NC DEPARTMENT OF HEALTH AND HUMAN SERVICES EIS MANUAL

ELIGIBILITY INFORMATION SYSTEM EIS 3101

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CHANGES TO MEDICAID CASES

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EIS 3101 – CHANGES TO MEDICAID CASES


I. COMPLETING THE DSS-8125

II. SIGNATURES AND DATE

III. KEY THE DSS-8125.

IV. OUTPUTS

V. FOR ANY CHANGE NOT LISTED, SEE ”OTHER CHANGED DATA”


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EIS 3101 – CHANGES TO MEDICAID CASES

CHANGE OF ADDRESS

REISSUED 10/01/12 - CHANGE NO. 01-13

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I. COMPLETING THE DSS-8125

REVISED 10/01/12 - CHANGE NO. 01-13

I. A. (CONT’D) (CHANGE OF ADDRESS)

REISSUED 10/01/12 - CHANGE NO. 01-13

IV. (CONT’D) (CHANGE OF ADDRESS)

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II. SIGNATURES AND DATE

    A. Enter the DATE COMPLETED.

    B. Sign the DSS-8125 in the WORKER'S SIGNATURE field.

    C. The county director or his designee must sign the form in the DIRECTOR'S SIGNATURE field.

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III. KEY THE DSS-8125.

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IV. OUTPUTS

    When the DSS-8125 processes successfully, the following are received:

    A. Case Profile

      An updated Case Profile is produced the night the change processes and is mailed to the county the following workday.

    B. Automated DMA-5016-If the case is long term care, an automated DMA-5016 is produced the night the change processes and is mailed to the facility the next workday.

    C. Caseworker Supervisor Report

      All changes completed by an IMC are reported on the Caseworker Supervisor Report. The number of actions completed is determined from the WORKER NUMBER.

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V. FOR ANY CHANGE NOT LISTED, SEE ”OTHER CHANGED DATA”

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