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Eligibility Information System Table of Contents

EIS 1000 – INTRODUCTION

EIS 1050 – EIS INQUIRY

EIS 1051 - APPLICATION INQUIRY

EIS 1052 - CASE LEVEL INQUIRY

EIS 1053 - CHECK HISTORY INQUIRY

EIS 1054 - INDIVIDUAL INQUIRY

EIS 1055 - THIRD PARTY HEALTH AND ACCIDENT RESOURCE INFORMATION INQUIRY

EIS 1056 – COMMON NAME DATABASE TABLE OF CONTENTS

EIS 1056 - COMMON NAME DATABASE

EIS 1057 - MASTER CLIENT INDEX (MCI) TABLE OF CONTENTS

EIS 1057 – MASTER CLIENT INDEX (MCI)

EIS 1059 – WORKER/SUPERVISOR INQUIRY AND UPDATE

EIS 1060 – WORK FIRST/TRANSITIONAL QUARTERLY REPORTING INQUIRY

EIS 1061 – X/PTR – REPORT DISTRIBUTION SYSTEM

EIS 1062 – TRANSITIONAL BENEFITS REPORTS TRACKING INQUIRY

EIS 1063 – AUTOMATED DMA - 5016

EIS 1101 – DEPARTMENT OF TRANSPORTATION (DOT) INQUIRY

EIS 1102 – DEPARTMENT OF CORRECTIONS (Public OFFENDER WEBSITE) INQUIRY

EIS 1103 – SOCIAL SECURITY NUMBER VALIDATION

EIS 1104 - beneficiary data exchange (bendex)

EIS 1104 – BENEFICIARY EXCHANGE (BENDEX)

HIB Entitlement (Part A)

SMI Entitlement (Part B)

Payment History

EIS 1105 - STATE DATA EXCHANGE (SDX) TABLE OF CONTENTS

EIS 1105 – STATE DATA EXCHANGE (SDX)

EIS 1106 – EMPLOYMENT SECURITY COMMISSION INQUIRY (ESC)

EIS 1107 – STATE ONLINE QUERY/THIRD PARTY QUERY

EIS 1108 – SAVE VERIFICATION INFORMATION SYSTEM

EIS 1109 – ONLINE VERIFICATION (OLV)

EIS 1200 – STATE OFFICE CONTACTS

EIS 1201 – BROADCAST MESSAGES

EIS 1250 – GLOSSARY

EIS 2010 - COMPLETING AN APPLICATION FORM – INTRODUCTION

EIS 2011 - COMPLETING AN APPLICATION FORM FOR NEW APPLICATIONS AND REAPPLICATIONS MEDICAID TO THE AGED, BLIND, AND DISABLED

EIS 2012 - COMPLETING AN APPLICATION FORM FOR NEW APPLICATIONS, REAPPLICATIONS, AND ADD-AN-INDIVIDUAL APPLICATIONS FOR M-AF, M-IC, M-PW, AND M-RF

EIS 2013 - COMPLETING AN APPLICATION FORM FOR NEW APPLICATIONS AND REAPPLICATIONS FOR I—AS AND H—SF

EIS 2015 - COMPLETING AN APPLICATION FORM FOR NEW APPLICATIONS, REAPPLICATIONS, AND ADD-AN-INDIVIDUAL FOR S-AA, S-AD, AND S-CD

