJ ACTUAL DDS REPORT CARD

Actual DDS Report Card

DHREJ ACTUAL TIME REPORT CARD

Actual Time Report Card

DHREJ ADJ APP MANAGEMENT REP

Adjusted Application Management Report

DHREJ ADJ APP REPORT CARD

Adjusted Application Report Card

DHREJ ADJ APP REPORT CARD SUM

Adjusted Application Report Card Summary

DHREJ ADJ APPS INCLUDED REPORT

Adjusted Applications Included Report

DHREJ ADJ DDS REPORT CARD

Adjusted DDS Report Card

DHREJ ADJ DDS REPORT CARD SUM

Adjusted DDS Report Card Summary

DHREJ ADJ SUM APP APC MGMT RPT

Adjusted Summary Application APC Management Report

DHREJ ADJ SUM APP MGMT REPORT

Adjusted Summary Application Management Report

DHREJ AFDC MR NOTICE REGISTER

AFDC Monthly Reporting Notice Register

DHREJ AFDC MR REGISTER

AFDC MONTHLY REPORTING REGISTER

DHREJ AFDC TR EOP TERM NOTICE RG

AFDC Transitional End-of-Period Notice Register

DHREJ ALEX V FLAHERTY REPORT CD

Alexander V Flaherty Report Card

DHREJ APP PROCESSED SUMMARY REP

Applications Processed Summary Report

DHREJ APPLICATIONS REOPENED RPT

Applications Reopened Report

DHREJ BENEFIT DIVERSION CASES

Benefit Diversion Cases

DHREJ BREAST/CERV CERT ENDING

Breast/Cerv Cert Ending

DHREJ CAR ACC ENROLL RPT NCHC

Carolina Access Enrollment Report NCHC

DHREJ CAR ACC ENROLLMENT REPORT

Carolina Access Enrollment Report

REISSUED 10/01/09 – CHANGE NO. 01-10

IX. (CONT’D)

XPTR Access Code

English Report Name

DHREJ CAROLINA ACC PVDR AVAILBTY

Carolina Access Provider Availability

DHREJ CA PVDR DIR - LAST CHANGES

Carolina Access Provider Directory Sorted by Last Change Date

DHREJ CAROLINA ACC PVDR DIRECTRY

Carolina Access Provider Directory

DHREJ CAROLINA ACCESS CNTY MED

CCNC/CA Medicaid Enrollment Report

DHREJ CAROLINA ACCESS CNTY NCHC

CCNC/CA NCHC Enrollment Report

DHREJ CAROLINA ACCESS CNTY SUM

CCNC/CA Medicaid & NCHC Enrollment Report

DHREJ CASE MANAGEMENT REPORT

Case Management Report

DHREJ CASEWKR SUPERVSR SUMM REPT

Caseworker/Supervisor Summary Report

DHREJ CASEWORKER IVD WORK LIST

EIS Caseworker IVD Worklist

DHREJ CASEWORKER SUPERVISOR REPT

Caseworker/Supervisor Report

DHREJ DDS REPORT CARD

DDS Report Card

DHREJ DEDUCTIBLE CASES UPDATED

Deductible Cases Updated

DHREJ DMA IVD WORK LIST

EIS Caseworker IV-D Work List

DHREJ E & A RPT

Error and Attention Report

DHREJ EIS ACTIVE CASES BY DIST

EIS Active Cases by District

DHREJ ELIGIBLES BY AGE,RACE,SEX

Open Eligibles By Age Groupings,Race and Sex

DHREJ EXEMPT PVDR CODE REPORT

Exempt Provider Codes

DHREJ F&C/NCHC ADMIN COST BASIS

Family and Children’s/NC Health Choice Administrative Cost Basis

DHREJ FACILITY TABLE

DMA/DSS Cross Reference Facility Table

DHREJ FACILITY TABLE – ADMIN

DMA/DSS Cross Reference Facility-Table

DHREJ FORMS PROCESSED RPT

Report of Forms Processed

DHREJ HLTH CHOICE ELIG TOTALS

Health Choice Indiv Eligibility Totals

REVISED 10/01/09 – CHANGE NO. 01-10

IX. (CONT’D)

XPTR Access Code

English Report Name

DHREJ HMO IND ON CASE&INV PRVD#

HMO Indicators Updated on Case Root and Invalid Provider Number Report

DHREJ IND NOT REINSTATED

Individuals Not Reinstated

DHREJ INVALID CA EXEMPTIONS

Medicaid Recipients With Invalid Carolina Access Exemptions

DHREJ LTC CASES SSI INDICATOR = Y

Long Term Care Cases with an SSI Indicator of “Y”

