RFP ATTACHMENT 6.1, PRO FORMA CONTRACT ATTACHMENT F STATE OF TN CORRESPONDENCE AND NOTICE REQUIREMENTS Reference Number Requirement Correspondence/Notices (CN) COR1 The system shall have the ability to generate and route appropriate correspondence. COR2 The system shall set the review due date and generate a review appointment notice to the client one month prior as appropriate. COR3 The system shall generate a notice to the client with the reason for denial when an application is denied. COR4 The system shall automatically generate client notices using system generated and user entered authorization reasons. COR5 The system shall generate the appropriate notices specifying impact on action to each individual in the case. COR6 The system shall have the ability to send forms and attachments and automatically issue a special notice when a case meets certain criteria. COR7 The system shall recreate all documents generated for an individual or case upon demand and route as directed within user specified time parameters. COR8 The system shall include a preprinted application populated with client specific data that can be utilized by the client to identify changes at recertification of the case. COR9 The system shall create renewal notices for those individuals who leave the TennCare Standard household without reapplying for TennCare Standard within the time period given to their original TennCare Standard case to review their eligibility. COR10 The system shall generate initial renewal TennCare Standard notice, 30 day reminder notice if no contact has been made to this point, and a 70 day closure notice if no case is pending. COR11 The system shall generate a verification request to the client when a previously verified piece of information is expiring. COR12 The system shall allow the user to request a verification letter be sent. COR13 The system shall automatically generate a notice to the client if an application for a SSN has been sent to SSA and the client has not notified the caseworker of the SSN. The time period for generating the notice shall be determined by the State. COR14 The system shall automatically send a closure notice when a non-institutional disabled Medicaid case is approved or denied and interim benefits are stopped. COR15 The system shall, for clients with breast or cervical cancer, send the client a notice of presumptive approval of TennCare Medicaid and a request to apply for regular TennCare Medicaid and to submit a treatment plan prior to the expiration of the 45th day of their presumptive period. COR16 The system shall generate denial notices for individuals not technically eligible for any TennCare Medicaid program or subprogram. COR17 The system shall generate one notice when a approval/denial transaction is performed is performed at the same time. COR18 The system shall support the ability to notify the individual of every program and subprogram they have applied for and the outcome in a single notice. COR19 The system shall automatically generate a replacement ME packet through batch or on-line request and maintain a history of that request. COR20 The system shall generate status changes to designated providers. COR21 The system shall enable the use of Microsoft Office Product correspondence templates created by the State when generating notices. COR22 The system shall allow staff to add free-form text to an existing standard notice. COR23 The correspondence shall have bold headings, shading, sub-paragraphs and multiple fonts. COR24 The system shall retain history of all documents issued automatically or user initiated. COR25 The system shall allow users to view and reprint an exact duplicate of any correspondence that has been created and issued by the system. RFP ATTACHMENT 6.1, PRO FORMA CONTRACT ATTACHMENT F STATE OF TN CORRESPONDENCE AND NOTICE REQUIREMENTS Reference Number Requirement COR26 The system shall provide a history of notices as well as a summary of the notices generated for an individual or case. COR27 The system shall provide the ability to search notice history by individuals, case, type, and other defined parameters. COR28 The system shall capture an indicator of how the notice was delivered such as handed to the client, e-mailed or sent via US Postal Service. COR29 The system shall provide the ability to utilize more than one method to distribute correspondence including e- mail, mail, hand to hand. COR30 The system shall store predefined correspondence templates and standard paragraph text. COR31 The system shall individualize each notice to clearly identify eligible and ineligible individuals specifying each program and subprogram which their eligibility is tested.. COR32 The system shall create a receipt and document the receipt of information provided based on program policy/rules. COR33 The system shall automatically create a receipt and a log entry, which includes date and time, when an application, verification, or claim payment is received based on program policy/rule. COR34 The system shall provide appointment letters to be mailed to the client for all scheduled events with a defined future date. COR35 The system shall provide user with the ability to indicate that mail was returned undeliverable and prompt user to check address matches. COR36 The system shall have the ability to generate a notice when a change is reported or a claim payment is made. COR37 The system shall generate referrals to clients and providers utilizing system data to populate class, appointment and provider information based on program policy/rules. COR38 The system shall have the ability to send the Minor Parent a ‘Notice of Potential Eligibility’ if the Major Parent refuses to sign the PRP or fails eligibility. COR39 The system shall generate a notice upon user request to be sent to the client if a service provider has indicated that the client is not complying with the PRP. COR40 The system shall generate a notice to the client after the expiration of a 10-day conciliation notice, for a first or subsequent occurrence, notifying them of the closure of the sanctioned case. COR41 The system shall calculate expected end dates for interruptions and exemptions that are time limited and produce alerts and associated notices for the program based on program policy/rules. COR42 The system shall provide the user the ability to request a PRP to be mailed to the client for a signature. COR43 The system shall send the applicant a notice listing all the verifications by program/subprogram that must be provided to the user to complete the application process. COR44 The system shall make available a generic list of needed verifications for individuals when printing and mailing an application for benefits. COR45 The system shall generate notices to the head of case informing them of a restoration or supplemental benefit issuance amount. COR46 The system shall print correspondence in English and/or Spanish. COR47 The system should have the flexibility to add additional languages for correspondence.. COR48 