Revision Date: October, 2015 v1.1 OREG ONE LIGIBILITY Aging and People with Disabilities 1

Revision Date: October, 2015 v1.1 Module Objectives and Agenda After completing this module, you will be able to: Identify the Triggers that result in an APD task Recognize the different task views Dashboard Inquiry – Office Activity – Unit Inquiry – Office Activity – Queue Inbox Start, View, and Reassign the APD task Locate and identify application information that triggered the APD task Working from the Worker Portal Inbox Viewing Correspondence 2

Revision Date: October, 2015 v1.1 Key Term / ConceptDefinition APApplicant Portal WPWorker Portal APD TaskNon-MAGI Referral – APD Aged Blind Disabled Procedural Denial MAGI denial based on a person not completing the application process. For example - not providing requested missing info, not signing the application, not providing income verification. Non-Procedural Denial MAGI denial based on eligibility criteria, for example being over income for all programs, being over the age limit for available programs, having other health coverage that makes you ineligible. Federally Facilitated Marketplace (FFM) Federal site (healthcare.gov) where individuals can apply for medical. The FFM determines eligibility for Advanced Payment of the Premium Tax Credit (APTC) and Cost Sharing Reductions (CSR) as well as facilitates enrollment into a Qualified Health Plan (QHP). Key Terms and Concepts 3

Revision Date: October, 2015 v1.1 About Tasks Tasks can be system-generated or created manually. They direct a worker to take an action or to perform follow-up. Currently all APD tasks will be system-generated, and will require an APD/AAA worker to follow-up with an OSIPM, QMB, or a service eligibility determination. When the task is first generated it is reviewed by 5503 staff. If a referral is appropriate 5503 will route the task to the appropriate APD branch. 4

Revision Date: October, 2015 v1.1 TOPIC - 01 Identify the Triggers that Result in an APD task 5

Revision Date: October, 2015 v1.1 Triggers that Result in APD Task 6 An APD task will be generated when an individual meets all of the following: a)Is not currently receiving OSIPM or an MSP; b)Has not been denied or terminated MAGI due to a procedural denial; and c)The individual meets any of the following conditions: 1.Is blind or disabled; 2.Is 65 years of age or older; 3.Is receiving SSI; 4.Is receiving any Part of Medicare or a Medicare Supplement; 5.Is receiving or requesting long-term care services*; or 6.Is denied or terminated MAGI and is receiving SSDI. *A process for DD service requests is currently being developed.

Revision Date: October, 2015 v1.1 Scenarios 7 APD Conditions Eligibility ResultTask Scenario #1 Is blind or disabled Is 65 years of age or older Is receiving SSI Is receiving any Part of Medicare or a Medicare Supplement Is receiving or requesting long- term care services Is receiving SSDI Individual is denied MAGI due to failure to provide income verification (Procedural Denial) No APD Task

Revision Date: October, 2015 v1.1 Scenarios 8 APD Conditions Eligibility ResultTask Scenario #2  Is blind or disabled  Is 65 years of age or older  Is receiving SSI  Is receiving any Part of Medicare or a Medicare Supplement Is receiving or requesting long- term care services  Is receiving SSDI Individual is denied MAGI due to being over income APD Task generated

Revision Date: October, 2015 v1.1 Scenarios 9 APD Conditions Eligibility ResultTask Scenario #3  Is blind or disabled  Is 65 years of age or older  Is receiving SSI  Is receiving any Part of Medicare or a Medicare Supplement Is receiving or requesting long- term care services  Is receiving SSDI Individual is approved for MAGI APD Task generated

Revision Date: October, 2015 v1.1 Scenarios 10 Scenarios APD Conditions Eligibility ResultTask Scenario #4 Is blind or disabled  Is 65 years of age or older  Is receiving SSI  Is receiving any Part of Medicare or a Medicare Supplement  Is receiving or requesting long- term care services  Is receiving SSDI Individual is approved for MAGI APD Task generated

Revision Date: October, 2015 v1.1 Scenarios 11 Scenarios APD Conditions Eligibility ResultTask Scenario #5  Is blind or disabled  Is 65 years of age or older  Is receiving SSI  Is receiving any Part of Medicare or a Medicare Supplement  Is receiving or requesting long- term care services Is receiving SSDI Individual is approved for MAGI No APD Task

Revision Date: October, 2015 v1.1 TOPIC - 02 Dashboard and Office Activity Views Starting, Viewing, and Reassigning 12