DHREJ MED EARNINGS DISREGARD

Medicaid Earnings Disregard Cases

DHREJ MEDICARE DRUG LTRS

Medicare Discount Drug Card Outreach Letters To MQB-B/E Recipients

DHREJ MED REG RUN

(Obsolete September 1, 2009)

Medicaid Regular Run Register (All Non-SSI and SSI recipients in MPW, MIC, MRF, HSF, IAS, MQB, and MSB)

DHREJ MED STRAGGLER RUN

(Obsolete September 1, 2009)

Medicaid Straggler Run Register

DHREJ MIC RE-ENROLLMENT

DHREJ MIC RE-ENROLLMENT

DHREJ MN ABD REV INC PROD PRPTY

MN ABD Review Income Producing Property

DHREJ MONTHLY ACT APPS EXCLUDED

Monthly Apps Excluded Report Card

DHREJ MONTHLY ACT APPS INCLUDED

Monthly Actual Apps Included Report

DHREJ MONTHLY ACT DDS REP CARD

Monthly Actual DDS Report Card

DHREJ MONTHLY ACT DDS REP SUM

Monthly Actual DDS Report Card Summary

DHREJ MONTHLY ACT REP CARD SUM

Monthly Actual Time Report Card Summary

DHREJ MONTHLY ACTUAL REP CARD

Monthly Actual Time Report Card

DHREJ MONTHLY ADJ APP REP CARD

Monthly Adjusted Apps Report Card

DHREJ MONTHLY ADJ APP REP SUM

Monthly Adjusted Apps Report Card Summary

DHREJ MONTHLY ADJ APPS INCLUDED

Monthly Adjusted Apps Included Report

DHREJ MONTHLY ADJ DDS REP CARD

Monthly Adjusted DDS Report Card

DHREJ MONTHLY ADJ DDS REP SUM

Monthly Adjusted DDS Report Card Summary

DHREJ MONTHLY NCHC ACT APPS EXC

Monthly NCHC Report Card Apps Excluded

REISSUED 10/01/09 – CHANGE NO. 01-10

IX. (CONT’D)

XPTR Access Code

English Report Name

DHREJ MONTHLY NCHC ACT APPS INC

Monthly NCHC Report Card Actual Apps Included

DHREJ MONTHLY NCHC ACT REP CARD

Monthly NCHC Choice Actual Time Report Card

DHREJ MONTHLY NCHC ADJ APPS INC

Monthly NCHC Report Card Adjusted Apps Included

DHREJ MONTHLY NCHC ADJ REP CARD

Monthly NCHC Adjusted Time Report Card

DHREJ MONTHLY NCHC ADJ REP SUM

Monthly NCHC Adjusted Apps Report Card Summary

DHREJ MQB(QI) RE-ENROLLMENT

MQB(QI) Re-Enrollment Due

DHREJ NCHC ACT RPT CRD APP EXC

NC Health Choice Actual Applications Excluded

DHREJ NCHC ACT RPT CRD APPS INC

NC Health Choice Actual Applications Included

DHREJ NCHC ACT TIME REPORT CARD

NC Health Choice Actual Time Report Card

DHREJ NCHC ADJ REPORT CARD SUM

NC Health Choice Adjusted Report Card Summary

DHREJ NCHC ADJ RPT CRD APP INC

NC Health Choice Adjusted Applications Included

DHREJ NCHC ADJUSTED REPORT CARD

NC Health Choice Adjusted Report Card

DHREJ NCHC APPS DENIED/WITHDRAWN

NC Health Choice Applications Denied or Withdrawn

DHREJ NCHC CWKR/SUPERVISOR RPT

NC Health Choice Caseworker/Supervisor Summary Report

DHREJ NCHC CWKR/SUPERVSR SUMM RP

Health Choice Casewkr Supervisor Summary Rpt

DHREJ NCHC ENROLLMENT FEES

NC Health Choice Enrollment Fees

DHREJ NCHC LIMITED FUNDING

NC Health Choice Limited Funding

DHREJ NCHC REPORT CARD

NC Health Choice Report Card

DHREJ NCHC RPT CRD APP EXCL

NC Health Choice Report Card Applications Excluded

DHREJ NCHC RPT CRD APP INCL

