North Carolina Department of Health & Human Services

NC FAST Best Practices & Tips North Carolina Department of Health & Human Services

Agenda • Welcome • Keys to Understanding MAGI Application Processing • Finding Helpful Resources • Intro to Trainer Office Hours • Q&A • Please note: The information included in the following presentation is subject to change based upon business guidance and functional releases. • Last Updated: 3/20/2014

Introduction Photo: geograph.org.uk

Introduction Photo: wikipedia.com

Introduction • Unlike the Traditional Application, the Streamlined (MAGI) application is designed to require very little evidence management by the user. • In many situations, unnecessary changes to evidence submitted through the Streamlined Application may interfere with successfully processing the application, and can result in incorrect eligibility decisions. • This presentation will review the basic principles, as well as helpful tips, for managing evidence on the Streamlined Application.

Process Differences P26 P7 *Validate Change is not a required step to process the app, but may assist in uncovering issues with evidence before the case is authorized.

P7 Insurance Affordability – Authorize Eligible Decision Once the MAGI Application is submitted… Insurance Affordability Application Case OPEN When an Eligibledecision is Authorized… Insurance Affordability Application Case Insurance Affordability Integrated Case Family & Children’s Medicaid Or NC Health Choice Product Delivery Case CLOSED OPEN ACTIVE

P7 Insurance Affordability – Authorize Eligible Decision Once the MAGI Application is submitted… Insurance Affordability Application Case OPEN When an Ineligibledecision is Authorized… Insurance Affordability Application Case Insurance Affordability Integrated Case Product Delivery Case Account transfer to the FFM CLOSED OPEN

P7 Insurance Affordability – Authorize Eligible Decision Once the MAGI Application is submitted… Insurance Affordability Application Case OPEN When an Administrative Denial is used… Insurance Affordability Application Case Insurance Affordability Integrated Case Product Delivery Case Account nottransferred to the FFM CLOSED

Managing Streamlined Application Evidence • Evidence start dates default to whichever is earlier, the • Application Date • or the • Application Submission Date

Managing Streamlined Application Evidence

Managing Streamlined Application Evidence • When to edit evidence: • Entered incorrectly during the IEG • An End Date is needed for an existing piece of evidence • The Application Details need to be modified • When to deleteevidence: • Added mistakenly during the IEG

Managing Streamlined Application Evidence • Why would Application Detailsneed to be modified?

Managing Streamlined Application Evidence

Managing Streamlined Application Evidence • Edit the child’s Application Details evidence.

Managing Streamlined Application Evidence • Edit the parent’s Application Details evidence.

Managing Streamlined Application Evidence • Additional reasons a user might edit Application Details • Deny an individual on the application • Withdraw an individual from the application • Reopen an individual’s application

Managing Streamlined Application Evidence • Tax Relationship evidence may appear incorrect at first glance, but once you expand the toggle and view the details, the correct information will display.

Managing Streamlined Application Evidence • When to Addevidence? • Issues are created by attempting to add evidence that is not needed. P26 P7 • Requires inverse relationship • Does NOT require inverse relationship

Managing Streamlined Application Evidence • When to add evidence? • Accidently omitted during the IEG • or • one of the following evidences applies: • Application Filer Consent • Pregnancy Base Period • Participant Address

Managing Streamlined Application Evidence In order to pull OVS for additional household members add Application Filer Consent

Managing Streamlined Application Evidence • When a member of the HH is pregnant and there is Income evidence reported for any household member add • Pregnancy Base Period

Managing Streamlined Application Evidence • Some FFM apps are missing Participant Address evidence for the additional household members. • Add • Participant Address

Managing Streamlined Application Evidence • The address listed on the MAGI application may not be the same as the address listed on the Person page. • If worker has contacted the client and the address on the Person page is no longer current, update the address. • MAGI rules use the Participant Address on the MAGI application, but NC TRACKS uses the address on the Person page. • Every individual’s Participant Address on the MAGI application must be identical in order to be counted in the Household.

Managing Streamlined Application Evidence • At this time, workers do not need to accept or reject • Incoming Evidence

Managing Streamlined Application Evidence Some income types that used to be counted are notcounted in the MAGI methodology Use caution entering an Income type of “Other” because MAGI rules will count this income type.

Managing Streamlined Application Evidence P26 P7 Individual PDC created for each eligible household member One PDC includes multiple eligible household members

Managing Streamlined Application Evidence Program Classification Information can be found on the Person Page under Benefit History P26 P7 Individual PDC created for each eligible household member One PDC includes multiple eligible household members

P7 Resources • FAST Help: • Caseworker FFM Application Job Aid • Comparing Evidence Dashboards: Insurance Affordability and Income Support • Interim P7 Forced Eligibility Solution for Insurance Affordability Application Cases • Streamlined Application to Case and Key Differences Checklist • Streamlined or Traditional Application Decision Tool • County Readiness Materials  P7 Fact Sheets • NC FAST Postcard • NC FAST Learning Gateway: • P7 Training • NC FAST Updates  MAGI First Touch Recertifications

North Carolina Department of Health & Human Services