Revision Date: October, 2015 v1.1 Dashboard 13

Revision Date: October, 2015 v1.1 Office Activity #1 14

Revision Date: October, 2015 v1.1 Office Activity #2 15

Revision Date: October, 2015 v1.1 Office Activity – Unit View 16

Revision Date: October, 2015 v1.1 Unit View #3 17

Revision Date: October, 2015 v1.1 Office Activity – Queue View #1 18

Revision Date: October, 2015 v1.1 Office Activity – Queue View #2 19

Revision Date: October, 2015 v1.1 Office Activity – Queue View #3 20

Revision Date: October, 2015 v1.1 Office Activity – Queue View #4 21

Revision Date: October, 2015 v1.1 Office Activity – Queue View #5 22

Revision Date: October, 2015 v1.1 View History will allow those with the appropriate rights to see the actions taken on this task by others (usually 5503 at this point) Office Activity – Queue View # Reassign Queue will allow you to transfer the selected task to another branch. Note: If you reassign from the Office Activity, Queue view, you will not have to mark as new. Mark as New won’t work here because these tasks are already new. Mark as Complete probably isn’t good option here since these tasks haven’t been started or assigned.

Revision Date: October, 2015 v1.1 Office Activity – Viewing Contact Details 24

Revision Date: October, 2015 v1.1 Office Activity – Contact Details #2 25

Revision Date: October, 2015 v1.1 Office Activity – Contact Details #3 26

Revision Date: October, 2015 v1.1 Office Activity – Contact Details #4 27

Revision Date: October, 2015 v1.1 Office Activity – Contact Details #5 28

Revision Date: October, 2015 v1.1 Office Activity – Contact Details #6 29

Revision Date: October, 2015 v1.1 Office Activity – Reassign Queue 30

Revision Date: October, 2015 v1.1 TOPIC - 03 Working with the Task Starting, Viewing Case Details, Reassigning 31

Revision Date: October, 2015 v1.1 Triggers – Navigation Examples 32 TriggerCenter Navigation Tab Selection Left Panel Navigation Screen Selection Individual’s age >= 65 years? Data Collection  Individual Individual Disabled or Blind? Data Collection  Individual Individual Information Receiving SSI benefits now? Data Collection  Individual Individual Information Individual is receiving or requesting long term care services? Data Collection  Individual Individual Information Individual is denied or terminated and receiving SSDI? Data Collection  Non Financial/Financial Income Summary Individual is receiving any Part of Medicare or a Medicare Supplement? Data Collection  Non Financial/Financial Health Insurance Policy This chart shows you where to look to determine what trigger generated the APD task. Quick Search by case# (top menu bar) = Case Summary – Lots of stuff here! View (right panel) = Application Details

Revision Date: October, 2015 v1.1 Starting a Task 33

Revision Date: October, 2015 v1.1 Starting a Task 34 Write these down!!!

Revision Date: October, 2015 v1.1 Quick Search

Revision Date: October, 2015 v1.1 Search Results 36

Revision Date: October, 2015 v1.1 Case Summary 37

Revision Date: October, 2015 v1.1 Contact Information 38

Revision Date: October, 2015 v1.1 Viewing MAGI Eligibility Status for Case Members 39

Revision Date: October, 2015 v1.1 Individual Results 40

Revision Date: October, 2015 v1.1 Case Notes 41

Revision Date: October, 2015 v1.1 Case Notes 42

Revision Date: October, 2015 v1.1 Case Summary 43

Revision Date: October, 2015 v1.1 Electronic Case File 44

Revision Date: October, 2015 v1.1 Case Summary 45

Revision Date: October, 2015 v1.1 Application Information 46

Revision Date: October, 2015 v1.1 Data Collection 47

Revision Date: October, 2015 v1.1 Data Collection - Individual 48

Revision Date: October, 2015 v1.1 Individual Contact Information 49 Case Summary – View – Data Collection – Individual – Individual Information - Contact Information

Revision Date: October, 2015 v1.1 Individual Contact Information 50

Revision Date: October, 2015 v1.1 Scroll Down to Bottom to Find Address Summary for Individual 51

Revision Date: October, 2015 v1.1 Data Collection - Individual 52

Revision Date: October, 2015 v1.1 Individual - Continued 53

Revision Date: October, 2015 v1.1 Individual Information 54

Revision Date: October, 2015 v1.1 Individual Information – Joel Cat 55

Revision Date: October, 2015 v1.1 Data Collection – Individual - Individual Information 56

Revision Date: October, 2015 v1.1 Data Collection – Non Financial/Financial 57

Revision Date: October, 2015 v1.1 Data Collection – Non Financial/Financial – Income Summary 58

Revision Date: October, 2015 v1.1 Data Collection – Non Financial/Financial – Health Insurance Policy 59

Revision Date: October, 2015 v1.1 Health Insurance Policy 60 Scroll to bottom

Revision Date: October, 2015 v1.1 Health Insurance Policy 61

Revision Date: October, 2015 v1.1 Topic 04 Working from the Inbox Searching, Reassigning, and Closing

Revision Date: October, 2015 v1.1 Accessing the Inbox The inbox is a more personalized screen for the logged-in staff. The Inbox screen can be accessed by clicking Inbox from the main menu bar. 63 The Inbox screen can be accessed from any screen in Worker Portal by clicking Inbox on the main menu bar.

