NC DEPARTMENT OF HEALTH AND HUMAN SERVICES EIS MANUAL

ELIGIBILITY INFORMATION SYSTEM EIS 2400

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APPLICATION PROCESSING REPORTS

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EIS 2400 – APPLICATION PROCESSING REPORTS


VII. APPLICATION PROCESSING REPORTS


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EIS 2400 – APPLICATION PROCESSING REPORTS

REVISED 11/01/06 - CHANGE NO. 03-07

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VII. APPLICATION PROCESSING REPORTS

PAGE

ENGLISH REPORT NAME

XPTR ACCESS CODE

2

ADJUSTED APPLICATION MANAGEMENT REPORT

DHREJ ADJ APP MANAGEMENT REP

8

ADJUSTED SUMMARY APPLICATION MANAGEMENT REPORT

DHREJ ADJ SUM APP MGMT REPORT

10

ADJUSTED APPLICATION REPORT CARD

DHREJ MONTHLY ADJ APP REP CARD

11

ADJUSTED APPLICATION REPORT CARD SUMMARY

DHREJ MONTHLY ADJ APP REP SUM

12

ACTUAL TIME REPORT CARD

DHREJ MONTHLY ACTUAL REP CARD

13

ACTUAL TIME REPORT CARD SUMMARY

DHREJ MONTHLY ACT REP CARD SUM

13

ADJUSTED APPLICATIONS INCLUDED REPORT

DHREJ MONTHLY ADJ APPS INCLUDED

15

ACTUAL APPLICATIONS INCLUDED REPORT

DHREJ MONTHLY ACT APPS INCLUDED

17

ACTUAL APPLICATIONS EXCLUDED REPORT

DHREJ MONTHLY ACT APPS EXCLUDED

18

APPLICATIONS PROCESSED SUMMARY REPORT

DHREJ APP PROCESSED SUMMARY REP

19

APPLICATIONS REOPENED REPORT

DHREJ APPLICATIONS REOPENED RPT

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VII. (CONT’D)

PAGE

ENGLISH REPORT NAME

XPTR ACCESS CODE

19

ADJUSTED DDS REPORT CARD

DHREJ MONTHLY ADJ DDS REP CARD

20

ADJUSTED DDS REPORT CARD SUMMARY

DHREJ MONTHLY ADJ DDS REP SUM

20

ACTUAL DDS REPORT CARD

DHREJ MONTHLY ACT DDS REP CARD

20

ACTUAL DDS REPORT CARD SUMMARY

DHREJ MONTHLY ACT DDS REP SUM

21

NC HEALTH CHOICE ADJUSTED REPORT CARD

DHREJ MONTHLY NCHC ADJ REP CARD

21

NC HEALTH CHOICE ADJUSTED REPORT CARD

DHREJ MONTHLY NCHC ACT REP CARD

21

NC HEALTH CHOICE ADJUSTED APPLICATIONS INCLUDED

DHREJ MONTHLY NCHC ADJ APPS INC

22

NC HEALTH CHOICE ACTUAL APPLICATIONS INCLUDED

DHREJ MONTHLY NCHC ACT APPS INC

22

NC HEALTH CHOICE ACTUAL APPLICATIONS EXCLUDED

DHREJ MONTHLY NCHC ACT APPS EXC

22

Explanation of

WEEKLY REPORT CARD REPORTS

Weekly versions and monthly versions of the Report Card reports are located in XPTR under report names that designate whether it is the weekly or monthly report.

24

NC HEALTH CHOICE ADJUSTED REPORT CARD SUMMARY

DHREJ MONTHLY NCHC ADJ REP SUM

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VII.A. (CONT'D)

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VII.A.4. (CONT'D)

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VII.A.4.P. (CONT'D)

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VII.A.5.D. (CONT'D)

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VII.A.5. (CONT'D)

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VII.A.6. (CONT'D)

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VII.B.1. (CONT'D)

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VII.B.1. (CONT'D)