NC Health Choice Report Card Applications Included

DHREJ NCHC/MED APPR APPS BY SOUR

NCHC and Family and Children’s Medicaid Approved Application By Source

DHREJ NCHC/MED APPS APPR 10/1/98

NC Health Choice Applications Taken/Approved since October 1, 1998

REVISED 10/01/09 – CHANGE NO. 01-10

IX. (CONT’D)

XPTR Access Code

English Report Name

DHREJ NCHC/MIC RE-ENROLLMENT

NCHC/MIC Re-Enrollment Due

DHREJ NO UPDATE CP < 123100/UNBAL

Cases Not Updated - Cases with CP “TO DATE” Less than or Equal to 12/31/00 or Budget Out of Balance

DHREJ NONCOMPLIANCE REM FINE REG

Non-Compliance Remedial Fine Register

DHREJ NON-COOP WITHOUT IVD SANC

Non-Cooperation Individuals Without A IVD Sanction

DHREJ NOTICE REGISTER

Notice Register Report

DHREJ NUMBER NON REINST ACTIVES

Number of Individuals that are Active but were not Reinstated

DHREJ NUMBER OF IND REINSTATED

Number of Individuals that were Reinstated

DHREJ PASSALONG POT ELIGS-D&W

Passalong Potential Eligibles – Disabled and Widows

DHREJ PERCENT OF NONSSI CASES OV

Percent of Non-SSI Cases Overdue

DHREJ PERCENT OF SSI CASES OVERD

Percent of SSI Cases Overdue

DHREJ POT ELIG FOR PROG TRAN/TRM

Potential New Deductible Cases, Cases Eligible for Program Transfer, or Termination

DHREJ PRG/CAT RACE/SEX REPT

Open Eligibles By Eligibility Program/Category, Race and Sex

DHREJ PULL-LIST FOR COUNTIES

(Obsolete September 1, 2009)

Pull Check/ID Card Listing

DHREJ PULL-LIST VERSION 1

(Obsolete September 1, 2009)

Pull Check/ID Card Listing

DHREJ PULL-LIST VERSION 2

(Obsolete September 1, 2009)

Pull Check/ID Card Listing Match Check/ID Card Pulls

DHREJ QI1 CERT PERIOD EXTENDED

MQB-E Certification Extension

DHREJ QUAL INDIV ELIG TOTALS

MQB-QI1 Indv Eligibility Totals

DHREJ QUAL INDIV TERMINATED

Qualifying Individuals Terminated

DHREJ RE-ENROLL MIC RPT SUM - 1

MIC Re-enrollment Report Summary

DHREJ RE-ENROLL MIC RPT SUM – 2

MIC Re-enrollment Summary

DHREJ RE-ENROLL NCHC RPT SUM –1

NC Health Choice Re-enrollment Report Summary

DHREJ RE-ENROLL NCHC RPT SUM –2

NC Health Choice Re-enrollment Report Summary

REVISED 10/01/09 – CHANGE NO. 01-10

IX. (CONT’D)

XPTR Access Code

English Report Name

DHREJ RE-ENROLL RPT SUMMARY – 1

NC Health Choice Re-enrollment Report Summary

DHREJ RE-ENROLL RPT SUMMARY – 2

NC Health Choice Re-enrollment Report Summary

DHREJ RECIPIENTS WITHOUT CA PVDR

Medicaid Recipients Not Linked With a Carolina Access Provider

DHREJ REIND INDS ONGOING

Reinstated Individuals with Ongoing Eligibility

DHREJ REPORT CARD APPS EXCLUDED

Alexander V Flaherty Report Card Applications Excluded

DHREJ REPORT CARD APPS INCLUDED

Alexander V Flaherty Report Card Applications Included

DHREJ SSA MASS RVISON AUDIT RPT

SSA Mass Revision Audit Report

DHREJ SSI AMT > ZERO NDICATOR = N

Cases with an SSI Amount Greater than Zero with SSI Indicator of “N”

