Copyright © 2013 Accenture All Rights Reserved. Accenture, its logo, and High Performance Delivered are trademarks of Accenture. Ohio Integrated Eligibility System Eligibility and Case Management: MAGI Unit 1

Copyright © 2013 Accenture All Rights Reserved. 2 Course Introduction Faculty and Participant Introductions Name Office Location Role Copyright © 2013 Accenture All Rights Reserved. 2

Ground Rules Turn off cell phones. Make the most of face-to-face training; ask questions and share your own insights and expertise. Leave the room only during break times or in the event of an emergency; manage expectations for your other responsibilities. 3 Copyright © 2013 Accenture All Rights Reserved. Course Introduction

The Eligibility and Case Management: MAGI course is intended for case managers, case workers and other workers who will use the Accenture Benefits Management System (ABMS) to manage MAGI cases. This course prepares you to: successfully use ABMS to navigate through the process of determining benefits. Record non-financial data and financial data, and use ABMS to determine eligibility and benefit calculations. Maintain continuing cases. Copyright © 2013 Accenture All Rights Reserved. 4 Course Purpose Course Introduction

Course Agenda Unit 1: Introduction to Medicaid Case Processing Unit 2: Adding Non-Financial Case Information Unit 3: Adding Financial Case Information Unit 4: Adding Remaining Medicaid Eligibility Information Unit 5: Running Eligibility Determination and Benefit Calculation (EDBC) Unit 6: Maintaining a Continuing Medicaid Case 5 Copyright © 2013 Accenture All Rights Reserved. Course Introduction

Course Objectives After completing this course, you will be able to: Describe the Medicaid case process. Add non-financial case information. Add financial case information. Add eligibility information. Run a Eligibility Determination and Benefit Calculation (EDBC). Maintain a continuing Medicaid case. 6 Copyright © 2013 Accenture All Rights Reserved. Course Introduction

Training Topic Expectations 7 Copyright © 2013 Accenture All Rights Reserved. Course Introduction We will NOT: Train on the county-specific process outside the system. Address policy questions – will be covered during Policy Video Conference & the Trainer Virtual Coaching video conference. Address system updates occurring post-mid September. A delta training will address these. Run EDBC or generate NOAs. We WILL: Review the Ohio Integrated Eligibility System functionality. Provide a structured, hands-on activity in the live training environment. Use simulations to address functionality not in training environment (EDBC, NOAs). Document your questions for follow-up with SMEs.

Course Introduction Training Environment Key Points The training environment that you will use in today’s training is a production-like environment but not a clone of production. The training environment is current as of the last week in August. The production environment may reflect additional functionality. Future communications to the user community will announce updates to the production environment made through go- live. The training environment is available during class only. Simulations are available outside of class to practice system functionality. 8

Unit 6: Maintaining a Continuing Medicaid Case Training Environment Login Instructions 1.Desktop PC Login Instructions Enter your User Name and Password located on the post it note attached to the bottom right of your monitor. The format of this ID looks like the following: Copyright © 2013 Accenture All Rights Reserved. 9 User NamePassword TRNMITS##mitstrng1

Unit 6: Maintaining a Continuing Medicaid Case Training Environment Login Instructions 2.Eligibility and Case Management Training Environment Login Instructions Open the Internet Explorer Web Browser. Click the link titled, Eligibility and Case Management Training Environment, located in the bookmark bar just below the URL field. Enter your assigned User Name and Password which are located on the post-it note attached to the bottom left of your monitor. The format should look similar to the following: Copyright © 2013 Accenture All Rights Reserved. 10 User NamePassword (Note: # refers to User#)

The Ohio Integrated Eligibility System Simulations The simulations in the course will prepare you to: Successfully use ABMS to navigate through the process of determining benefits. Record non-financial data and financial data. Use the Ohio Integrated Eligibility System to determine eligibility and benefit calculations. Learn how to maintain continuing cases. 11 Copyright © 2013 Accenture All Rights Reserved. Course Introduction

