1. 0 Presumptive Eligibility for State and County Workers January 30 th / February 4 th, 2014

2. 1 Training Materials Student GuideSupport Materials Training Materials Job Aids and course materials can be found on the project website.project website

3. 2 Addressing Questions We will have time for questions at the end of each chapter. Questions

4. 3 Your Trainers Today… Trainer Introductions

5. 4 Course Objectives By the end of this course, participants will: Understand what Presumptive Eligibility (PE) is and why it is used Articulate the PE policy changes that will be taking place Identify the resident groups that are eligible for PE Understand the key business process changes for processing PE and what impacts the changes have on workers’ daily activities Identify the key business process changes for linking Deemed Newborns cases that are processed at the Qualified Entity Understand potential scenarios that workers may face Understand what the systems will look like for workers and Qualified Entities Understand how to use the new systems to process PE Policy Process System

6. 5 Chapter TitleApproximate Duration Introduction: Background of Presumptive Eligibility (PE)10 minutes Chapter 1: PE Policy Changes10 minutes Chapter 2: PE Process for Workers20 Minutes Chapter 3: Qualified Entities and the PE and Deemed Portal15 minutes Closing: Course Wrap Up and Q&A with Trainers5 minutes Course Agenda

7. 6 Introduction: Background of Presumptive Eligibility

8. 7 Who ? Why What Why is PE used?: What is PE?: Who has been eligible for PE in the past?: A program that provides immediate, temporary access to health services by giving residents temporary healthcare coverage through Medicaid, if they appear eligible Allows residents to receive timely care for medical needs while waiting for a full Medicaid eligibility determination Ohio residents who are U.S. citizens or have satisfactory immigration status with gross family income < 200% of the FPL and who are part of one of these categories: Pregnant women Children Under Age 19 February 10 th, Qualified Entities will become the primary processor of PE Until recently, County Departments of Job and Family Services (CDJFS) were the sole processors of PE Last year, 3 Qualified Entities began processing PE in a successful pilot Past20122014 Progression of Presumptive Eligibility Eligible once per pregnancy Does not cover in-patient stays or labor & delivery cost Eligible once per year

9. 8  PE will be processed in the Ohio Integrated Eligibility system instead of through CRIS-E  Qualified Entities will now process PE requests for residents through a new PE and Deemed Portal (PE Portal)  Ohio Administrative Code (OAC) has expanded PE coverage to new resident groups and also describes the processes that Qualified Entities are required to follow in order to process PE requests  PE coverage begins when a resident is found to be presumptively eligible for Medicaid and ends when a full Medicaid application determination is completed OR at the end of the month following the month of the PE approval Beginning February 10, 2014, changes to the PE program will have Policy, Process, and System impacts for workers. Ongoing PE Progression Policy Process System  Workers will have new business processes to complete PE determinations  New business processes are defined for Qualified Entities to process PE requests when a resident is determined presumptively eligible PE Changes Effective February 10, 2014 Qualified Entities are those determined by the Ohio Department of Medicaid (ODM) to be capable of processing and authorizing PE requests. They include: Hospitals, Federally Qualified Health Centers (FQHCs) and Federally Qualified Health Center Look-Alikes (FQHC-LAs).

10. 9 Introduction Summary Introduction: Key Takeaways Presumptive Eligibility provides immediate, temporary access to healthcare by giving residents temporary healthcare coverage through Medicaid, if they appear eligible 1 Due to policy and system changes, workers will process PE differently than they do presently using a simpler process 2 On February 10 th, Qualified Entities will begin processing PE at the point of care, becoming the primary avenue for PE to be processed 3

11. 10 Chapter 1 – Presumptive Eligibility Policy Changes

12. 11 The purpose of this chapter is to describe the changes to PE policy that will impact who is covered by PE and how PE is processed. Chapter Purpose Chapter 1: Presumptive Eligibility Policy Changes Understand how the Ohio Administrative Code has changed to expand coverage and include Qualified Entities as the primary processors of PE By the end of this chapter, you will be able to: Identify which new categories of residents are eligible to be covered by PE and how long coverage lasts Understand what Qualified Entities are and articulate their expanded role in processing PE requests PolicySystemProcess This course will provide a comprehensive overview of PE policy to guide all course participants to a shared understanding of PE. Chapter Note

