NC DEPARTMENT OF HEALTH AND HUMAN SERVICES EIS MANUAL

ELIGIBILITY INFORMATION SYSTEM EIS 1055

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THIRD PARTY HEALTH AND ACCIDENT RESOURCE INFORMATION INQUIRY

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EIS 1055 - THIRD PARTY HEALTH AND ACCIDENT RESOURCE INFORMATION INQUIRY

I. GENERAL INFORMATION

II. TPR POLICY INQUIRY (TP)

III. TPR INDIVIDUAL INQUIRY (TI)

IV. INSURANCE COMPANIES BY NAME OR CODE

EIS 1055 - THIRD PARTY HEALTH AND ACCIDENT RESOURCE INFORMATION INQUIRY

REVISED 05/01/03 - CHANGE NO. 06-03

I. GENERAL INFORMATION

Use the following selections to view Third Party Resource (TPR) health insurance information for a specific policy or individual. EIS updates TPR data on these screens using the TA and TU functions. See Third Party HEALTH AND ACCIDENT RESOURCE INFORMATION, EIS 3350.

II. TPR POLICY INQUIRY (TP)

A. View Policy Data

Use this selection to view information on a specific health insurance policy, including all individuals associated with the policy.

The insurance policy number is the key to policy data in EIS.
EIS uses the insurance policy number, insurance company code and insurance type code to uniquely identify insurance policies.

Example: All these policies are unique.

Insurance Policy Number	Insurance Company Name Code	Insurance Type Code
12345	ABC	00
12345	EFG	04
12345	RQK	16

B. Enter TP in SELECTION and the insurance policy number in KEY.

C. Press ENTER. EIS displays the first policy with this number and up to seven individuals covered by the policy.

D. Navigation

Press PF8 to scroll forward through additional policies with this number. Additional policies may be with different insurance companies or different insurance types.

Press PF9 to view more individuals on a policy.

REVISED 05/01/03 - CHANGE NO. 06-03

III. TPR INDIVIDUAL INQUIRY (TI)

A. View Individual Data

Use this selection to view all insurance information for an individual.

B. Enter TI in the SELECTION field and the EIS Individual ID in KEY.

C. Press ENTER. EIS displays the first policy for this individual.

D. Press PF8 to view additional policies for the individual.

IV. INSURANCE COMPANIES BY NAME OR CODE

A. The Insurance Company Names and Codes are listed on the Division of Medical Assistance Internet website and in SCC4CICS.

B. The Internet address is:

http://www.dhhs.state.nc.us/dma/tpr.html

The codes display in two formats, an Excel spreadsheet and an Adobe PDF document.

REISSUED 05/01/03 - CHANGE NO. 06-03

IV. INSURANCE COMPANIES BY NAME OR CODE (cont’d)

C. To logon to SCC4CICS, follow these instructions:

1. Key “SCC4CICS” from the Banner screen. Press ENTER. The message WELCOME TO SCC4CICS ‘DHHS’ displays at the top of the next screen. This is the RACF screen.

2. From the RACF screen, key your USERID, the BILL-CDE, and your PASSWORD. Press ENTER.

3. A blank screen displays. Key “EIS3”. Press ENTER.

4. The Primary Menu screen displays.

REISSUED 05/01/03 - CHANGE NO. 06-03

IV.C. INSURANCE COMPANIES BY NAME OR CODE (cont’d)

5. From the Primary Menu screen, key Selection 04 for Miscellaneous Inquiry. Press ENTER. The Miscellaneous Inquiry menu displays.

REVISED 05/01/03 - CHANGE NO. 06-03

IV.C. INSURANCE COMPANIES BY NAME OR CODE (cont’d)

6. Perform the following inquiry functions from the Miscellaneous Inquiry Screen.

a. Insurance Companies by Code

(1) From the Miscellaneous Inquiry menu, key Selection 03. Key the insurance company code in the space to the right of Insurance-Co-Code.

(2) Press ENTER.

(a) The insurance company names, name codes, and addresses display in insurance company name code order, beginning with the company identified by the code entered on the Miscellaneous Inquiry Menu.

(b) Four insurance companies display at a time. To see additional insurance company names and name codes, press “PF1”. When there are no additional companies to list, NO MORE DATA IS AVAILABLE FOR PF1 REQUEST displays at the bottom of the screen.

b. State-Wide Insurance Company Alpha List

(1) From the Miscellaneous Inquiry menu, key selection 04. Key the insurance company name in the space to the right of Start-List-With.

(2) Press ENTER.

(a) The insurance company codes, name codes, and addresses display in insurance company name code order, beginning with the company name entered on the Miscellaneous Inquiry Menu.

(b) Four insurance companies display at a time. To see additional insurance company names and name codes, press PF1. When there are no additional companies to list, NO MORE DATA IS AVAILABLE FOR PF1 REQUEST displays at the bottom of the screen.

c. Insurance Company Code Not Found

See EIS 3350, Insurance Company Name Code, if you are unable to identify the correct code.

7. Use the following instructions to logoff:

a. Key 99 in the Next Selection field.

b. Press ENTER.

c. The message, EIS SESSION TERMINATED, displays. Key LOGOFF over this message. Press ENTER.