The system shall be able to group all correspondence for an addressee on a daily basis in order to minimize the number of pieces of correspondence to an individual. COR49 The system shall compute, track and display the mail-date. COR50 The system shall create an effective date for appropriate user or system generated action based on the mail date of the notice. COR51 The system shall have the ability to generate mass periodic correspondence. Upon request these notices could be generated to a select population based on parameters. RFP ATTACHMENT 6.1, PRO FORMA CONTRACT ATTACHMENT F STATE OF TN CORRESPONDENCE AND NOTICE REQUIREMENTS Reference Number Requirement COR52 The system shall generate appropriate notices based on applying a mass change to all or a select group of cases within a program or subprogram. COR53 The system shall generate a notice of patient liability change, approval or closure to the nursing home or lead agency for institutionalized TennCare Medicaid cases. COR54 The system shall provide the option of either printing correspondence or reprints locally or centrally at State designated location. COR55 The system shall provide an eligibility authorization letter informing the client about their reporting requirements and the income limit so they will know what income changes to report. COR56 The system shall generate and track a Simplified Reporting form for FS. COR57 The system shall use the address associated to an individual and shall default to the case mailing address if the case address is more recent when correspondence is generated.. COR58 The system shall be able to generate appeal forms with specified notices. COR59 The system shall provide parents terminated from the child care waiting list a notice of the date and reason for termination. COR60 The system shall issue the child care provider a remittance document for child care payments made for each child. COR61 The system shall have the ability to issue a child care certificate. COR62 The system shall issue a billing document to each provider if they do not wish to participate in the electronic billing process. COR63 The system shall be able to generate statements and notices for child care claims and overpayments. COR64 The system shall generate a notice to the custodial parent concerning the results of a child support good cause investigation. COR65 The system shall have the ability to generate a demand letter as requested for payment of a claim. COR66 The system shall provide a means for users to make on-line claim referrals to TennCare OIG. COR67 The system shall generate FF final closure notices if subsequent closure for the same reason/s occurs within a specified period of time. COR68 The system shall generate a CSR contact letter. COR69 The system shall send a verification of good cause request, if the CSR indicates that good cause may exist on the system and the conciliation notice was mailed prior to the customer contact. COR70 The system shall generate a notice to client informing them of their choice to continue or save countable months when client is not exempt or interrupted and is receiving a FF grant less than $10.00. COR71 The system shall have the ability to generate a notice to a non-parental caretaker as defined by program policy/rule. COR72 The system shall have the ability to generate notices to multiple addresses. COR73 The system shall have the ability to generate the PRP for mailing or printing. COR74 The system shall have the ability to send a notice to the current caregiver of TennCare Medicaid closure when DCS custody ends. COR75 The system shall ensure all correspondence mailed will meet requirements for bulk mailing discount rates including formatting electronic barcodes as defined by State postal. COR76 The system shall allow the user to select and request a copy of on-line summaries to be generated and mailed. COR77 The system shall retain case grouping history of the results of each subprogram's test including status dates and associated reasons and generate appropriate notices COR78 The system shall have the ability to allow specified users to send referrals for support services to any provider who has access to the system based on security specifications. RFP ATTACHMENT 6.1, PRO FORMA CONTRACT ATTACHMENT F STATE OF TN CORRESPONDENCE AND NOTICE REQUIREMENTS Reference Number Requirement COR79 The system shall inform the provider of the client's eligibility for services via written notice or interface, as appropriate for Long Term Care and HCBS (institutionalized). COR80 The system shall provide the ability to recreate previously sent notices, referrals, forms with the ability to send to different address and track as a forwarded mail document. COR81 The system shall have the ability to print or mail a claim waiver request as needed. COR82 The system shall generate notices for the Families First (FF) program. COR83 The system shall generate notices for the Food Stamp (FS) program. COR84 The system shall generate notices for the Child Care program. COR85 The system shall generate notices for the TennCare Medicaid, TennCare Standard, QMB, SLMB, QI1 and the Medicare Part D programs. COR86 The system shall generate notices for the Refugee Assistance program. COR87 The system shall generate notices for the Foster Care program. COR88 The system shall generate notices for the Adoption Assistance program. COR89 The system shall generate notices on all reported changes including those that do not result in a benefit change. COR90 The system shall generate all benefit issuance notices, for all programs. COR91 The system shall generate EBT notices COR92 The system shall generate appointment notices. COR93 The system shall generate sanction, disqualification and penalty notices for all programs. COR94 The system shall generate mass change (MC) notices COR95 The system shall generate conversion notices associated with the implementation of the new system. COR96 The system shall generate intercounty and caseload transfer notices. COR97 The system shall generate benefit reduction due to bankruptcy notices. COR98 The system shall generate conciliation notices. COR99 The system shall generate free-form notices. COR100 The system shall generate any required notices, correspondence or forms related to appeals. COR101 The system shall generate all notices for the First Wheels program. COR102 The system shall generate the six-language attachment to all correspondence as required. COR103 The system shall generate program time limit notices. COR104 The system shall generate verification request notices. COR105 The system shall generate Customer Service Review notices and correspondence. COR106 The system shall generate Child Care eligibility and certificate notices, for clients and providers. COR107 The system shall be able to generate statements and notices related to Claims and Investigations from all programs. COR108 The system shall generate correspondence for all service providers.
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