13. 12 Groups Eligible for PE in 2014 Ohio Administrative Code has expanded PE coverage to two new groups: Parents and Relative Caretakers and Extension Adults. However, some key differences exist: Two New Groups PolicySystemProcess Children under 19 Pregnant Women Parents and Relative Caretakers Extension Adults Federal Poverty Limit (FPL) Under 200% Under 90% Under 138% for adults ages 19-64 and Parents 91-138% Coverage Frequency Once per year Once per pregnancy Coverage Details Ambulatory prenatal care (Doctor visits) covered, but not in-patient stays (hospitalization), labor & delivery. Immediate, time ‐ limited, full access to Medicaid coverage

14. 13 Who is Able to Process PE as of February 10, 2014? ‏ In the past, PE was only processed at CDJFS and the three new Qualified Entities participating in the pilot. Moving forward, CDJFS and all new Qualified Entities will process PE. PE Processors Existing Processors CDJFS will still be able to process PE in cases where a full eligibility determination cannot be completed. However, they will no longer be the sole processors. Chapter 3 of this course will describe the PE Process for Qualified Entities. CDJFS + Qualified Entities are those determined by the Ohio Department of Medicaid (ODM) to be capable of processing and authorizing PE requests. New, Primary Processors New Qualified Entities Qualified Entities include: Hospitals, Federally Qualified Health Centers (FQHCs) and Federally Qualified Health Center Look-Alikes (FQHC-LAs) PolicySystemProcess

15. 14 Chapter 1 Summary Chapter 1: Key Takeaways PolicySystemProcess The new groups that will be eligible for PE coverage include Parent and Relative Caretakers and Extension Adults 2 Qualified Entities will now be the primary processors of PE requests 3 Ohio Administrative Code has expanded the groups that are eligible to receive PE and the entities that can now process PE 1

16. 15 Chapter 1: Policy - Knowledge Checkpoint Think about the groups that are eligible to receive PE given recent policy changes. Tim is a 29 year-old Hamilton county resident and relative caretaker of his 7 year-old nephew. He earns $1,049 per month and does not have any existing healthcare coverage. Tim was hurt on his way to work and visits a Qualified Entity for medical attention. How should the Qualified Entity handle this situation? PolicySystemProcess

17. 16 Chapter 1: Policy - Knowledge Checkpoint Due to the recent policy changes, Tim may be eligible for Medicaid if he falls within the Relative Caretaker group since he has primary responsibility for his nephew’s care (a child under 19), and has a gross family income at or below 90% FPL. Since Tim requires immediate treatment, the Qualified Entity should process a PE request to grant coverage. Think about the groups that are eligible to receive PE given recent policy changes. Tim is a 29 year-old Hamilton county resident and relative caretaker of his 7 year-old nephew. He earns $1,049 per month and does not have any existing healthcare coverage. Tim was hurt on his way to work and visits a Qualified Entity for medical attention. How should the Qualified Entity handle this situation? PolicySystemProcess

18. 17 Questions: Chapter 1

19. 18 Chapter 2 – Presumptive Eligibility Process for Workers

20. 19 The purpose of this chapter is to introduce the updated, simplified PE process for workers and provide a demonstration of how to use the system. Chapter Purpose Chapter 2: Worker Business Process Overview Understand the updated steps workers will follow to process PE By the end of this chapter, you will be able to: Understand the different channels through which a Medicaid application will be received that may necessitate PE coverage Navigate the Ohio Integrated Eligibility system to process PE PolicySystemProcess This chapter will explore the simplified standard steps a worker will take to process PE in the Ohio Integrated Eligibility system. Chapter Note

21. 20 CDJFS Process Overview: Then and Now PE Then Receive a Medicaid application PE Now ‏ With the introduction of the Ohio Integrated Eligibility system, workers will process PE using different action steps. The Ohio Integrated Eligibility system does not require the user to enter a new screen for PE processing. Changes to PE Processing Eligibility determination could not be completed Process PE in CRIS-E using either the expedited process or the ROMPIR driver Eligibility determination could not be completed Return to Program Detail screen to add “PE” to the case and select “PE” from the Run EDBC screen PolicySystemProcess Workers will no longer need to run a ROMPIR driver to process PE.