EIS 2051- MAKING CHANGES TO MEDICAID APPLICATIONS

EIS 2052 - MAKING CHANGES TO SA APPLICATIONS

EIS 2150 - DENYING AN APPLICATION

EIS 2200 - WITHDRAWING AN APPLICATION

EIS 2240 – AUTHORIZED REPRESENTATIVE

EIS 2251 - APPROVING M-AA, M-AB, AND M-AD NEW APPLICATIONS OR REAPPLICATIONS

EIS 2252 - APPROVING M-SB NEW APPLICATIONS OR REAPPLICATIONS

EIS 2253 - APPROVING M-QB NEW APPLICATIONS OR REAPPLICATIONS

EIS 2254 – APPROVING M-AF AND M-RF NEW APPLICATIONS OR REAPPLICATIONS

EIS 2255 – APPROVING M-IC NEW APPLICATIONS OR REAPPLICATIONS

EIS 2256 – APPROVING M-PW NEW APPLICATIONS OR REAPPLICATIONS

EIS 2257 - APPROVING AN M-AF, M-RF, AND M-IC ADD-AN-INDIVIDUAL APPLICATION

EIS 2258 - APPROVING I-AS (TITLE IV-E FOSTER CARE/ADOPTION ASSISTANCE) NEW APPLICATIONS OR REAPPLICATIONS

EIS 2259 – APPROVING H-SF (NON TITLE IV-E FOSTER CARE) NEW APPLICATIONS OR REAPPLICATIONS

EIS 2264 – APPROVING AN S-AA OR S-AD NEW APPLICATION OR REAPPLICATION

EIS 2265 – APPROVING AN S-CD NEW APPLICATION OR REAPPLICATION

EIS 2266 – APPROVING AN S-CD ADD-AN-INDIVIDUAL APPLICATION

EIS 2268 - DMA-5022 INSTRUCTIONS SPECIAL ASSISTANCE application approvals

EIS 2303 - CASEWORKER SUPERVISOR REPORT

EIS 2304 - NOTICE REGISTER REPORT

EIS 2305 – ADULT MAIL-IN APPLICATION REPORTS

EIS 2400 - APPLICATION PROCESSING TABLE OF CONTENTS

EIS 2400 – DSS-8124 APPLICATION SCREEN AND DSS-8124I

EIS 2400 – DSS-8124 APPLICATION ERRORS

EIS 2400 – DISABILITY DETERMINTAION SECTION (DDS) DATA

EIS 2400 – BENEFIT ISSUANCE FOR REOPENED APPLICATIONS

EIS 2400 – DISPOSITION DATE

EIS 2400 – APPLICATION PROCESSING REPORTS

EIS 2500 – PROGRAM OF ALL INCLUSIVE CARE FOR THE ELDERLY (pace) Table of Contents

EIS 2500 – PROGRAM OF ALL INCLUSIVE CARE FOR THE ELDERLY (PACE)

EIS 2600 – HEALTH COVERAGE FOR WORKERS WITH DISABILITIES (HCWD)

EIS 3000 - BENEFIT ISSUANCE FOR ACTIVE CASES

EIS 3051 – REDETERMINING ELIGIBILITY FOR MEDICAID ONLY PROGRAMS

EIS 3052 – REDETERMINING ELIGIBILITY FOR REFUGEE AND SPECIAL ASSISTANCE

EIS 3100 - MAKING CHANGES TO CASES

EIS 3101 – CHANGES TO MEDICAID CASES

EIS 3102 – CHANGES TO R-RF AND SA CASES

EIS 3104 - DMA-5022 INSTRUCTIONS FOR MAKING CHANGES TO SPECIAL ASSISTANCE CASES

EIS 3105 - DEDUCTIBLE BALANCE/PATIENT MONTHLY LIABILITY TRANSACTION

EIS 3151 - REQUESTING A MEDICAID ID CARD

EIS 3152 REQUESTING REPLACEMENT CHECKS

EIS 3200 - TERMINATING A CASE

EIS 3210 - MQB-E AUTOMATED RE-ENROLLMENT PROCESS

EIS 3250 - PROCESSING CASH OVERPAYMENT COLLECTIONS

EIS 3300 - RESOLVING DUPLICATE IDS

EIS 3350 – THIRD PARTY HEALTH AND ACCIDENT RESOURCES INFORMATION (DMA-2041)

EIS 3400 - ERROR REPORTING

EIS 3402 - ERROR AND ATTENTION REPORT

EIS 3450 - GENERAL INSTRUCTIONS FOR AID PROGRAM/CATEGORY TRANSFERS

EIS 3451 – AID PROGRAM/CATEGORY TRANSFERS TO MEDICAID PROGRAMS

EIS 3452 – AID PROGRAM/CATEGORY TRANSFERS TO SPECIAL ASSISTANCE PROGRAMS

EIS 3500 – COUNTY TRANSFERS FOR ACTIVE CASES

EIS 3510 – FAMILY PLANNING WAIVER – CAPPED ENROLLMENT

EIS 3520 – MEDICARE ENTITLEMENT AND ENROLLMENT

EIS 3551 – CASE MANAGEMENT REPORT

EIS 3552 – POSSIBLE DUPLICATE ID REPORTS

EIS 3553 – PENDING COUNTY REASSIGNMENT REPORT

EIS 3564 – HEALTH COVERAGE FOR WORKERS WITH DISABILITIES REPORTS

EIS 3555 – CASE PROFILE

EIS 3556 – NOTICE REGISTER REPORT

EIS 3557 – MIC RE-ENROLL REPORTS 1 AND 2

EIS 3558 – RECIPIENTS IN NON-MEDICAL INSTITUTIONS REPORTS

EIS 3559 – AGE 65 LETTERS/REPORTS

EIS 3561 – TRANSITIONAL NOTICE REGISTER

EIS 3562 – TRANSITIONAL CASES DUE REVIEW REPORT

EIS 3563 – AAF AUTOMATIC TRANSFERS TO MAF 24/60 MONTH, WORK FIRST BENEFITS, SANCTION AND BENEFIT DIVERSION CASES TIME LIMITS HAVE BEEN REACHED

