GPA by xiangpeng

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									     Grandfathered PA and Member ID
               Assignment
•   Abbreviations
     – GPA – Grandfathered PA
     – CDC – Customer Data Core


•   Please continue to enter all CDCs into ICIS with transaction dates LESS THAN
    7/1/2010. Do not wait. The more you enter, the more we may be able to move
    over to APS.

•   Note: The instructions on what to do about customers admitted late in June are
    detailed in another training.

• Note: ‘MHSAS’ eligibility does not start until 7/1/2010. This is
  why it does not show up on the eligibility website.
Questions? mareynolds@odmhsas.org
This training covers 4 groups of customers. Each group relates to the Grandfathered PA report.

To access the Grandfathered PA report:                                      The four groups are:
1. Log into ICIS                                                            Group 1: “PAEndDate<GoLiveDate”
2. From the home page, click on PI Reports                                  Group 2: “DMH is searching for Member ID”
3. Click on Newest Additions                                                Group 3: “No Member ID”
4. Click on "COR1005 - PA/CDC Due Date - Grandfathered PAs"                 Group 4: Customers not appearing in Grandfathered PA Report




                                                                                                                Note: The
                                                                                                             instructions on
                                                                                                            what to do about
                                                                                                               customers
                                                                                                             admitted late in
                                                                                                           June are detailed in
                                                                                                            another training.
Group 1: “PAEndDate<GoLiveDate”
•   Customers highlighted in yellow on the GPA Report.

•   Customers were admitted prior to 1/1/2010 and have not had a CDC update since
    1/1/2010.

•   I allowed the deadline to move to midnight on Monday, June 21st, 2010 to update
    the CDC transactions for customers.

•   Once updated, customers will receive a GPA. If not updated, still active and
    receiving services, agencies must enter a new CDC into CareConnections and do a
    request for services.

•   The old CDC will still be transferred over, but not a PA.

•   There is a small possibility that just updating the CDC will not create a GPA. After
    updating the CDC, double-check to see if the customer has any other issues which
    will prevent them from receiving a GPA.
   Group 2: “DMH is searching for Member ID”

• Customers highlighted in pink on the GPA Report.

• ODMHSAS sent these customers to OHCA for matching and new
  Member ID assignment, if necessary.

• DO NOT TRY TO GET A NEW MEMBER ID! Doing so could possibly
  create duplication, costing taxpayers thousands of dollars.

• Customers will have their Member IDs on the GPA Report by June
  23, 2010.

• We will double-check to see if any ODMHSAS providers create new
  Member IDs for these individuals. Do not try to obtain a new
  Member ID.
  Group 3: “No Member ID”
• Customers also highlighted in yellow on the GPA Report.

• Customers may already have a Member ID, but ODMHSAS
  is not trying to find it.

• Customers are typically ones which the admission CDC was
  submitted after 6/15/2010, or problems with their SSN
  prohibited ODMHSAS/OHCA from obtaining a Member ID.

• Instruction on how to obtain a Member ID and what to do
  with the Member ID to insure a GPA are detailed later in
  these instructions.
    Group 4: Customers not appearing in
         Grandfathered PA Report
• These customers are NOT listed on the GPA Report

• These customers may already have a Member ID, but
  ODMHSAS is not trying to find it.

• These customers are typically ones which the CDC has
  not yet been submitted into ICIS.

• Instruction on how to get a Member ID and what to do
  with the Member ID to insure a GPA are detailed later
  in these instructions.
                 Comments on Group 3 and 4
•   The following instructions discuss how to determine if a customer already has a Member ID, how to
    get one if they do not, and how to report the Member ID to ICIS. This allows customers to receive a
    GPA and for their CDCs to be transferred to APS.

•   If new Member IDs are created, those records still have to be moved to APS in an ‘Eligibility File.’
    This takes time. If you wait until the last moment, new Member IDs might not get moved in a timely
    fashion.

•   The deadline for reporting Member IDs into ICIS is 5 p.m., Tuesday, June 22, 2010.

•   After June 22, 2010, I strongly encourage you to continue looking for existing IDs, obtain new
    Member IDs if none exist, and update ICIS with the Member IDs.

•   The possibility exists that we might be able to generate a Grandfathered PA and move the CDCs for
    customers after the June 22, 2010 deadline, but there is no guarantee. If we are able to do so, you
    are wise to continue this process.

•   Moving additional Grandfathered PAs and CDCs after the deadline is dependent upon staff time and
    system capabilities. I will personally do what I can. I suspect this will be a small group of records.
Step 1: Determine if you have any customers listed as having ‘No Member ID’ or are
not reported on the GPA Report.
Step Two: Log in to the
OHCA’s SoonerCare
Secure Website.
Step Three: From any of the screens that you
have access to, the navigation buttons
located at the top of the screen will take you
to the eligibility option.
Step Four: Search to determine if the customer already has a Member ID.
Search using SSN
Search using name. Trying nickname, maiden name, married name, anything and everything.
If they are a child, ask the responsible party what the ‘LEGAL’ name is.
Exhaust every possible search function.
Step Five: If you find a Member ID, it will be nine characters (123456789). Write down
the number and skip to Step Seven. If you do not find a Member ID, click on the ‘Add
New Member’ button and continue on to Step Six.


Please note: ‘MHSAS’ eligibility does not start until 7/1/2010. This is why it does not
show up on the website.

AFTER 7/1/2010, look to see if they have ‘MHSAS’ eligibility. If they do not, you should
contact Provider Services at 800-522-0114 or 405-522-6205, option 1.
Step Six: For those customers who you
have done everything possible to see if
they have a current Member ID and are
unable to find a current Member ID for
them, then enter the required
information to obtain a new Member
ID.

For females, enter their current last
name. If the customer does not have a
SSN, you may enter all ZEROS. A middle
initial is not required.

Please note: ODMHSAS will regularly analyze data to
identify trends and performance improvement needs
related to data management and information
gathering, including success rates at securing
complete SSNs. ODMHSAS may conduct onsite
reviews when concerning trends emerge, including if
an agency has obtain new Member IDs for an unusual
amount of customers with SSN reported as all
zeros. In those cases, agencies will be required to
document efforts to secure SSNs and propose a plan
of correction to improve the rate at which SSNs are
obtained.
• After you have repeated this process for all
  necessary customers, log out of OHCA’s
  website and log into ICIS.
Step Seven: Log into ICIS
Click on ‘Medicaid ID Entry”
Step Eight: From the GPA Report, locate
the ICIS ID and type the ICIS ID for the
individual you want to add the Member
ID, and then click on ‘Client ID’.
Step Nine: Type in the Member
(Medicaid) ID and click on ‘Save’
If the Member (Medicaid) ID is on file for
another customer, please contact Mark A.
Reynolds at mareynolds@odmhsas.org.
To verify the change, click on ‘Client
Information’ from the ICIS home page,
type in the ICIS Client ID, then click
‘View Client’.
The Member (Medicaid) ID should now
appear.
          Comments from Mark
• Only search for Member IDs for customers from
  Groups 3 and 4
• Search for every possible combination you can
  imagine. The majority of customers accessing services
  from ODMHSAS already have a Member ID.
• Duplicating a Member ID may create a great deal of
  work for you when you have to go back and credit
  every claim for that customer and then resubmit those
  claims.
• Minimize the number of customers that you report all
  zeros for in the SSN field. This makes me very sad.

								
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