22. 21 PE request is completed at the point of care A full Medicaid application is entered Add “PE” on New Program screen and choose “PE” on the Run EDBC page CDJFS will only process PE when the eligibility determination for an application cannot be completed in the Ohio Integrated Eligibility system. Individual/Household PolicySystemProcess There are now two paths by which residents can receive PE coverage. The first path is through CDJFS. Paths to PE PE Portal Medicaid PE PE Processing Roles – CDJFS Eligibility determination could not be completed Qualified Entities follow up with residents who receive PE coverage Qualified Entities take all reasonable steps to assist residents in completing full Medicaid application Qualified Entities now have the ability to process PE

23. 22 PE Process in Counties In Person/Paper Application Phone Application Ohio Benefits Self-Service Portal: Fall Out Regardless of how an application is received, workers may need to explore PE in the new system. The four channels through which a worker will receive an application include:  Resident submits a paper application, or applies for Medicaid in person at CDJFS  Resident submits an online application through eGateway  Resident calls the Ohio Medicaid Consumer Hotline to fill out a Medicaid application  Resident applies for Medicaid through the Ohio Benefits Portal, but eligibility determination cannot be completed and the application falls out PE Process in Counties PolicySystemProcess eGateway Ohio Benefits

24. 23 System Snapshot: Task in the Ohio Integrated Eligibility system Ohio Benefits PolicySystemProcess On the Task Portlet page, a list of required tasks will be populated on this page that a worker is required to complete for the identified cases. No Touch fall out tasks will be populated here.

25. 24 Individual/Household applies for Medicaid through one of four channels – in-person/paper application, eGateway, phone application, or Ohio Benefits Self- Service Portal 12 3 Worker processes the full application and runs EDBC for Medicaid 4 Eligibility determination could not be completed and a notification will appear in the system 5 Worker returns to Program Detail screen and adds “PE” to the case 6 7 Approved resident will receive PE coverage until the end of the following month, or until a Medicaid application is either approved or denied. Once a full eligibility determination has been made, PE coverage will discontinue PolicySystemProcess Steps to Process PE Notice of Action (NOA) is generated containing information including eligibility decision, PE program type, billing number, etc. If application came through In-person/paper application or eGateway, worker checks for known applicant in “New Person Search” in the Ohio Integrated Eligibility system. If applicant is not found, worker enters application in the Ohio Integrated Eligibility system If application came in through phone application or the Ohio Benefits Self Service portal, proceed to Step 3 Worker navigates to the Run EDBC page to run EDBC for PE 8

26. 25 PolicySystemProcess System Snapshot: Run EDBC for Medicaid On the Run EDBC page, a line item will appear for each program that you are able to run a benefit calculation. Before processing a request for PE, you must first check for Medicaid eligibility by completing the following steps: Click the checkbox next to Medicaid Click the Run EDBC Button

27. 26 System Snapshot: Eligibility Determination Cannot be Completed PolicySystemProcess In the event that the Ohio Integrated Eligibility system is unable to complete an eligibility determination due to insufficient information or missing verifications, you will receive an error message similar to the example displayed below.

28. 27 System Snapshot: Add PE on Program Detail Screen PolicySystemProcess After it has been determined that a full Medicaid application is unable to be completed, workers must explore PE eligibility by adding PE to the case using the New Program link.

29. 28 System Snapshot: Run EDBC for PE PolicySystemProcess After PE has been added to the case, workers should navigate back to the Run EDBC page and attempt to determine eligibility for PE

30. 29 System Snapshot: Notice of Action PolicySystemProcess Once a determination has been made for Presumptive Eligibility, a Notice of Action (NOA) will be generated to inform the resident of the eligibility decision. The NOA will list the following information: 1.Eligibility Decision 2.PE Program Type 3.Billing Number 4.Eligibility Begin Date (If approved) 5.Denial Reason (If denied)