          (7) Total Number of Applications Pending for Hardship Waiver Determination
          (8) Total Number of Applications Pending for NC Health Choice Enrollment Fee
          (9) Total Number of Applications Pending for Additonal Time to Provide Information
          (10) Total Number of Applications Pending
          (11) Total Number of Applications Due Within 5 Days
          (12) Total Number of Applications Due Within 6-10 Days
          (13) Total Number of Applications Due Within 11-15 Days
          (14) Total Number of Applications Not Due For At Least 16 Days
          (15) Total Number of Applications Pending Beyond the Time Standard - This will reflect the actual time, subtracting out DMA-5098 or DMA-5099 days, and counting through the date of the report.
      2. This report is sorted by county, district number, due date, and worker number.
      3. As the report is 80 spaces wide, the following columns are stacked:
        a. CTY CASE # and WKR #
        b. DDS BEG END
        c. ST and DD
        cdc. DUE/BEG

    C. ADJUSTED APPLICATION REPORT CARD

      1. The “Adjusted Application Report Card” is produced on the 5th work night of the month to capture EIS statistics for each county concerning compliance with the thresholds in the previous month. It is available in XPTR the 6th workday of the month.
      2. The average processing time and percentage processed timely are calculated using approved, denied, and withdrawn applications.

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

VII.C. (CONT'D)

      3. Adjusted due dates and excluded time will be considered in the calculations.
      4. This report is sorted by county and by two major categories: MAD and Other Medicaid. “Other Medicaid” will also be divided by the individual aid program/categories and includes AAF and MQB-E. The total for “MAD” and “Other Medicaid” is displayed.
      5. The following information will display on the report card:
        a. County Number
        b. Program/Category
        c. Applications Processed
        d. Applications Approved
        e. Applications Denied
        f. Applications Withdrawn
        g. Applications Overdue
        h. Percent Processed Timely (by major category and for each aid program/category)
        i. Average Processing Time (by major category and for each aid program/category)
        j. Total Number of Included Applications
        k. State Totals by County, Major category (MAD and OTHER), and Aid Program/Category.

    D. ADJUSTED APPLICATION REPORT CARD SUMMARY

      1. The “Adjusted Report Card Summary” is used to indicate if the county has passed or failed their report card in the previous 12 months using the adjusted processing time.
      2. This report is run monthly and accumulates information for 12 months. At the end of 12 months, the oldest month is dropped off. The report is available in XPTR the 6th workday of the month.
      3. The following information is included on the report:
        a. Category

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VII.C. (CONT'D)

          (1) MAD
          (2) OTHER (Includes AAF and MQB-E within MQB)
        b. Passed or Failed the Report Card

          NOTE: COUNTY MUST PASS BOTH THE PPT AND THE APT TO BE CONSIDERED PASSED ON THE REPORT CARD.

    E. ACTUAL TIME REPORT CARD

      1. The “Actual Time Report Card” is produced on the 5th work night of the month to capture EIS statistics for each county concerning compliance with the thresholds in the previous month. It is available in XPTR the 6th workday of the month.
      2. The average processing time and percentage processed timely are calculated using approved, denied, and withdrawn applications.
      3. Calculations are based on the actual time taken to process an application. Due dates are not adjusted and time is not excluded when forms DMA-5098 or DMA-5099 are mailed.
      4. This report is sorted by county and by two major categories: MAD and Other Medicaid. “Other Medicaid” will also be divided by the individual aid program/categories and includes AAF and MQB-E. The total for “MAD” and “Other Medicaid” is displayed.
      5. The following information will display on the Report Card:
        a. County Number
        b. Program/Category
        c. Applications Processed
        d. Applications Approved
        e. Applications Denied
        f. Applications Withdrawn
        g. Applications Overdue
        h. Percent Processed Timely (by major category and for each aid program/category)

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VII.E.1. (CONT'D)

        i. Average Processing Time (by major category and for each aid program/category)
        j. Total Number of Included Applications
        k. State Totals by County, Major category (MAD and OTHER), and Aid Program/Category.