Revision Date: October, 2015 v1.1 Inbox Allows user to indicate task outcome. The default view of the Inbox screen displays outstanding tasks. It also provides the ability to search for a specific task. 64

Revision Date: October, 2015 v1.1 Inbox. 65 The Status indicates if the task is In Progress or Complete The red dates indicate that ONE considers this task “overdue” An in- progress task can be accessed by clicking the Continue link from the Action column.

Revision Date: October, 2015 v1.1 Searching from the Inbox This section allows you to enter a case or application # directly and then click Search below, or look them up using the name, SSN, or date of birth using the Lookup buttons. 66 This section allows you to search by dates or task name, but also contains the Search button.

Revision Date: October, 2015 v1.1 Search Using Application Lookup – Step 1 67

Revision Date: October, 2015 v1.1 Search Using Application Lookup – Step 2 68

Revision Date: October, 2015 v1.1 Search Using Application Lookup – Step 3 69

Revision Date: October, 2015 v1.1 Search Using Application Lookup 70

Revision Date: October, 2015 v1.1 Reassign Queue from Inbox – Step 1 71

Revision Date: October, 2015 v1.1 Reassign Queue from Inbox – Step 1 72

Revision Date: October, 2015 v1.1 Reassign Queue from Inbox – Step 2 73

Revision Date: October, 2015 v1.1 Closing a Task from the Inbox This section displays the search results for the search performed on this screen. 74 This is the Warning icon which appears when a task is overdue. Scroll right to see that the Due Dates of all overdue tasks are displayed in red.

Revision Date: October, 2015 v1.1 Closing the APD Task Once the outcome of the task has been determined, the outcome is captured on the Non-MAGI Task screen within the ONE system. This screen will be displayed after clicking Continue. 75

Revision Date: October, 2015 v1.1 In order to close the APD task: Select the Referral Status (mandatory field) Enter the Determination Date (mandatory field) Select the Program Name The field is only active if the Referral Status is Completed – Approved Enter Eligibility Start Date and Eligibility End Date The field is only activate if the Referral Status is Completed- Approved Closing the APD Task (Continued) 76

Revision Date: October, 2015 v1.1 Next, the APD Task must be Marked as Complete as the final step. Check the task to be closed Click Mark as Complete Closing the APD Task (Continued) 77

Revision Date: October, 2015 v1.1 Closing the APD Task The closure of the APD task automatically sends responses to the Federally Facilitated Marketplace (FFM) for records requiring a response. Therefore, it is critical that each task in the APD non-MAGI task queue is closed with the non-MAGI eligibility decision and effective dates noted. 78

Revision Date: October, 2015 v1.1 Scenario Referral Status Determination Date Program Name Eligibility Start Date Eligibility End Date OSIPM and MSP Approved Complete- Approved Date Of ActionOSIPM OSIPM Effective Date Redetermination Due Date OSIPM Only Approved Complete- Approved Date Of ActionOSIPM OSIPM Effective Date Redetermination Due Date MSP Only Approved Complete- Approved Date Of Action Medicare Savings Plan MSP Effective Date Redetermination Due Date OSIPM and QMB Denied Complete- Denied Date Of ActionLeave Blank Services Only Approved Complete- Denied Date Of ActionLeave Blank Services Only Denied Complete- Denied Date Of ActionLeave Blank Individual approved MAGI and only trigger marked is Blind/Disabled Invalid APD Application Referral Date Of ActionLeave Blank Misc Invalid Referrals ( N/A 79

Revision Date: October, 2015 v1.1 Quick Quiz 1.Where would a worker go to find information about an individual’s Medicare? 2.T/F A procedural denial always generates a task. 3.Name one place you can go to assign yourself a task. 4.T/F Clicking Start or Continue will open the case so you can view the details. 80

Revision Date: October, 2015 v1.1 TOPIC - 05 Correspondence 81

Revision Date: October, 2015 v1.1 Correspondence 82

Revision Date: October, 2015 v1.1 Correspondence 83

Revision Date: October, 2015 v1.1 Correspondence 84

Revision Date: October, 2015 v1.1 Correspondence 85

Revision Date: October, 2015 v1.1 Module Summary You should now be able to: Identify the Triggers that Result in APD task View and Open the APD task from Office Activity and Inbox Reassign and Close an APD Task in Worker Portal 86

Revision Date: October, 2015 v1.1 Questions? 87 Contact: Michael Avery Trevor Baker Jeff Stell Heather Williams 5503 Phone Bank