31. 30 Chapter 2 Summary Chapter 2: Key Takeaways PolicySystemProcess Medicaid applications that are unable to be processed through the Ohio Benefits Self-Service Portal will create a task for a worker to complete in the Ohio Integrated Eligibility system Workers should always attempt to process full Medicaid first before exploring PE 1 If the eligibility determination for a full Medicaid application cannot be completed, a notification will appear. Return to Program Selection to choose “Presumptive Eligibility” as a program. Then, on the Run EDBC page, check the Presumptive Eligibility box to run EDBC for PE 2 3

32. 31 Chapter 2: CDJFS PE Process - Knowledge Checkpoint Michelle may be eligible for PE if her eligibility determination cannot be completed. Michelle, a parent caretaker, visits her local Allen CDJFS to apply for Medicaid. Michelle has an upcoming doctor’s appointment, and would like to apply for Medicaid. How should the worker proceed? PolicySystemProcess

33. 32 First the worker will check for Michelle in the “New Person Search” in the Ohio Integrated Eligibility system. Michelle is not in the system, so the worker will enter Michelle in the Ohio Integrated Eligibility system as a new case and run EDBC for full Medicaid. If the eligibility determination cannot be completed, a notification will appear. If this happens, the worker will return to the Program Selection screen and select “Presumptive Eligibility”. Then the worker will go to the Run EDBC page, select “Presumptive Eligibility”, and run EDBC for PE. Michelle may be eligible for PE if her eligibility determination cannot be completed. Michelle, a parent caretaker, visits her local Allen CDJFS to apply for Medicaid. Michelle has an upcoming doctor’s appointment, and would like to apply for Medicaid. How should the worker proceed? Chapter 2: CDJFS PE Process - Knowledge Checkpoint PolicySystemProcess

34. 33 Questions: Chapter 2

35. 34 Chapter 3 – Qualified Entities and the Presumptive Eligibility and Deemed Portal

36. 35 The purpose of this chapter is to introduce the Qualified Entity PE process and the Presumptive Eligibility and Deemed Portal (PE Portal) that will be used to process PE requests. Chapter Purpose Understand the steps Qualified Entities take to process PE requests and the associated impacts for workers By the end of this chapter, you will be able to: Understand worker involvement after Qualified Entities process Deemed Newborns through the PE Portal Understand the requirements Qualified Entities must adhere to as new primary processors of PE requests PolicySystemProcess Qualified Entities must agree to the terms and conditions established by ODM in order to process PE requests, and must take all reasonable measures to assist residents in completing a full Medicaid application. Chapter Note Chapter 3: Qualified Entities and the Presumptive Eligibility and Deemed Portal

37. 36 Qualified Entity Process Overview: Then and Now Qualified Entities did not process PE Qualified Entities are now new primary processors of PE PE Then PE Now PolicySystemProcess ‏ Qualified Entities will now function as the primary processor of PE and will use a new PE and Deemed Portal to process requests. Qualified Provider New Role PE processing abilities were granted through new Ohio Administrative Codes in 2012 Qualified Entities must adhere to the terms and conditions set by the Ohio Department of Medicaid to have the ability to process PE PE pilot programs were rolled out at 3 new Qualified Entities where requests were processed in MITS Qualified Entities now use a new PE and Deemed Portal to process PE requests

38. 37 PE request is completed at the point of care A full Medicaid application is entered Select “PE” on Program Selection screen and choose “PE” on the Run EDBC page CDJFS will only process PE when the eligibility determination for an application cannot be completed in the Ohio Integrated Eligibility system. Individual/Household PolicySystemProcess There are now two paths by which residents can receive PE coverage. The second, primary path is through Qualified Entities, where PE can be granted at the point of care. Paths to PE PE Portal Medicaid PE PE Processing Roles – Qualified Entities Eligibility determination could not be completed Qualified Entities follow up with residents who receive PE coverage Qualified Entities take all reasonable steps to assist residents in completing full Medicaid application Qualified Entities now have the ability to process PE