DHREJ SSI APP MED DENIED TRP REF

SSI Approval-Medicaid Denied=TRP Refusal

DHREJ SSI EXEMPT MEDICARE REPORT

SSI Exempt Medicare Report

DHREJ SSI IND IN EIS PENDING APP

SSI Individual in EIS Pending Application

DHREJ SSI MED CREATED/MODIFIED

SDX Updates-SSI Cases Modified or Created in EIS

DHREJ SSI MED STRAGGLER RUN

(Obsolete September 1, 2009)

SSI Medicaid Straggler Run Register

DHREJ SSI TERM INDIV PREV AFDC

SSI Terminated-Individual Previously in AFDC

DHREJ SSI TERMINATION ALERT RPT

SSI Termination Alert Report

DHREJ SSI TERMINATION RPT

SSI Termination Report

DHREJ SSI/SDX EXCEPTIONS

SSI/SDX Exceptions Error Report

DHREJ TBR 4/7/10TH MTH NOTICE RG

TBR 4/7/10th Month Notice Register

DHREJ TERMINATED REINSTATEMENT

Individuals Reinstated and now Terminated

DHREJ TERMS INDS NCHC WAIT LIST

Reinstated Individuals Terminated and now on NCHC Waiting List

DHREJ TRANS CASES DUE REVIEW

Transitional Cases Due Review

DHREJ TRANSITIONAL NOTICE REG

Transitional Notice Register

REISSUED 10/01/09 – CHANGE NO. 01-10

IX. (CONT’D)

XPTR Access Code

English Report Name

DHREJ UNITED CONV CASES UPDATED

United Conversion – Cases Updated

DHREJ UNITED CONV INDS UPDATED

United Conversion – Individuals Updated

DHREJ UNITED CONV MGD CARE UPDT

United Conversion – Managed Care Updated

DHREJ WAIVED NONCOMP REM FINE RG

Non-Compliance Remedial Fines Paid Register

DHREJ WEEKLY ACT APPS EXCLUDED

Weekly Apps Excluded Report Card

DHREJ WEEKLY ACT APPS INCLUDED

Weekly Actual Apps Included Report

DHREJ WEEKLY ACT DDS REP CARD

Weekly Actual DDS Report Card

DHREJ WEEKLY ACT REP CARD SUM

Weekly Actual Time Report Card Summary

DHREJ WEEKLY ACTUAL REP CARD

Weekly Actual Time Report Card

DHREJ WEEKLY ADJ APP REP CARD

Weekly Adjusted Apps Report Card

DHREJ WEEKLY ADJ APP REP SUM

Weekly Adjusted Apps Report Card Summary

DHREJ WEEKLY ADJ APPS INCLUDED

Weekly Adjusted Apps Included Report

DHREJ WEEKLY ADJ DDS REP CARD

Weekly Adjusted DDS Report Card

DHREJ WEEKLY ADJ DDS REP SUM

Weekly Adjusted DDS Report Card Summary

DHREJ WEEKLY NCHC ACT APPS EXC

Weekly NCHC Report Card Apps Excluded

DHREJ WEEKLY NCHC ACT APPS INC

Weekly NCHC Report Card Actual Apps Included

DHREJ WEEKLY NCHC ACT REP CARD

Weekly NCHC Choice Actual Time Report Card

DHREJ WEEKLY NCHC ADJ APPS INC

Weekly NCHC Report Card Adjusted Apps Included

DHREJ WEEKLY NCHC ADJ REP CARD

Weekly NCHC Adjusted Time Report Card

DHREJ WEEKLY NCHC ADJ REP SUM

Weekly NCHC Adjusted Apps Report Card Summary

DHREJ WF QTRLY REPORTING REG

Work First Quarterly Reporting Register

DHREJ WF TERM RESEARCH ADD SUMM

Work First Terminations Research Address Summary

DHREJ WF TERMS COUNTY REOPENED

Work First Terminations County Reopened

REVISED 05/01/11 – CHANGE NO. 04-11

IX. (CONT’D)

XPTR Access Code

English Report Name

DHREJ WF TERMS CTY REOPEN SUMM

Work First Terminations County Reopened Summary

DHREJ WF TERMS REOPENED SUMMARY

Work First Terminations Reopened Summary