EIS 3564 – HEALTH COVERAGE FOR WORKERS WITH DISABILITIES REPORTS

EIS 3600 – WORK FIRST/TRANSITIONAL QUARTERLY REPORTING

WORK FIRST/TRANSITIONAL QUARTERLY REPORTING – PART TWO

WORK FIRST/TRANSITIONAL QUARTERLY REPORTING – PART THREE

WORK FIRST/TRANSITIONAL QUARTERLY REPORTING – PART FOUR

EIS 3700 – JOB BONUS TRACKING SCREEN

EIS 3800 – TRANSITIONAL BENEFITS REPORTS TRACKING

EIS 3900 – ASSETS TRANSFER TRACKING SCREEN

EIS 4000 CODES APPENDIX TABLE OF CONTENTS

EIS 4000 – CODES APPENDIX A – WORK FIRST CODES

EIS 4000 – CODES APPENDIX B – MEDICAID CODES

EIS 4000 - CODES APPENDIX C – REFUGEE ASSISTANCE

EIS 4000 - CODES APPENDIX D – SPECIAL ASSISTANCE CODES

EIS 4000 – CODES APPENDIX E – TRANSITIONAL CODES

EIS 4050 - MAILING ADDRESS APPENDIX

EIS 4100–Community Care of North Carolina/CAROLINA ACCESS

EIS 4200 – SSI MEDICAID-INTRODUCTION
PART ONE

EIS 4200 – SSI MEDICAID-EXCEPTION PROCESSING
PART TWO

EIS 4200 – SSI MEDICAID-APPROVAL/DENIAL
PART THREE

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

EIS 4200 – SSI MEDICAID-CHANGING AN SSI MEDICAID CASE
PART FIVE

EIS 4200 – SSI MEDICAID-TERMINATIONS
PART SIX

EIS 4200 – SSI MEDICAID-APPLICATIONS
PART SEVEN

EIS 4200 – SSI MEDICAID-REPORTS
PART EIGHT

EIS 4300 - NC HEALTH CHOICE – INTRODUCTION PART ONE

EIS 4300 - COMPLETING AN APPLICATION FORM FOR NEW APPLICATIONS, REAPPLICATIONS, AND ADD-AN-INDIVIDUAL APPLICATIONS FOR NC HEALTH CHOICE – PART TWO

EIS 4300 - MAKING CHANGES TO NC HEALTH CHOICE APPLICATIONS
PART THREE

EIS 4300 - NC HEALTH CHOICE APPLICATION DISPOSITIONS – PART FOUR

EIS 4300 - NC HEALTH CHOICE – ONGOING CASE MAINTENANCE
PART FIVE

EIS 4300 – NC HEALTH CHOICE – NOTICES AND CODES
PART SIX

EIS 4300 – NC HEALTH CHOICE – REPORTS
PART SEVEN

EIS 4900 – DATA ENTRY APPENDIX A - LOGON/LOGOFF PROCEDURES

EIS 4900 – DATA ENTRY APPENDIX B - DSS-8124 (KEYING AN APPLICATION)

EIS 4900 – DATA ENTRY APPENDIX C - CHILD SUPPORT
EIS/ACTS INTERFACE, PART ONE

EIS 4900 – DATA ENTRY APPENDIX C - CHILD SUPPORT
EIS/ACTS INTERFACE, PART TWO

EIS 4900 – DATA ENTRY APPENDIX C - CHILD SUPPORT
EIS/ACTS INTERFACE, PART THREE

EIS 4900 – DATA ENTRY APPENDIX C - CHILD SUPPORT
EIS/ACTS INTERFACE, PART FOUR

EIS 4900 – DATA ENTRY APPENDIX C - CHILD SUPPORT
EIS/ACTS INTERFACE, PART FIVE

EIS 4900 – DATA ENTRY APPENDIX C - CHILD SUPPORT
EIS/ACTS INTERFACE, PART SIX

EIS 4900 – DATA ENTRY APPENDIX D - DATE SCREEN

EIS 4900 - DATA ENTRY – APPENDIX E - DSS-8125 (APPROVING AN APPLICATION)

EIS 4900 – DATA ENTRY APPENDIX E - DSS-8125 (MAKING CHANGES TO A CASE)

EIS 4900 – DATA ENTRY APPENDIX F - DMA-2041 (THIRD PARTY RECOVERY)

EIS 4900 – DATA ENTRY APPENDIX G - DMA-5022

EIS 4900 – DATA ENTRY APPENDIX H - DSS-8128

EIS 4900 – DATA ENTRY APPENDIX I – CITIZENSHIP EXCEPTION SCREEN