39. 38 All Qualified Entities must agree to the terms and conditions set by the Ohio Department of Medicaid governing PE determinations and enrollment of Deemed Newborns. Qualified Entity Acknowledgement of Terms and Conditions PolicySystemProcess  Be subject to termination of authority for any reason supported by evidence of acts or omissions adversely affecting the Medicaid program, including, but not limited to the following: If 15% or more of presumptively enrolled individuals fail to file a Medicaid Application for ongoing coverage within ninety (90) days after the PE request was processed If 15% or more of individuals who have been processed for PE, completed a Medicaid Application for ongoing coverage, and are found ineligible for Medicaid by a County Job and Family Services caseworker Multiple occasions of unauthorized use of MITS Terms and Conditions* include agreement to: Terms and Conditions * A full list of terms and conditions can be found at: http://www.medicaid.ohio.gov/Portals/0/Providers/Training/PE_Acknowledgement_Form.pdfhttp://www.medicaid.ohio.gov/Portals/0/Providers/Training/PE_Acknowledgement_Form.pdf

40. 39 PE Request Process for Qualified Entities PolicySystemProcess 2 Qualified Entity checks MITS to verify if resident already has healthcare coverage Individual/Household goes to Qualified Entity for care 1 3 4 If Qualified Entity does not find resident, Qualified Entity will process a PE request through the PE and Deemed Portal by entering resident’s self-attested information 5 Qualified Entity accepts the “Approved” or “Denied” results in the PE and Deemed Portal 6 If approved, the Qualified Entity provides documentation of PE coverage to the resident containing the Medicaid billing ID number Approved resident will receive PE coverage until the end of the following month, or until a full Medicaid application is processed. Once a full Medicaid application is either approved or denied, PE coverage will discontinue

41. 40 PE Portal Home Page PE Request Process PE & Deemed Newborn Program Page Personal Information Self-Attestation My Requests Submit Presumptive Eligibility Request Presumptive Eligibility Deemed Newborn Application information (who is seeking coverage) Have you received PE in the last 12 months? Is this person a US citizen? Does this person have a qualifying immigration status? Does anyone have income? The PE portal is designed to grant coverage based on the responses to the self- attestation questions. PolicySystemProcess Submit Request Processing a PE Request in the PE and Deemed Portal

42. 41 Once a Qualified Entity accepts the results of the PE request, the request is first transferred to the Ohio Integrated Eligibility system and, if approved, then to MITS. Submitting and Accepting Results PolicySystemProcess Interaction between PE and Deemed Portal, Ohio Integrated Eligibility system and MITS

43. 42 ‏ You will have limited involvement with the PE and Deemed Portal and the overall Qualified Entity process. Ultimately, your involvement begins when the resident applies for full Medicaid. County Involvement What this Means for Workers PolicySystemProcess Little to no worker involvement with the PE and Deemed Portal. Exception Deemed Newborns

44. 43 Deemed Newborn Process for Qualified Entities Once the Deemed Newborn process is completed by the Qualified Entity, a task is created in the worker portlet. Provided the birth mother is eligible for and receiving full Medicaid on the date of the child's birth, the child shall be automatically eligible, and shall remain eligible, until the end of the month of the child’s first birthday. Processing Deemed Newborn Qualified Entity County Select “Deemed Newborn” Provide mother’s information Enter Deemed Newborn’s information PolicySystemProcess

45. 44 Mother’s case exists in the Ohio Integrated Eligibility system: Worker will add the Mother’s case to the newborn’s as a “companion case.” Next, if the Mother is receiving benefits for other programs such as SNAP, TANF, etc, add the newborn’s information to the mother’s existing case in CRIS-E. Then, run EDBC in CRIS-E to complete the process. Mother’s case exists in CRIS-E: Add the newborn’s information to the mother’s existing case in CRIS-E. Then, run EDBC in CRIS-E to complete the process. Also, ensure the Mother’s information has been entered into the Deemed Newborn’s case as a “person associated with the case” in the Ohio Integrated Eligibility system. PolicySystemProcess Process for Linking Deemed Newborns from Qualified Entities 2 Worker will use the following logic to determine which system the mother’s case exists in: If there is a case number on the Person Match Detail page, the mother’s case exists in the Ohio Integrated Eligibility system If there is NOT a case number on the Person Match Detail page, the mother’s case exists in CRIS-E Worker checks for the newborn’s mother using the “New Person Search” in the Ohio Integrated Eligibility system 1 3 It is important to take action on the “link” task within 10 business days. If the task is not completed, it will be escalated to a Supervisor.