DHREJ WF TERMS RESEARCH ADDRESS

Work First Terminations Research Address

DHREJ WORK FIRST TERMS REOPENED

Work First Terminations Reopened

DHREJA 8128 ASSETS TRANS DISCREP

8128 Assets Transfer Discrepancy

DHREJA ADULT MAILIN APPS DENIED

Adult Mail-In Applications Denied

DHREJA ADULT MAILIN APPS TRACKED

Adult Mail-In Applications Tracking Report

DHREJA AUTH REP FOR SSI MED IND

AUTHORIZED REPRESENTATIVE FOR SSI MEDICAID INDIVIDUAL

DHREJA AUTH REP VERIFICATION

AUTHORIZED REPRESENTATIVE VERIFICATION

DHREJA CAR ALT SEGS CLOSED 63099

Carolina Alternatives Segments Closed 6/30/99

DHREJA CASE/IND IVD INDICATOR CH

Case/Individual IVD Indicator Change

DHREJA CASEWORKER IDV WORK LIST

Caseworker Individual Worklist

DHREJA COLA 503 LEADS

503 Leads

DHREJA COLA AUDIT RPT

SSA Mass Revision Audit Report

DHREJA COLA CP<1231XX OR UNBAL

Cases Not Updated or Equal To 12/31/02 or Budget Out of Balance

DHREJA COLA DED CASES UPDATED

Deductible Cases Updated

DHREJA COLA LTC & SSI=Y

Long Term Care Cases With An SSI Indicator of “Y”

DHREJA COLA NOTICE REGISTER RPT

Cola Notice Register Report

DHREJA COLA POT PROG TRAN/TERM

Potential New Deductible Cases, Cases Eligible For Program Transfer, Or Terminations

DHREJA COLA SSI>ZERO & SSI=N

Cases With An SSI Amount Greater Than Zero With SSI Indicator of “N”

DHREJA COLA VA REPORT

Cola VA Report

DHREJA COUNTY DISTRICT CHANGES

County District Changes

DHREJA ERRORS & UPDATES FM 8128

Errors And Updates From 8128 Update

DHREJA HIPAA PRIVACY NOTICE

HIPAA Privacy Notice

REVISED 05/01/11 – CHANGE NO. 04-11

IX. (CONT’D)

XPTR Access Code

English Report Name

DHREJA HOLIDAY TABLE DISPLAY RPT

Holiday Table Entries

DHREJA MONEY FOLLOWS PERSON RPT

Money Follows the Person Report

DHREJA NC RECIPIENT REGISTER

North Carolina Recipient Register

DHREJA PACE PML REGISTER

5016 Forms Printed

DHREJA PASSALONG POT ELIGS-D&W

Individuals Potentially Eligible For Passalong

DHREJA PASSALONG 503 LEADS 97-02

MQB and Terminated Individuals Potentially Eligible for Passalong-

DHREJA PENDING CNTY REASSIGNMENT

Pending County Reassignment

DHREJA PML REGISTER

5016 Forms Printed

DHREJA POT MED CLASS CHANGE REPORT

Medicaid Class Change Q/B Report

DHREJA POV POT ELIG FOR PRG REV

Poverty Potential Eligibles for Program Review

DHREJA PREG MED HOME PROV DIR

Pregnancy Medical Home Provider Directory

DHREJA PROV ENROLL SUMMARY REPORT

Carolina Access Provider Enrollment Summary Report

DHREJA PROVIDER CODE ERROR REP

Provider Code Error Report

DHREJA PROVIDER ENROLL REPORT

Carolina Access Provider Enrollment Report

DHREJA PROVIDER UPDATE REPORT

Provider Update Report

DHREJA PULL LIST RR1 BLUE CARD

(Obsolete September 1, 2009)

Pull Listing For Regular Run 1 & 2

DHREJA PULL LIST RR1 HSF

(Obsolete September 1, 2009)

Pull Listing For HSF

DHREJA PULL LISTRR1 MPW

(Obsolete September 1, 2009)

Pull Listing For MPW

DHREJA PULL LIST RR1 MQB

(Obsolete September 1, 2009)