    F. ACTUAL TIME REPORT CARD SUMMARY

      1. The “Actual Time Report Card Summary” is used to indicate if the county has passed or failed their report card in the previous 12 months using the actual time taken to process applications.
      2. This report is run monthly and accumulates information for 12 months. At the end of 12 months, the oldest month is dropped off. It is available in XPTR the 6th workday of the month.
      3. The following information is included on the report:
        a. Category
          (1) MAD
          (2) OTHER (Includes AAF and MQB-E within MQB)
        b. Passed or Failed the Report Card

          NOTE: COUNTY MUST PASS BOTH THE PPT AND THE APT TO BE CONSIDERED PASSED ON THE REPORT CARD.

    G. ADJUSTED APPLICATIONS INCLUDED REPORT

      1. The “Adjusted Applications Included Report” lists all applications, including MQB-E, which were included in the calculation of the compliance thresholds. This report calculates processing time using the adjusted due dates and the excluded time when forms DMA-5098 or DMA-5099 are mailed. The report is produced the 5th work night of the month for the previous month's statistics. It is available in XPTR the 6th workday of the month.
      2. This report is sorted by county and worker number within the program/category.
      3. The following information will display on the report:
        a. County Number
        b. Program/Category (Report Card)

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VII.G.3 (CONT'D)

        c. Worker Number
        d. Application Number
        e. Application Date
        f. Applicant Name
        g. Case ID
        h. County Case Number
        i. Disposition (Approved, Denied, Withdrawn)
        j. Disposition Date
        k. Processing Time
        l. Date Registered
        m. Disposition Keyed
        n. Other Identifying Data:
          (1) DDS
          (2) Pend
          (3) DDS Beg MM/DD/YY - if the application is approved, denied, or withdrawn before DDS enters a Begin Date, this field will be blank. The DDS end date will show the date the approval, denial, or withdrawal was keyed.
          (4) DDS End MM/DD/YY
          (5) Disability Determination
          (6) Onset Date MM/DD/YY
          (7) Soc Sec Adopted
          (8) Reason
          (9) Begin Date MM/DD/YY
          (10) End Date MM/DD/YY
          (11) Orig Reason
          (12) Orig Begin and End Dates

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VII.G.3. (CONT'D)

          (13) Orig App Date MM/DD/YY
          (14) Orig Disp Date MM/DD/YY
          (15) Date Info Requested MM/DD/YY
          (16) Date Last Info Received MM/DD/YY
          (17) Social Security Appeal Reversal
          (18) Original Application Date MM/DD/YY
          (19) Improper Discouragement/Denial/Withdrawal
          (20) Orig Discouragement Date MM/DD/YY
          (21) Found By Monitors
          (22) Incorrect Denial
        o. Worker Total Applications
        p. Worker Total Overdue Applications
        q. Worker Average Processing Time (Days)

    H. ACTUAL APPLICATIONS INCLUDED REPORT

      1. The “Actual Applications Included Report” lists all applications, including MQB-E, which were included in the calculation of the compliance thresholds. This report calculates processing time by using the actual number of days used to process the applications. The report is produced the 5th work night of the month for the previous month's statistics. It is available in XPTR the 6th workday of the month.
      2. This report is sorted by county and worker number within the program/category.
      3. The following information will display on the report:
        a. County Number
        b. Program/Category
        c. Worker Number
        d. Application Number
        e. Application Date
        f. Applicant Name

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VII.H. (CONT'D)

        g. Case ID
        h. County Case Number
        i. Disposition (Approved, Denied, Withdrawn)
        j. Disposition Date
        k. Processing Time
        l. Date Registered
        m. Disposition Keyed
        n. Other Identifying Data:
          (1) DDS
          (2) Pend
          (3) DDS Beg MM/DD/YY - if the application is approved, denied, or withdrawn before DDS enters a Begin Date, this field will be blank. The DDS end date will show the date the approval denial, or withdrawal was keyed.
          (4) DDS End MM/DD/YY
          (5) Disability Determination
          (6) Onset Date MM/DD/YY
          (7) Soc Sec Adopted
          (8) Reason
          (9) Begin Date MM/DD/YY
          (10) End Date MM/DD/YY
          (11) Orig Reason
          (12) Orig Begin and End Dates
          (13) Orig App Date MM/DD/YY
          (14) Orig Disp Date MM/DD/YY
          (15) Date Info Requested MM/DD/YY
          (16) Date Last Info Received MM/DD/YY
          (17) Social Security Appeal Reversal
          (18) Original Application Date MM/DD/YY