46. 45 PolicySystemProcess 2 On the Case Summary page for the Deemed Newborn, click the Add button in the Companion Case selection Under the Case Info tab, search for the Deemed Newborn’s case using the Person Search page 1 After you successfully link the mother’s case to the Deemed Newborn as a companion case, the Deemed Newborn’s case will appear in the companion case section of the mother’s Case Summary page. Linking Companion Case in the Ohio Integrated Eligibility system 3 Search for the newborn’s mother using the Select Person page 4 Click the radio button next to mother’s name and hit the Select button 5 The companion case should now appear in the Deemed Newborn’s Case Summary page

47. 46 Chapter 3 Summary Chapter 3: Key Takeaways PolicySystemProcess Qualified Entities will take all reasonable steps to assist residents who receive PE in completing a full Medicaid application 1 State and County Workers have little involvement when a PE request is submitted by a Qualified Entity. County Workers will only have involvement when a full Medicaid application is submitted 2 All Deemed Newborn information from the PE and Deemed Portal will transfer to the Ohio Integrated Eligibility system where a task will be generated for the Worker to link or add the Deemed Newborn to its mother’s case or vice versa. 3

48. 47 Think about what information the Qualified Entity will need to gather from Jan. Jan is unemployed, does not have any healthcare coverage, and is pregnant. She goes to The OSU Medical Center for treatment. What steps must the Qualified Entity take to consider her eligibility for PE? Chapter 3 – Qualified Entity Process Knowledge Checkpoint 1 PolicySystemProcess

49. 48 The Qualified Entity checks MITS to ensure Jan is not enrolled in Medicaid. Afterwards, the Qualified Entity asks Jan a series of questions to consider whether she is eligible for PE. Jan answers the questions. Once the Qualified Entity establishes Jan is eligible for PE based on her self-attestations, the Qualified Entity enters her information into the portal and accepts the results. The Qualified Entity will then take all reasonable steps to assist Jan in completing a full Medicaid application. Jan is unemployed, does not have any healthcare coverage, and is pregnant. She goes to The OSU Medical Center for treatment. What steps must the Qualified Entity take to consider her eligibility for PE? Chapter 3 – Qualified Entity Process Knowledge Checkpoint 1 Think about what information the Qualified Entity will need to gather from Jan. PolicySystemProcess

50. 49 Keep in mind that Jan is currently enrolled in Medicaid and will have a case in the system. Jan completes the full Medicaid application and is approved for coverage. Jan delivers her baby, Gabriella, at The OSU Medical Center. Gabriella is processed as a Deemed Newborn through the PE and Deemed Portal at The OSU Medical Center. What will happen at CDJFS when Gabriella is entered in the system? Chapter 3 – Qualified Entity Process Knowledge Checkpoint 2 PolicySystemProcess

51. 50 Once Gabriella is processed through the PE and Deemed Portal, a task will be created in the Ohio Integrated Eligibility system. The worker will check for Jan in the “New Person Search”. If Jan’s detail page lists a case number, this signals that her case exists in the Ohio Integrated Eligibility system and the worker will then add Jan’s case as a companion case to Gabriella’s case. However, if Jan’s detail page does not list a case number, this signals that her case exists in CRIS-E. If this is the case, the worker will add Gabriella to Jan’s existing case and make sure that Jan’s information is listed in Gabriella’s case. Chapter 3 – Qualified Entity Process Knowledge Checkpoint 2 Jan completes the full Medicaid application and is approved for coverage. Jan delivers her baby, Gabriella, at The OSU Medical Center. Gabriella is processed as a Deemed Newborn through the PE and Deemed Portal at The OSU Medical Center. What will happen at CDJFS when Gabriella is entered in the system? Keep in mind that Jan is currently enrolled in Medicaid and will have a case in the system. PolicySystemProcess