Pull Listing For MQB

DHREJA PULL LIST RR3 CARD ONLY

(Obsolete September 1, 2009)

Pull Listing For Regular Run 3 (Card Only)

DHREJA PULL LIST RR3 CHECK/CARD

(Obsolete September 1, 2009)

Pull Listing For Regular Run 3

DHREJA PULL LIST RR4 CARD ONLY

(Obsolete September 1, 2009)

Pull Listing For Regular Run 4 (ID Card Only)

DHREJA PULL LIST RR4 CHECK ONLY

(Obsolete September 1, 2009)

Pull Listing For Regular Run 4 (Matched Check/Card)

DHREJA PULL LIST RR4 CHECK/CARD

(Obsolete September 1, 2009)

Pull Listing For Regular Run 4 (Matched Check/Card)

REVISED 05/01/11 – CHANGE NO. 04-11

IX. (CONT’D)

XPTR Access Code

English Report Name

 

DHREJA PULL LIST SUMMARY REPORT(Obsolete September 1, 2009)

Pull Listing For The Month Of “Month CCYY”

DHREJA SECURITY-HSMA/HSMD MED EL

Limited Medicaid Eligibility Report of Governmental Medicaid Providers

DHREJA SECURITY REPORT

EIS RACF Security Report

DHREJA T OF ASSETS INDICATOR=N

Transfer of Assets Indicator = N

DHREJA TRANS ASSET EVAL NEEDED

Transfer of Assets Evaluation Needed

DHREJA TRANS ASSET EVAL SUMM

Transfer of Assets Evaluation Summary

DHREJA TRANS ASSET SANCTIONS

Transfer of Assets –Individuals With Sanction

DHREJA TWO IND ID’VE MANAG CARE

Two Individual IDs Have Managed Care

DHREJA WD3593-BD MONTH BOARD LIST

Monthly Board List

DHREJA XREF ACTIVE INDIVIDUALS

Cross Referenced IDs By County Active Individuals

DHREJA XREF ALL INDIVIDUALS

Cross Referenced IDs By County All Individuals

DHREJA XREF TERMINATED INDS

Cross Referenced IDs By County Terminated Individuals

DHRHWA SSN VALIDATION

List of SSNs that did not validate and no action has been taken

DHRHWA SSN VALIDATION ERRORS

List of SSNs that did not validate with the SSA

DHRHWA ZERO SSN SUGGESTION

SSN Provided by SSA for Individuals in EIS with an Invalid SSN

DHRMCI MC610 INTERSTATE MATCH

Quarterly Interstate Match Report

DHRMCI POTENTIAL MATCH REPORT

Master Client Index Match Report

DHRMCI VA MATCH BY CNTY

Quarterly VA Match by County

DHRMCI VA MATCH MSTR RPT

Quarterly VA Match Master Report

DHRRLA FAMPLAN PER ANNUAL REPORT

Family Plan Program Expenditure Report

DHRRLA FAMPLAN PER MONTH TO DATE

Family Plan Program Expenditure Report

DHRRLA FAMPLAN PER YEAR TO DATE

Family Plan Program Expenditure Report

DHRRLA KATRINA PER ANNUAL REPORT

Katrina Program Expenditure Report

DHRRLA KATRINA PER MONTH TO DATE

Katrina Program Expenditure Report

REISSUED 05/01/11 – CHANGE NO. 04-11

IX. (CONT’D)

XPTR Access Code

English Report Name

DHRRLA KATRINA PER YEAR TO DATE

Katrina Program Expenditure Report

DHRRLA MEDICAID ACH PROVIDERS

Medicaid Adult Care Home Provider Listing

DHRRLA PER ANNUAL

NC MMIS Program Annual Expenditure Report

DHRRLA PER MONTHLY MONTH-TO-DATE

NC MMIS Program Month-To-Date Expenditure Report

DHRRLA PER MONTHLY YEAR-TO-DATE

NC MMIS Program Year-To-Date Expenditure Report

DHRRLA PROVIDER EARNINGS CY

Provider Earnings

DHRRLA PROVIDER EARNINGS RPT SFY

Provider Earnings

DHRVES EIS SSN/ESC & UIB MATCH

Quarterly ESC Report

DHRVSD SDX CHANGED BY TPQY

2 versions:

