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NC DEPARTMENT OF HEALTH AND HUMAN SERVICES EIS MANUAL

ELIGIBILITY INFORMATION SYSTEM EIS 4200

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SSI MEDICAID-OPEN/SHUT APPROVAL - PART FOUR

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EIS 4200 – SSI MEDICAID-OPEN/SHUT APPROVAL PART FOUR


I SSI MEDICAID CASE CREATION

II. BENEFIT ISSUANCE

III. AUTOMATED NOTICES

IV. RETROACTIVE MEDICAID


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EIS 4200 – SSI MEDICAID-OPEN/SHUT APPROVAL
PART FOUR

REISSUED 10/01/09 - CHANGE NO. 01-10

When SSI is approved and terminated at the same time, SSI Medicaid is also approved open/shut. The Medicaid Eligibility Code displayed on the online SDX indicates open/shut SSI Medicaid eligibility when there is a code C, G, Q or Y for one Change Month followed by a code R, D or W for a later change month posted to the SDX at the same time. EIS receives data from the SDX related to the SSI approval and termination just as it does for other SSI transactions. EIS creates an SSI Medicaid case and issues benefits and recipient notices.

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I SSI MEDICAID CASE CREATION

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II. BENEFIT ISSUANCE

Example-Written as if we are in September.

 

June

July

August

September

Open in EIS

SSI approved June

SSI approved

July

   

When is SSI Medicaid approved?

June through July

 

No Ex Parte

Required

REVISED 10/01/09 - CHANGE NO. 01-10

II B. 2. (cont’d)

Example-Written as if we are in September.

 

June

July

August

September

Open in EIS

SSI approved

June

SSI approved

July

SSI approved

August

 

When is SSI

Medicaid

approved?

June through August

No Ex Parte

Required

Example-Written as if we are in September.

 

July

August

September

October

Open in EIS

SSI approved July

SSI approved August

SSI approved September

SSI approved October

When is SSI Medicaid approved?

EIS authorizes SSI Medicaid July through October.

No Ex Parte Required

REVISED 03/01/99 - CHANGE NO. 10-99

II. C. 1. (CONT’D)

Example-Written as if we are in September.

 

June

July

August

September

Not open in EIS

SSI approved June

SSI approved

July

   

When is SSI Medicaid approved?

June through July

   

Example-Written as if we are in September.

 

June

July

August

September

Not open in EIS

SSI approved June

SSI approved July

SSI approved

August

 

When is SSI Medicaid approved?

June through 12/31/9999

Ex Parte

Required

Example-Written as if we are in September.

 

July

August

September

October

Not open in EIS

SSI approved July

SSI approved August

SSI approved September

SSI approved October

When is SSI Medicaid approved?

July through 12/31/9999

Ex parte required

REVISED 03/01/99 - CHANGE NO. 10-99

II. (CONT’D)

EXAMPLE:

JANUARY

FEBRUARY

MARCH

APRIL

 

AUTHORIZED REGULAR MEDICAID IN EIS EFF FEB 13

AUTHORIZED REGULAR MEDICAID IN EIS

AUTHORIZED REGULAR MEDICAID IN EIS

SSI MEDICAID APPROVED EFF JAN

SSI MEDICAID APPROVED, EIS FILLS IN MISSING ELIGIBILITY AND TERMINATES SSI MEDICAID FEB 28

   

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III. AUTOMATED NOTICES

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IV. RETROACTIVE MEDICAID

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