52. 51 Questions: Chapter 3

53. 52 Course Wrap-up

54. 53  For CDJFS, PE will only be processed in the case that an eligibility determination on a full Medicaid application cannot be completed  When processing PE the worker will add PE on the Program Selection screen, then select PE on the Run EDBC screen  State and County Workers have little involvement when a PE request is submitted by a Qualified Entity. Workers will only have involvement when a full Medicaid application requires action in the Ohio Integrated Eligibility system  PE is available for Ohio residents who are US citizens or have satisfactory immigration status and fall into one of four categories: children, pregnant women, parent/relative caretakers, or Extension Adults*  PE coverage begins when a resident is found to be presumptively eligible for Medicaid and ends when a full Medicaid application determination is completed OR at the end of the month following the month of PE approval  Qualified Entities are now new, primary processors of PE requests Recap/Wrap-Up  PE for CDJFS will be processed in the Ohio Integrated Eligibility system  PE for Qualified Entities will be processed through the new PE and Deemed Portal  Deemed Newborns from the PE and Deemed Portal will transfer to Ohio Integrated Eligibility system and create a task for a worker to link or add the newborn’s and mother’s cases PolicySystemProcess

55. 54 A period of adjustment as users adapt to new technology and changes to processing. New groups of residents will be eligible to receive PE, in addition to pregnant women and children. The only actions required at CDJFS from the PE and Deemed Portal will be to link Deemed Newborn cases and take action on tasks that are created in the Ohio Integrated Eligibility system. With Qualified Entities now serving as primary processors of PE, workers may encounter questions coming in from Qualified Entities. ? What to Expect… 10

56. 55 Qualified Entity Support ‏ Workers may encounter situations in which they receive questions directly from Qualified Entities. The following resources exist to support Qualified Entities with their questions.* If Qualified Entities contact you for questions, please redirect them to the email below. Answering Questions pequestions@medicaid.ohio.gov With Qualified Entities now serving as primary processors of PE, workers may encounter questions coming in from Qualified Entities. ? Qualified Entity Enrollment Site PE Questions Mailbox http://www.medicaid.ohio.gov/PRO VIDERS/EnrollmentandSupport/Pr oviderEnrollment.aspx Qualified Entity PE Training http://www.medicaid.ohio.gov/PRO VIDERS/Training.aspx Will be updated on 2/4 with new training video and Job Aid * Support contact information is also available in the Job Aid: Presumptive Eligibility (PE) Key Contacts

57. 56 Support Contacts for Super Users Phone 1-866-846-4528 Technical or Password Issues Sample issues: Password not working Account locked Not able to access Ohio Integrated Eligibility system homepage Receiving “Page not Found” error EDBC producing incorrect results Technical or Password Issues Sample issues: Password not working Account locked Not able to access Ohio Integrated Eligibility system homepage Receiving “Page not Found” error EDBC producing incorrect results MAGI Policy Questions Sample issues: If a parent has SSA Disability and Medicare, but is over income for MA C, would they be eligible if his/her income is between 90-138% FPL? How did EDBC calculate the budget? Why is my household size not correct? MAGI Policy Questions Sample issues: If a parent has SSA Disability and Medicare, but is over income for MA C, would they be eligible if his/her income is between 90-138% FPL? How did EDBC calculate the budget? Why is my household size not correct? Contact the IE Technical Help Desk Email DASOhioIE.Maintenance @das.ohio.gov Workers should always contact the County Super User first, and the Super User will follow up with these support channels if needed

58. 57 Supporting Materials TitleDescription Job Aid – Presumptive Eligibility in the Ohio Integrated Eligibility System Effective February 10 th, 2014 Illustrates the process and system steps that State and County Workers need to follow to process PE and link Deemed Newborn cases moving forward from 2/10. Job Aid – Presumptive Eligibility (PE) Key Contacts Serves as a quick reference guide, highlighting email/phone contacts available to answer policy and technical questions. It also includes links to the PE Training Materials and websites providing additional Medicaid info Course – Presumptive Eligibility for State and County Workers (PPT, Full Slide PDF, and 3 slides/page with notes space) Prepares workers with background knowledge of the Presumptive Eligibility (PE) process, an overview of the changes that occurred as of February 10, 2014, the key PE business processes that have been affected, and how the new systems will support these processes. These materials can be found on the project website.project website