The Ohio Integrated Eligibility System Simulations 12 Copyright © 2013 Accenture All Rights Reserved. Course Introduction Unit 2: Add Non-Financial Information Simulation 1: Answer Non-Financial Questions Simulation 2: Add and Verify Demographics Simulation 3: Add and Verify U.S. Citizenship Statistics Simulation 4: Add Household Information Simulation 5: Link Relationships Simulation 6: Add Employment Information Unit 3: Add Financial Information Simulation 1: Answer Financial Questions Simulation 2: Add Income Information Simulation 3: Add Income Tax Information Unit 1: Introduction to the Medicaid Process Simulation 1: Establish a Case Simulation 2: Assign a Case to an Eligibility Worker Simulation 3: View Your Assigned Cases Simulation 4A: Add a Person Simulation 4B: Assign a Person to the Administrative Role of Additional Correspondence Recipient Simulation 4C: Update the Application Date Simulation 4D: Assign a Secondary Worker Simulation 4E: Update the Address Information for a Case Member

The Ohio Integrated Eligibility System Simulations 13 Copyright © 2013 Accenture All Rights Reserved. Course Introduction Unit 5: Run Eligibility Determination and Benefit Calculation (EDBC) Simulation 1: Run EDBC Simulation 2: Verify EDBC Simulation 3: Generate a Notice of Action (NOA) Simulation 4: Add Journal Entry Unit 6: Maintain Case Information Simulation 1: Add a New Person to a Case Simulation 2: Add a New Person to Medicaid Simulation 3: Deny an Application Using Negative Action Detail Page Unit 4: Add Medicaid Eligibility Information Simulation 1: Add a Pregnancy to a Household Simulation 2: Document the Method of Informing Individuals about Healthchek and Pregnancy Related Services Simulation 3: Complete Healthchek and Pregnancy Related Services List Simulation 4: Complete the Medicaid Eligibility Review Verification Request Checklist Simulation 5: Add Retroactive Medicaid

Accessing the Ohio Integrated Eligibility System Simulations To access the Ohio Integrated Eligibility System simulations login to the Ohio Academy training site at and select Eligibility and Case Management ILT Simulations for Units 1-6 from your course list Copyright © 2013 Accenture All Rights Reserved. Course Introduction

Online Help Support The Ohio Integrated Eligibility System includes an Online Help function. We have a basic version of the Help function in the Training environment today. The “live” system will include customized Online Help for Ohio. 15 Course Introduction Copyright © 2013 Accenture All Rights Reserved.

Online Help Support Page Example 16 Course Introduction

Job Aid List The following Job Aids for the Ohio Integrated Eligibility System are available: Case Assignment Intake Process Login Attempts and Password Administration No Touch Processing No Touch Screen Flows Rescissions – For Phase 1.0 Hearings Process Security Administration View-Only Access 17 Course Introduction

Unit 1: Introduction to Medicaid Case Processing Unit 1 – Introduction and Objectives This unit will provide you with an overview of the Medicaid Eligibility process. After completing this unit, you will be able to: Describe the Medicaid Eligibility Process. Establish a Case. Assign a Case. View Your Assigned Programs View and Maintain Case Information Let’s overview the eligibility determination and notification process. Copyright © 2013 Accenture All Rights Reserved. 18

Unit 1: Introduction to Medicaid Case Processing Unit 1 Agenda Introduction to Medicaid Processing Establish a Case Assign a Case to an Eligibility Worker View Assigned Cases Maintain Case Information Copyright © 2013 Accenture All Rights Reserved. 19 Let’s start by taking a closer look at the eligibility determination and notification process.

Unit 1: Introduction to Medicaid Case Processing Introduction to Medicaid Case Processing At a high level the eligibility determination and notification process looks like this: Copyright © 2013 Accenture All Rights Reserved. 20 Next: A closer look how these steps are worked within a scenario. Receive Application The Medicaid eligibility determination process begins when an application for assistance is received. Establish Case A case worker adds all case members to the system and programs are selected based upon the application. Assign Program to Eligibility Worker A designated person assigns all programs to the appropriate case workers. Create Work Assignment Journal Entry In some cases, a journal entry is created when a program is assigned to a case worker. Schedule Intake Appointment (Individual Request Only) A case worker schedules any necessary appointments. Collect and Enter Data The case worker reviews and validates case information. Request Verifications When data collection is incomplete, the case worker requests any needed verifications and provides the individual a copy of the Verification Request List. Determine Eligibility The case worker runs EDBC and allows the Ohio Integrated Eligibility System to determine program eligibility. Send Notice of Action The case worker sends the appropriate approval, change in benefits, or Notice of Action (NOA).

