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NC FAST Best Practices & Tips. North Carolina Department of Health & Human Services. Agenda. Welcome Keys to Understanding MAGI A pplication P rocessing Finding Helpful Resources Intro to Trainer Office Hours Q&A

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slide1

NC FAST Best Practices & Tips

North Carolina

Department of

Health & Human Services

slide2

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
slide3

Introduction

Photo: geograph.org.uk

slide4

Introduction

Photo: wikipedia.com

slide5

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.
slide6

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.

slide7

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

slide8

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

slide9

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

slide10

Managing Streamlined Application Evidence

  • Evidence start dates default to whichever is earlier, the
  • Application Date
  • or the
  • Application Submission Date
slide12

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
slide13

Managing Streamlined Application Evidence

  • Why would Application Detailsneed to be modified?
slide14

Managing Streamlined Application Evidence

  • Why would Application Detailsneed to be modified?
slide17

Managing Streamlined Application Evidence

  • Edit the child’s Application Details evidence.
slide18

Managing Streamlined Application Evidence

  • Edit the child’s Application Details evidence.
slide19

Managing Streamlined Application Evidence

  • Edit the parent’s Application Details evidence.
slide20

Managing Streamlined Application Evidence

  • Edit the parent’s Application Details evidence.
slide21

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
slide22

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.
slide23

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.
slide24

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
slide25

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
slide26

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
slide27

Managing Streamlined Application Evidence

In order to pull OVS for additional household members add

Application Filer Consent

slide28

Managing Streamlined Application Evidence

In order to pull OVS for additional household members add

Application Filer Consent

slide29

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
slide30

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
slide31

Managing Streamlined Application Evidence

  • Some FFM apps are missing Participant Address evidence for the additional household members.
  • Add
  • Participant Address
slide32

Managing Streamlined Application Evidence

  • Some FFM apps are missing Participant Address evidence for the additional household members.
  • Add
  • Participant Address
slide33

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.
slide34

Managing Streamlined Application Evidence

  • At this time, workers do not need to accept or reject
  • Incoming Evidence
slide35

Managing Streamlined Application Evidence

  • At this time, workers do not need to accept or reject
  • Incoming Evidence
slide36

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.

slide37

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.

slide38

Managing Streamlined Application Evidence

P26

P7

Individual PDC created for each eligible household member

One PDC includes multiple eligible household members

slide39

Managing Streamlined Application Evidence

P26

P7

Individual PDC created for each eligible household member

One PDC includes multiple eligible household members

slide40

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

slide41

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