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

VII.H.3. (CONT'D)

          (19) Improper Discouragement/Denial/Withdrawal
          (20) Orig Discouragement Date MM/DD/YY
          (21) Found By Monitors
          (22) Incorrect Denial
        o. Worker Total Applications
        p. Worker Total Overdue Applications
        q. Worker Average Processing Time (Days)

    I. ACTUAL APPLICATIONS EXCLUDED REPORT

      1. The “Actual Applications Excluded Report” captures all application approvals, denials, and withdrawals, which were not included in the calculation of the compliance thresholds. The report calculates the actual days used to process the applications and is produced on the 5th work night of the month for the previous month's statistics. It is available in XPTR the 6th workday of the month.

        Listed below are the types of applications excluded.

        a. Administrative Actions
        b. Transitional Medicaid Applications (AAF Payment Type “4” and “5”)
        c. Special Assistance Applications (SAA, SAD, and SCD)
        d. MPW Presumptive Eligibility Applications
        e. Automatic Newborn Coverage and Inclusions (Application Types “3” and “7”)
        f. Refugee Assistance Applications (RRF and MRF)
        g. Foster Care Applications (HSF and IAS)
        h. St/Co Appeal Reversal
        i. MSB - Medicaid-State Aid to Blind
      2. This report is sorted by county number and worker number within county.
      3. The following information will display on the report:
        a. County Number

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VII.I.1. (CONT'D)

        b. Worker Number
        c. Application Number
        d. Case ID
        e. County Case Number
        f. Disposition
        g. Aid Program/Category
        h. Reason For Exclusion
      4. This report displays the total number of applications excluded by aid program/category and a grand total of all applications excluded for each county.
      5. This report displays a statewide total number of applications excluded by aid program/category and a grand total at the end of the report.

    J. APPLICATIONS PROCESSED SUMMARY REPORT

      1. The “Applications Processed Summary Report” displays the total number of applications taken and disposed each calendar month and year-to-date for all aid program/categories. NCHC has a separate total within MIC. MQB-E is included with MQB.
      2. This report is run monthly on the last work night of the month to capture information from application activity in that calendar month. It is available in XPTR the 1st workday of the month.
      3. This report displays a monthly total and a year-to-date total by aid program/category for each county and the state.
      4. The year-to-date total is by calendar year (January to December). The year-to-date totals revert back to zero each January 1st.
      5. The report is sorted by county.
      6. Information included on the report is:
        a. Total Applications Taken Monthly and Year-To-Date by Aid Program/Category
        b. Total Applications Disposed Monthly and Year-To-Date by Aid Program/Category

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VII.J. (CONT'D)

          (1) Total Approved
          (2) Total Denied
          (3) Total Withdrawn
        c. County Totals
        d. State Totals

    K. APPLICATIONS REOPENED REPORT

      1. The “Applications Reopened Report” indicates the number of applications reopened due to:
        a. Incorrect Denials
        b. Improper Denials/Withdrawals found by the County
        c. Improper Denials/Withdrawals found by the Monitors
        d. Discouragement found by the County
        e. Discouragement found by the Monitors
        f. State/County Appeal Reversals
      2. This report is run once per month, to indicate all reopens dispositioned in the previous calendar month. It is available in XPTR the 6th workday of the month.
      3. The report includes the following information:
        a. Application Number
        b. Case ID
        c. Casehead Name
        d. Type of Reopen (as listed in 1. above)
        e. County Total by Type
        f. Total Number of Reopens by County
        g. State Totals by Type and Grand Total Reopened

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

VII. (CONT'D)

    L. ADJUSTED DDS REPORT CARD

      1. The “Adjusted DDS Report Card” is produced on the 5th work night of the month to capture EIS statistics for the Disability Determination Section concerning compliance with the thresholds in the previous month.
      2. The average processing time and percentage processed timely are calculated using approved, denied, and withdrawn applications.
      3. Adjusted due dates and excluded time will be considered in the calculations.
      4. The report is available in XPTR the 6th workday of the month.

