NC DEPARTMENT OF HEALTH AND HUMAN SERVICES EIS MANUAL

ELIGIBILITY INFORMATION SYSTEM EIS 3102

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CHANGES TO RRF AND SA CASES

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EIS 3102 – CHANGES TO R-RF AND SA CASES

I. COMPLETE AN AUTOMATED BUDGET CALCULATION FOR THE AFFECTED PAYMENT MONTH WHEN ENTERING A PAYMENT REVISION FOR A R-RF CASE. COMPLETE THE BUDGET BEFORE SUBMITTING THE DSS-8125 TO DATA ENTRY.

II. COMPLETING THE DSS-8125

III. SIGNATURES AND DATE

IV. SUBMIT THE DSS-8125 TO DATA ENTRY FOR KEYING.

V. OUTPUTS

VI. FOR ANY CHANGES NOT LISTED, SEE "OTHER CHANGED DATA."

VII. AUTOMATED NOTICES

PAYMENT REVISION

REVISED 10/1/05 – CHANGE NO. 02-06

I. COMPLETE AN AUTOMATED BUDGET CALCULATION FOR THE AFFECTED PAYMENT MONTH WHEN ENTERING A PAYMENT REVISION FOR A R-RF CASE. COMPLETE THE BUDGET BEFORE SUBMITTING THE DSS-8125 TO DATA ENTRY.

II. COMPLETING THE DSS-8125

A. Use the following instructions to change the payment of any active Refugee or Special Assistance case. If a numeric field requires less digits than spaces available, precede with zeroes.

1. Enter the CASEHEAD/PAYEE NAME at the top of the form for filing purposes.

2. Enter the COUNTY NAME.

3. Enter the CASE ID from the Case Profile.

4. Enter your assigned WORKER NUMBER.

5. Enter the COUNTY NUMBER from the Case Profile.

6. Ensure the DISTRICT NUMBER on the Case Profile is correct. If incorrect, enter the appropriate DISTRICT NUMBER.

7. Enter the appropriate AID PROGRAM/CATEGORY.

8. Enter the appropriate CHANGE CODE when you are changing a payment for a S-AA, S-AD, OR S-CD case. See the Codes Appendix to determine the appropriate code.

It is very important to enter the correct code. Unless overridden, an automated notice is produced based on the change code entered on the DSS-8125. The change code not only determines the text of the notice but also whether the notice is adequate or timely. See AUTOMATED NOTICES at the end of this section for more information regarding the automated notice.

NOTE: DO NOT ENTER A CHANGE CODE OR A NOTICE OVERRIDE IF THE
S-AA/S-AD CASE HAS CAP COVERAGE. AN AUTOMATED NOTICE IS NOT PRODUCED IN THIS SITUATION. SEND A MANUAL NOTICE REGARDING THE PAYMENT REVISION.

9. Enter "Y" in NOTICE OVERRIDE if you wish to override the S-AA, S-AD, or S-CD automated notice.

REVISED 10/1/05 – CHANGE NO. 02-06

II. A. 9. (CONT'D)

NOTE: DO NOT ENTER A NOTICE OVERRIDE IF THE CASE HAS CAP COVERAGE. NO NOTICE IS PRODUCED FOR A CAP CASE. A MANUAL NOTICE IS REQUIRED.

Always override the automated notice for S-AA, S-AD, and S-CD cases when:

a. The change code listed in the Codes Appendix is "other."

b. The change code listed in the Codes Appendix is marked with an asterisk (*).

c. Use of the automated notice will create an overpayment.

d. Medicare B changes from "N" to "Y" or "Y" to "N.

10. Enter the MONTHLY PAYMENT AMOUNT.

a. For Refuge cases, the amount must be the MAINTENANCE AMOUNT, minus the TOTAL COUNTABLE INCOME, divided by 2, minus any GRANT RECOUPMENT.

b. For Special Assistance, the amount must be the MAINTENANCE AMOUNT,minus the TOTAL COUNTABLE INCOME, minus any GRANT RECOUPMENT.

11. Enter the MONTHLY PAYMENT TYPE if different than indicated on the Case Profile.

12. Enter the MONTHLY PAYMENT EFFECTIVE DATE. The date must be the current processing month.

REVISED 02/01/11 – CHANGE NO. 03-11

II. (CONT'D)

B. DO NOT ENTER the following payment fields on the DSS-8125:

1. Application Data

2. Case Termination Data

3. County Issued and Prior Month Payment Data

4. Retro MA Data

5. Verification Indicator

6. Medicaid Effective Date

7. Issue CRD (See EIS 3105 for how to request replacement cards).

NOTE: ALL OTHER FIELDS ARE OPTIONAL. A DETAILED EXPLANATION OF EACH FIELD IS INCLUDED IN "OTHER CHANGED DATA."

C. Supplemental Notice Information (S-AA, S-AD, and S-CD only. Not applicable for R-RF).

The following three data elements have been added to the DSS-8125 Data Entry screen. A change code must be present in order to enter these fields. A recommended form in which to enter the information can be found at the end of this section. This form must be attached to the DSS-8125 when submitting to Data Entry for keying.

1. Enter the AUTHORIZED REPRESENTATIVE/CAP MANAGER/PACE AGENCY'S NAME and ADDRESS if one has been appointed to the case. An automated notice will be produced for both the payee and the authorized representative/CAP Manager or PACE Agency.

