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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? firstname.lastname@example.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 email@example.com. 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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