1. CHIP Outreach Refresher Training Enrollment Assistance and Best Practices July 30 th, 2010

2. System/Browser Upgrades  The CHIP Outreach Portal will not work with any browser older than Internet Explorer 7 or Mozilla Firefox.  If you go to the CHIP Outreach Portal Homepage and the only option it gives you is “change password”, then you need to upgrade your browser.  To upgrade your version of Internet Explorer go to www.microsoft.com  downloads & trials  Internet Explorer 8 Downloads. www.microsoft.com  P.S. – Check with your CHCs IT department before upgrading anything on your computer.

3. CHIP Outreach Portal Updates/Changes  A list of all 82 counties in MS has been added for your convenience. Now all you have to do is pick a county from the list instead of typing the county name in.  The “Pending Follow-up Date” now automatically sets for 30 days from the day you marked the enrollment status as “pending”. You can still type in a date if you would like to follow-up with a client sooner.  In the “reasons for denial” list, there is an “other” option. This will only be used if the reason they were denied for Medicaid does not fit the other three categories.  If there is a Case Note entered for a program record, the words “case note” on the tab will now appear in red to inform you that a case now exists.

4. CHIP Outreach Portal Updates/Changes cont’d.  If “No Insurance” is selected in the Insurance Type field, you will not be able to select any other insurance type. For instance, you cannot select “no insurance” and “Medicare”.  When searching for cases in the Case Search page, you have the option of “searching only my cases” or letting it search all cases for your health center. This will be helpful when conducting your follow-ups.  When searching a case or running reports, the option “only show head of household records” is permanently UNCHECKED. So now, it searches all cases unless you tell it to only search head of households.

5. CHIP Outreach Portal Updates/Changes cont’d.  On all date fields, if you click on the year in the pop-up calendar you will be able to change years.  In “Enrollment Status” for each household member, there is now a “not applying” option. This is for those household members who are not applying for Medicaid. Previously, you had to select either approved, denied, or pending and none of these are correct for someone who is not applying.  Remember in the Web System to HIT SAVE EVERY FEW MINUTES! The system will time you out quickly, and if you have not saved your work, you will lose it!

6. Project Webpage  We have created a page on the MPHCA website that has resources available.  The website is www.mphca.com. On the left of the page there is a “Resources” tab. From there you click on “Special Projects” then “CHIP Outreach”.  This webpage has all of the resources from both trainings, as well as additional resources that should prove helpful in your efforts.

7. Program Record Status  Remember that Program Record Status is the status of the record in the CHIP Outreach Portal.  Incomplete – selected when you are waiting to hear the enrollment status of each applicant  Complete – only select when the enrollment status is known for every household member  Cancelled – selected when every effort is made to contact the applicant and contact cannot be made.

8. Enrollment Status  Enrollment status in the Household Member section refers to the status of the Medicaid application.  There are 4 categories of enrollment status: 1. Approved – this category denotes that the client has been approved for Medicaid/CHIP benefits 2. Denied – this category denotes that the client has been denied for Medicaid/CHIP benefits 3. Pending – this category denotes that either the COS does not know whether the client has been approved or denied, or the application is in the process of being approved or denied 4. Not Applying – this category denotes that the household member is not applying for benefits.

9. Enrollment Status cont’d.  If the client has been denied benefits and that category has been selected, a “reason for denial” should be marked.  Documentation Not Provided  Excessive Income  Failure to Show for Interview  Other  Once an enrollment status has been determined for all household members, the program record can be marked “complete”

10. Case Search  If you know the Case ID # and need to quickly find a case, use the Case Lookup field located on the home page.  If the Case ID # is not known, go to the CASE SEARCH navigation tab on the Home Page.  On the Case Search page, cases may be searched by:  Case ID  Name  Age range  SSN #  When searching for cases, you can choose to show only head of household records, or all records.

11. Case Search – Additional Tab  Additional Search Criteria are added to the Case Search option to filter cases and run reports.  You can set the search criteria to show Program Record statuses or Enrollment Statuses that fall within certain date ranges.  To print a desired report, a button labeled “EXPORT” has been added.  The export button will automatically open the report in a Microsoft Excel document for printing.