    M. ADJUSTED DDS REPORT CARD SUMMARY

      1. The “Adjusted DDS Report Card Summary” is used to indicate if DDS has passed or failed their report card in the previous 12 months using the adjusted processing time. If the county processed no apps in a given month, the report will indicate a “blank” rather than pass/fail in the summary field of the report.
      2. The report is run monthly and accumulates information for 12 months. At the end of 12 months, the oldest month is dropped off.
      3. The report is available in XPTR the 6th workday of the month.

    N. ACTUAL DDS REPORT CARD

      1. The “Actual DDS Report Card” is produced on the 5th work-night of the month to capture EIS statistics for the Disability Determination Section concerning compliance with the thresholds in the previous month.
      2. The average processing time and percentage processed timely are calculated using approved, denied, and withdrawn applications.
      3. Calculations are based on the actual time taken to process an application.
      4. Adjusted due dates and excluded time are not considered in the calculations.
      5. The report is available in XPTR the 6th workday of the month.

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

VII. (CONT'D)

    O. ACTUAL DDS REPORT CARD SUMMARY

      1. The “Actual DDS Report Card Summary” is used to indicate if DDS passed or failed their report card in the previous 12 months using the actual time taken to process applications.
      2. The report is run monthly and accumulates information for 12 months. At the end of 12 months, the oldest month is dropped off.
      3. The report is available in XPTR the 6th workday of the month.

    P. NC HEALTH CHOICE ADJUSTED REPORT CARD

      1. The “NC Health Choice Adjusted Report Card” contains the same information as the “ADJUSTED APPLICATION REPORT CARD”.
      2. The only applications displayed on this report are NC Health Choice applications.
      3. The report is for statistical reporting purposes only since the NC Health Choice applications are not included in determining compliance with the thresholds.
      4. The NC Health Choice Adjusted Report Card is produced on the 5th work night of the month from data from the previous month. It is available in XPTR on the 6th workday of the month.

    Q. NC HEALTH CHOICE ACTUAL TIME REPORT CARD

      1. The “NC Health Choice Actual Time Report Card” contains the same information as the “ACTUAL TIME REPORT CARD”.
      2. The only applications displayed on this report are NC Health Choice applications.
      3. The report is for statistical reporting purposes only since the NC Health Choice applications are not included in determining compliance with the thresholds.
      4. The NC Health Choice Actual Time Report Card is produced on the 5th work night of the month from data from the previous month. It is available in XPTR on the 6th workday of the month.

REISSUED 03/01/04 - CHANGE NO. 05-04

VII. (CONT'D)

    R. NC HEALTH CHOICE ADJUSTED APPLICATIONS INCLUDED

      1. The “NC Health Choice Adjusted Applications Included” report lists all NC Health Choice application approvals, denials, and withdrawals, which were included in the calculation of the data for the “NC HEALTH CHOICE ADJUSTED REPORT CARD”.
      2. The report contains the same information as “ADJUSTED APPLICATIONS INCLUDED” report except this report includes only NC Health Choice applications.
      3. The report is produced the 5th work night of the month from data from the previous month. It is available in XPTR on the 6th workday of the month.

    S. NC HEALTH CHOICE ACTUAL APPLICATIONS INCLUDED

      1. The “NC Health Choice Actual Applications Included” report lists all NC Health Choice application approvals, denials, and withdrawals, which were included in the calculation of the data for the “NC HEALTH CHOICE ACTUAL TIME REPORT CARD”.
      2. The report contains the same information as “ACTUAL APPLICATIONS INCLUDED REPORT” except this report includes only NC Health Choice applications.
      3. The report is produced the 5th work night of the month from data from the previous month. It is available in XPTR on the 6th workday of the month.