SDX Claim ID or Medicare Code Changed

SDX Changed to Remove Medicare

DHRVSD SSI KIDS 18 & UNDER

SSI Kids 18 & Under

DHRVSD SSI KIDS NATIONAL ACTIVE

SSI Kids National Active

DHRVSD SSI KIDS NATIONAL INACTIVE

SSI Kids National Inactive

DHRVSD SSI KIDS NOT ON EIS

SSI Kids Not On EIS

DHRVSD SSI KIDS ON EIS

SSI Kids On EIS

DHRVSD SSI KIDS OVER 18

SSI Kids Over 18

DHRVSD SSI KIDS STATE ACTIVE

SSI Kids State Active

DHRVSD SSI KIDS STATE INACTIVE

SSI Kids State Inactive

DHRVSQ OLV SOLQ ANOMALY REPORT

OLV Anomaly Report

DHRVSQ OLV SOLQ USAGE BY COUNTY

OLV SOLQ Usage By County

DHRWDA 1275 DENIAL FOR INPATIENT

1275 Denial for Inpatient Adult/Home Care “T” Claims Report

DHRWDB 0-5 CHILDREN NCHC TO MED

0-5 Children NCHC to Medicaid

DHRWDB AGE 65 NOTICE REGISTER

Age 65 Notice Register

 

DHRWDB BCBS INDS NOT IN EIS FILE

BCBS Individuals Not In EIS File

REISSUED 08/01/11 – CHANGE NO. 01-12

IX. (CONT’D)

XPTR Access Code

English Report Name

DHRWDB BUY-IN DEATH DTE EXCEPTION

Code 29 Death Date Exception Report

DHRWDB BUY-IN PART A ACTIONS

List of Buy-In Part A Actions Sent to Baltimore

DHRWDB BUY-IN PART B ACTIONS

List of Buy-In Part B Actions Sent to Baltimore

DHRWDB CASES EXTENDED HOKE FIRE

Medicaid/NCHC Cases With Certification Periods Automatically Extended Due To Hoke County Fire

DHRWDB CHILDRN ENROL NCHC VS MED

Children Enrolled In NCHC Vs Medicaid

DHRWDB CITIZENSHIP APP RESPONSE

Citizenship App Responses

DHRWDB EIS INDS NOT IN BCBS FILE

DHRWDB EIS INDS NOT IN BCBS FILE

DHRWDB ERRORS FROM BUY-IN B TAPE

Report of Errors from Buy-In B Tape

DHRWDB FAM PLAN APPS REACTIVATED

Family Planning Waiver Applications Reactivated

DHRWDB FAM PLAN CAP ENROL DENIAL

Family Planning Waiver Capped Enrollment Denials

DHRWDB FAM PLAN ENROLL MGMT RPT

Family Planning Enrollment Management Report

DHRWDB FAM PLAN OUTCOME REACT

Family Planning Outcome of Reactivation

DHRWDB HCWD DETAIL ENROLLMENT FEE RECON

HCWD Detail Enrollment Fee Reconciliation Report

DHRWDB HCWD ENROLLMENT FEE RECON

HCWD Enrollment Fee Reconciliation Report

DHRWDB MAF-D APPS DENIED/WITHDRN

MAF-D Applications Denied/Withdrawn Totals

DHRWDB MED CARD ANNUAL

Report of cards issued at 2009 mass implementation and at annual reissue

DHRWDB MED CARD DAILY

Report of cards issued at application approval, name change and replacement cards

DHRWDB MED CARD MONTHLY

Report of cards issued monthly for PCP changes

DHRWDB MED HANDBOOKS MAILED

Medicaid Handbooks Mailed

DHRWDB MEDICAID ELIGIBILITY REPT

Medicaid Eligibility Report

DWRWDB MEDICARE FOR X-REF IDS

Medicare Changes for X-Ref IDs

DHRWDB MIC QUARTERLY DISP REP

MIC Quarterly Disposition Report

DHRWDB MMA PRO NO/Z IM SEGMENT

MMA Pro IM Segment is Blank or Z

REVISED 08/01/11 – CHANGE NO. 01-12

IX. (CONT’D)

XPTR Access Code

English Report Name

DHRWDB MPW QUARTERLY DISP REP

MPW Quarterly Disposition Report

DHRWDB MPW QUARTERLY PROV REP

MPW Quarterly Provider Report

DHRWDB MPW RECIPIENT PMH LETTER

MPW Recipient Pregnancy Medical Home Letter

    DHRWDB MQB BUDGET CHG

MQB Cases Budgeted With Family Size Budgeting (Number in the Needs Unit)