12. Reports  The REPORTS tab will allow you to run reports on:  Program Record Status Reminders - Shows Cases with an incomplete reminder date less than a week from today  Enrollment Status Annual Follow-up - Shows Cases within one month or less of the annual renewal date  Enrollment Status Pending Reminders - Shows Cases with a pending follow-up date less than 3 days from the date the report is run

13. Program Record Status Reminders  The Program Record Status Reminder report is linked to a clients Incomplete Program Record and the Incomplete Reminder Date.  The Program Record Status Reminder report will show all of the program records that have an incomplete reminder date within a week of the date the report is run.  This report should be run daily to see which clients the COS needs to follow-up with.

14. Enrollment Status Pending Reminders  The Enrollment Status Pending Reminders report is linked to the Enrollment Status and the Pending Follow-up Date of the Medicaid Application.  The Enrollment Status Pending Reminder report will show all clients whose enrollment status is pending (meaning the approval/denial status is not known)  This report should be run weekly so the COS can check with DOM to see if a client or household member has been approved or denied for benefits.

15. Enrollment Status Annual Follow-up  The Enrollment Status Annual Follow-up report is linked to the Enrollment status and Renewal date on a client or household member’s record.  The Enrollment Status Annual Follow-up report shows which client or household member’s annual redetermination date is approaching.  This report should be run weekly by the COS to follow- up with clients about their redetermination appointment.

16. Gathering Information and Completing Applications  Complete as much of the application as possible.  It is still ok to leave “blanks” when you don’t know or are unsure, but we need to be as thorough as possible.  This will help to maintain good working relationships between you (COS Staff) and the DOM regional offices.  VERY IMPORTANT: Before submitting a completed Medicaid Application to Medicaid, make sure you remember to write at the top “MPHCA CHIP OUTREACH”.  This is extremely vital to ensure that DOM can track the approval/denial status of the applications that we submit.  Remember that each application needs to be SIGNED by the applicant before submission.

17. Gathering Information and Completing Applications cont’d.  There are some cases in the Portal that have a household member showing “no insurance” and these same people are not applying for services.  This is ok if the member is over 19, but if a child 19 years old or under and has no insurance, there are only very few circumstances where they should not apply for benefits.  There are also some applications that are being turned in for families who have already applied for benefits. Make every effort to find out if the family already has a pending CHIP or Medicaid application.

18. Division of Medicaid Collaboration  Remember that one of goals is to assist the Medicaid Specialists in enrolling clients, not to burden them with more work.  Try hard to gather all of the necessary information on a client and send it in with the client’s application.  Help the client understand what paperwork and documents they need to take with them to the face-to- face interview.

19. Division of Medicaid Collaboration cont’d.  Remember that the focus of this project is to assist POTENTIALLY ELIGIBLE FAMILIES WITH CHILDREN in filling out CHIP applications.  There have been several questions regarding ABD applications as well as adults who do not qualify for services asking to be assisted.  When you are approached by an adult who most likely will not qualify for benefits take these steps:  Make sure you spend a little more time with the individual explaining Medicaid eligibility for adults is extremely limited.  If they insist on being assisted in filling out an application, please provide the service.  DO NOT enter them into the Outreach Portal.  DO NOT mark the application as MPHCA chip outreach project.  DO NOT submit (instruct the client to submit) the application.

20. DOM Report to MPHCA  The original plan for acquiring the Application or Enrollment Status for clients was to have DOM provide MPHCA with a report that outlines approval, denial, effective date of coverage and reason for denial.  The report from DOM was inadequate in helping to gain this information.  MPHCA is still working with DOM to ensure this project will be successful.  Because of this reporting obstacle, COS staff will now have to try to determine each applicants application status.

21. Determining Enrollment Status  COS staff must make effort to determine the enrollment status of individual client applications  Follow-up directly with individual clients using the contact information that was provided by the client (Pending Follow- Up reminder)  Utilize Envision software and United Healthcare Portal (work with CHC leadership). This software allows CHC staff to see if patients have Medicaid or CHIP benefits  This will understandably have a negative impact on productivity  When you do find out the Enrollment Status, change the statuses in the CHIP Outreach Portal.

22. Summary/Wrap-Up  Make sure that your internet browser is up-to-date.  Make note of the Portal changes and upgrades.  Visit the CHIP Outreach Resource Page often.  Utilize the Search and Report functions on the Portal page.  Complete as much as the application as possible, and make sure the client signs the application.  Note the application with MPHCA CHIP Outreach in RED!  Make every effort to follow-up with patients/clients to determine Enrollment/Application Status.

23. QUESTIONS?