    T. NC HEALTH CHOICE ACTUAL APPLICATIONS EXCLUDED

      1. The “NC Health Choice Actual Applications Excluded” report lists all NC Health Choice application approvals, denials, and withdrawals, which were NOT included in the calculation of the data for the NCHC REPORT CARD.
      2. The report contains the same information as the “ACTUAL APPLICATIONS EXCLUDED REPORT” except the report includes only NC Health Choice applications.
      3. The report is produced the 5th work night of the month for data from the previous month. It is available in XPTR on the 6th workday of the month.

REVISED 03/01/04 - CHANGE NO. 05-04

VII. (CONT'D)

    U. WEEKLY REPORT CARD REPORTS

      All reports related to Report Cards are run weekly. The weekly reports are run on Monday nights and include applications processed in the current calendar month through the Monday that they run. This enables the county to see, weekly, what their average processing time (APT) and percentage processed timely (PPT) is for the current calendar month.

      EXCEPTION: If the 5th work night is on Monday, the reports that are run are the monthly report cards for the previous calendar month and the weekly reports for the current calendar month are not run that week.

      Reports that are run weekly include the reports listed in VII.C. through VII.I. and VII.L. through VII.T., above, and VII.V., below.

      The weekly versions of these reports are available in XPTR each Tuesday. They are located in XPTR with the following names:

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VII.U. (CONT'D)

      ENGLISH REPORT NAME

      XPTR ACCESS CODE

      ADJUSTED APPLICATION REPORT CARD

      DHREJ WEEKLY ADJ APP REP CARD

      ADJUSTED APPLICATION REPORT CARD SUMMARY

      DHREJ WEEKLY ADJ APP REP SUM

      ACTUAL TIME REPORT CARD

      DHREJ WEEKLY ACTUAL REP CARD

      ACTUAL TIME REPORT CARD SUMMARY

      DHREJ WEEKLY ACT REP CARD SUM

      ADJUSTED APPLICATIONS INCLUDED REPORT

      DHREJ WEEKLY ADJ APPS INCLUDED

      ACTUAL APPLICATIONS INCLUDED REPORT

      DHREJ WEEKLY ACT APPS INCLUDED

      ACTUAL APPLICATIONS EXCLUDED REPORT

      DHREJ WEEKLY ACT APPS EXCLUDED

      ADJUSTED DDS REPORT CARD

      DHREJ WEEKLY ADJ DDS REP CARD

      ADJUSTED DDS REPORT CARD SUMMARY

      DHREJ WEEKLY ADJ DDS REP SUM

      ACTUAL DDS REPORT CARD

      DHREJ WEEKLY ACT DDS REP CARD

      ACTUAL DDS REPORT CARD SUMMARY

      DHREJ WEEKLY ACT DDS REP SUM

      NC HEALTH CHOICE ADJUSTED REPORT CARD

      DHREJ WEEKLY NCHC ADJ REP CARD

      NC HEALTH CHOICE ADJUSTED REPORT CARD

      DHREJ WEEKLY NCHC ACT REP CARD

      NC HEALTH CHOICE ADJUSTED APPLICATIONS INCLUDED

      DHREJ WEEKLY NCHC ADJ APPS INC

      NC HEALTH CHOICE ACTUAL APPLICATIONS INCLUDED

      DHREJ WEEKLY NCHC ACT APPS INC

      NC HEALTH CHOICE ACTUAL APPLICATIONS EXCLUDED

      DHREJ WEEKLY NCHC ACT APPS EXC

      NC HEALTH CHOICE ADJUSTED REPORT CARD SUMMARY

      DHREJ WEEKLY NCHC ADJ REP SUM

      County report card performance will continue to be based on the monthly report card that is run the 5th work night of each month.

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

VII. (CONT'D)

    V. NC HEALTH CHOICE ADJUSTED REPORT CARD SUMMARY

      1. The “NC Health Choice Adjusted Report Card Summary” is used to indicate if the county has passed or failed their NC Health Choice adjusted report card in the previous 12 months using the adjusted processing time. If the county processed no apps in a given month, the report will indicate a “blank” rather than pass/fail in the summary field of the report.
      2. The report is run monthly and accumulates information for 12 months. At the end of 12 months, the oldest month is dropped off.
      3. The report is available in XPTR the 6th workday of the month.

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