Unit 1: Introduction to Medicaid Case Processing The Medicaid Case Description John and Lori (nee Landon) Buchanan are a married couple. They file jointly and claim Lori’s son by a first marriage, JP, age 17. The Tax and Medicaid Household = John, Lori and JP. Child support income does not count. JP’s income (< filing threshold for dependents). Lori Buchanan is the primary applicant submitting an application for Medicaid. Lori’s primary language is English and the Date of Application is today’s date. Copyright © 2013 Accenture All Rights Reserved. 21

After receipt of the application, the next step is to Establish the Case in the Ohio Integrated Eligibility System. In this exercise, you will Establish a Case for John, Lori and JP. But first, let me show you how this is done. Exercise #1: Establish a Case Copyright © 2013 Accenture All Rights Reserved. 22 Unit 1: Introduction to Medicaid Case Processing Next: A close look at Assigning a Program to Eligibility Worker.

Unit 1: Introduction to Medicaid Case Processing Exercise #2: Assign Case to Eligibility Worker Copyright © 2013 Accenture All Rights Reserved. 23 Next: A look at how to View Your Assigned Programs. When an application for Medicaid is accepted from a customer who used Ohio Benefits, the Medicaid program is assignable to any worker according to the State of Ohio's procedures. In this exercise, you will Assign a Case to an Eligibility Worker. Before you get started, I will walk you through the process in Ohio Integrated Eligibility System.

Unit 1: Introduction to Medicaid Case Processing Exercise #3: View Your Assigned Cases Copyright © 2013 Accenture All Rights Reserved. 24 Next: A close look at how to Maintain Case Information. Cases are assigned to you either manually or automatically. In this exercise, you will View Your Assigned Cases. Watch first, as I walk you through this process.

Unit 1: Introduction to Medicaid Case Processing Exercises 4A-E: Maintain Case Information The Case Summary Page contains links to all pages where you will go to make changes to the case information. In this exercise, you will Maintain Case Information. This section contains exercises on how to: Add a Person Assign new person as an Additional Correspondence Recipient Update Application Date Add a Secondary Worker Update the Address Information for a Case Member We will walk you through each process and then you will have an opportunity to practice each exercise. Copyright © 2013 Accenture All Rights Reserved. 25 Next: Let’s summarize what we learned.

Unit 1: Introduction to Medicaid Case Processing Unit 1 Summary We have covered a lot of important material in this unit. Let’s quickly review the Medicaid processing steps: Copyright © 2013 Accenture All Rights Reserved. 26 Receive Application The Medicaid eligibility determination process begins when an application for assistance is received. Establish Case A case worker adds all case members to the system and programs are selected based upon the application. Assign Program to Eligibility Worker A designated person assigns all programs to the appropriate case workers. Create Work Assignment Journal Entry In some cases, a journal entry is created when a program is assigned to a case worker. Schedule Intake Appointment (Individual Request Only) A case worker schedules any necessary appointments. Collect and Enter Data The case worker reviews and validates case information. Request Verifications When data collection is incomplete, the case worker requests any needed verifications and provides the individual a copy of the Verification Request List. Determine Eligibility The case worker runs EDBC and allows the Ohio Integrated Eligibility System to determine program eligibility. Send Notice of Action The case worker sends the appropriate approval, change in benefits, or Notice of Action (NOA).

Unit 1: Introduction to Medicaid Case Processing Unit 1 Wrap-up This unit will provided you with an overview of the Medicaid Eligibility process. You should be able to: Describe the Medicaid Eligibility Process. Establish a Case. Assign a Case. View Your Assigned Programs. View and Maintain Case Information. Copyright © 2013 Accenture All Rights Reserved. 27

QUESTIONS?