2. Do not enter notice code.

3. Do not enter NOTICE TEXT.

III. SIGNATURES AND DATE

A. Enter the DATE COMPLETED.

B. Sign the DSS-8125 in the WORKER'S SIGNATURE field.

C. The county director or his designee must sign the form in the DIRECTOR'S SIGNATURE field.

IV. SUBMIT THE DSS-8125 TO DATA ENTRY FOR KEYING.

REISSUED 02/01/11 – CHANGE NO. 03-11

V. OUTPUTS

When the DSS-8125 processes successfully, the following are received:

A. Case Profile

An updated Case Profile is produced the night the change processes and is mailed to the county the following workday.

B. Benefit Issuance

1. If the DSS-8125 is processed successfully by the 4th workday from the end of the month the revised check is issued and mailed the last working day of the month.

2. If the DSS-8125 is processed after the 4th workday from the end of the month, the revised check is not issued until the next processing month. If you are completing an upward revision, use the DMA-5022 to issue an adjusted payment for the difference. If you are completing a downward revision, see the policy manual regarding overpayments.

C. Caseworker Supervisor Report

All changes completed by an IMC are reported on the Caseworker Supervisor Report. The number of actions completed is determined from the WORKER NUMBER.

VI. FOR ANY CHANGES NOT LISTED, SEE "OTHER CHANGED DATA."

VII. AUTOMATED NOTICES

A. General Information

1. An automated notice (DSS-8110-A) is produced for all S-AA, S-AD, and S-CD changes the night the DSS-8125 processes in the system unless "Y" is entered for "NOTICE OVERRIDE." A sample of the DSS-8110A is located at the end of this section.

2. The CHANGE CODE entered on the DSS-8125 determines the text of the notice and whether the notice is adequate or timely.

3. The system calculates the 60th calendar day for the notice.

4. The date of the automated notice is the next state workday after the DSS-8125 processes. This is the date the notice is mailed to the recipient. A copy of the notice is not mailed to the county.

5. A Notice Register Report is produced each night and is

mailed to the county the following workday. This report lists vital information related to all automated notices produced for that day. See EIS 3556 for more information regarding the Notice Register Report.

REVISED 10/1/09 – CHANGE NO. 01-10

VII. (CONT'D)

B. Adequate Notice

1. "Adequate" is clearly indicated at the top of the notice.

2. The system calculates the 60th calendar day for the notice.

3. The action indicated on the DSS-8125 takes place in EIS the same night the adequate notice is produced.

C. Timely Notice

1. "Timely" is clearly indicated at the top of the notice.

2. To produce an automated timely notice, you must complete the DSS-8125 and have it keyed into EIS at the same time you would have completed the manual DSS-8110.

3. The system calculates the tenth county workday and the 60th calendar day for the notice.

4. The action takes place in EIS eleven county workdays from the date of the notice. If the eleventh county workday falls after the keying deadline, EIS adjusts the month of change to the next benefit month.

For example: A DSS-8125 indicating a change in the benefit with a Medicaid effective date of July 1994 and a timely reason code for an automated notice is keyed June 13, 1994. The eleventh workday is June 29, 1994. The keying deadline is June 27, 1994. EIS changes the Medicaid effective date to August 1994.

This action is reported on the Notice Register for that day. The information related to the automated notice is displayed with an asterisk (*) entered in the "CHANGE/TERMINATION DATE" column of the report.

5. No further action is required by you for the action to occur.

6. An updated Case Profile is produced the night the action takes place in EIS.

7. DSS-8125 and Timely Action Pending

a. A DSS-8125 may not be placed on hold when there is a timely action pending.

REISSUED 10/1/09 – CHANGE NO. 01-10

VII. C. 7. a. (CONT'D)

NOTE: DSS-8125'S MAY CONTINUE TO BE KEYED. THOSE THAT ARE ERROR FREE PROCESS CORRECTLY. THOSE THAT CONTAIN AN ERROR MAY NOT BE PLACED ON HOLD, BUT MUST BE REKEYED ONCE THE ERROR IS CORRECTED.

b. A DSS-8125 may not be keyed on the day the timely action is to process unless it contains a change code or termination code and date.

8. Deleting the Action.

Because the action dies not actually process in EIS until the eleventh county workday, it is possible to stop the action. To do so, you must have your Data Entry Operator delete the action that is on hold in EIS. The deletion must occur no later than the eleventh county workday from the date of the notice.

Notify Data Entry to delete the pending action using one of the following methods:

a. Submit a copy of the DSS-8125 you sent originally to request change. Write "DELETE" in red across the top of the form; or

b. Submit a county form developed for this purpose. This form must contain the form ID number of the original DSS-8125 and a message to Data Entry to delete the form.

NOTE: FORM ID NUMBERS ARE LISTED ON THE NOTICE REGISTERS AND ARE AVAILABLE THROUGH INQUIRY IN RMDS FOR THREE DAYS AFTER THE DSS-8125 IS KEYED.

This action is reported on the Notice Register for that day. The information related to the automated notice is displayed with "DELETED" noted in the "COMMENTS" column of the register.

9. Rescinding the Action

It is important to note that there is another situation where an action pending in EIS is stopped.

If a subsequent DSS-8125 is keyed by the eleventh county workday from the date of the notice and the subsequent DSS-8125 causes a new notice to be produced, the pending action is stopped. In this situation, EIS "rescinds" the pending action and produces an automated notice for the new action.

Both actions are reported on the Notice Register for that day. The information related to the first automated notice

REVISED 10/01/05 – CHANGE NO. 02-06

VII. C. 9. (CONT'D)

is displayed with "RESCINDED" noted in the "COMMENTS" column of the register. The information related to the subsequent automated notice is also displayed with no entry in the "COMMENTS" column.