    DHRWDB MQB BUDGET CHG DENIALS

Denied Applications to Review For MQB Budget Change

    DHRWDB MQB BUDGET CHG DENY TOTAL

Totals for Denied Applications to Review For MQB Budget Change

    DHRWDB MQB BUDGET CHG TERMS

Terminated Cases to Review For MQB Budget Change

    DHRWDB MQB BUDGET CHG TERMTOTALS

Totals For Terminated Cases to Review For MQB Budget Change

DHRWDB NCHC ACTIVE RECIPIENTS

NC Health Choice Active Recipients

DHRWDB NCHC APPLICATIONS REACTIV

NC Health Choice Applications Reactivated

DHRWDB NCHC BY FAM AGE SEX RACE

NC Health Choice By Family Age Sex Race

DHRWDB NCHC BY FAM AGE SMART STR

NC Health Choice By Family Age Smart Start

DHRWDB NCHC DETAIL PREMIUM RECON

NC Health Choice Detail Premium Reconciliation

DHRWDB NCHC EXTENDED COVERAGE

NC Health Choice Extended Coverage

DHRWDB NCHC INDIV WITH MEDICARE

NC Health Choice Individual With Medicare

DHRWDB NCHC INTERFACE

BCBS/NCHC Interface Breakdown Report

DHRWDB NCHC OUTCOME OF REACTIVAT

NC Health Choice Outcome Of Reactivation

DHRWDB NCHC PREMIUM RECON

NC Health Choice Premium Reconciliation

DHRWDB NCHC PULL ERRORS

Listing of Fixed CNC Records with Error Code 19

DHRWDB NCHC RECON CERT NONMATCH

NC Health Choice Reconciliation Certification Nonmatch

DHRWDB NCHC RECON DEMOGRAPH DATA

NC Health Choice Reconciliation Demographic Data

DHRWDB NCHC RECON GRP/INC NONMAT

NC Health Choice Reconciliation Group/Income Nonmatch

REVISED 02/01/11 – CHANGE NO. 03-11

IX. (CONT’D)

XPTR Access Code

English Report Name

DHRWDB OVER 65 WITH NO RSDI#

Over 65 Individuals With No RSDI#

DHRWDB PACE CNTY XFER NOTICE

PACE County Transfers

DHRWDB PACE ENROLLED RECIPIENTS

Recipients Enrolled in PACE

DHRWDB PIEDMONT CNTY XFER NOTICE

Piedmont Health Plan County Transfer Notice Register

DHRWDB PIEDMONT HLTH PLAN NOTICE

Piedmont Health Plan Notice Register

    DHRWDB PRISONER INITIAL MATCH

Individuals active in EIS whose Medicaid is not suspended due to incarceration that match individuals in the custody of the North Carolina Division of Prisons

    DHRWDB PRISONER DAILY MATCH

Individuals active in EIS who are in the custody of the North Carolina Division of Prisons who were released, newly confined, or who have had changes in their status

DHRWDB RECIP IN NON-MED INSTIT

Recipients In Non-Medical Institutions

DHRWDB SENIOR CARE MATCH

Statistics for Senior Care Monthly Match

DHRWDB SSI MED REG RUN

(Obsolete September 1, 2009)

SSI Medicaid Regular Run (SSI Recipients in MAA, MAD, and MAB)

DHRWDB SUMMARY NCHC VS MEDICAID

Summary NC Health Choice Vs Medicaid

DHRWDB TPR DATA REPORT

Third Party Recovery Data Report

DHRWDB UNDUPLICATED MEDICAID ELIG

Unduplicated Medicaid Eligibility

    DHRWDB 5 YEAR BAN LIFTED

Pregnant women and children under age 19 who the 5 year ban for Medicaid eligibility is lifted

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