NC DEPARTMENT OF HEALTH AND HUMAN SERVICES EIS MANUAL
ELIGIBILITY INFORMATION SYSTEM EIS 3451
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AID PROGRAM/CATEGORY TRANSFERS TO MEDICAID PROGRAMS
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EIS 3451 – AID PROGRAM/CATEGORY TRANSFERS TO MEDICAID PROGRAMS
I. TRANSFERS TO TRANSITIONAL Medicaid
II. COMPLETING THE DSS-8125 (Transfers to transitional Medicaid)
III. KEY THE DSS-8125.
IV. OUTPUTS
V. AUTOMATED NOTICES
TRANSFERRING FROM A-AF OR M-AF TO TRANSITIONAL MEDICAID
REISSUED 02/01/11 – CHANGE NO. 03-11
I. TRANSFERS TO TRANSITIONAL Medicaid
A-AF and M-AF cases that become ineligible due to earned income are transferred to A-AF Payment type 5 (12 months transitional Medicaid).
A-AF and M-AF cases that become ineligible due to child support are transferred to A-AF Payment type 4 (4 months transitional Medicaid).
II. COMPLETING THE DSS-8125 (Transfers to transitional Medicaid)
Use the following instructions for all worker-initiated transfers from M-AF or A-AF (Payment Type 1, 2, or S) to Transitional Medicaid (A-AF Payment Type 4 or Payment Type 5).
A. Use the following instructions to complete the DSS-8125. Perform Case Data (CD) and Individual (ID) Inquiry in EIS to determine what case and/or individual data must be changed to support the transfer to Transitional Medicaid.
B. Enter the following required information. 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, if using a paper form.
2. Enter the COUNTY NAME, if using a paper form.
3. Enter the CASE ID.
4. Enter your WORKER NUMBER.
5. Enter the COUNTY NUMBER.
6. Ensure the DISTRICT NUMBER is correct. If incorrect, enter the appropriate DISTRICT NUMBER.
7. Enter “A” “AF” for AID PROGRAM/CATEGORY.
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.
REISSUED 02/01/11 – CHANGE NO. 03-11
II. B. (CONT’D)
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II.B. (CONT’D)
17. Make the following changes to the Individual data, if necessary.
a. Change in provider number. Only enter if provider is changing.
b. Enter income and net income.
18. Enter the DATE the form is completed, if using a paper form.
19. Sign the DSS-8125 in the WORKER'S SIGNATURE field, if using a paper form.
20. The county director or his designee must sign the form in the DIRECTOR'S SIGNATURE field, if using a paper form.
C. DO NOT ENTER the following information on the DSS-8125 when completing a transfer to Pay Type 4 or 5.
1. Case Data
a. VERIFICATION INDICATOR
b. APPLICATION NUMBER
c. ONGOING DISPOSITION REASON and DATE
d. RETRO DISPOSITION REASON and DATE
e. CASE TERMINATION REASON and DATE
f. OLD CASE TERMINATION REASON and DATE
g. PAYMENT AMOUNT
h. PAYMENT EFFECTIVE DATE
i. PAYMENT REVIEW PERIOD
j. RETRO MA 1 and RETRO MA 2 fields
k. AMBULATION CAPACITY
l. DOMICILIARY RATE
m. GRANT RECOUPMENT DATA
n. SPECIAL NEEDS DATA
REISSUED 02/01/11 – CHANGE NO. 03-11
II. C. (CONT’D)
2. Individual Data
For transfers from M-AF:
a. JOBS/WORK REGISTRATION
b. E&T CODE and DATE
c. JOBS/WORK SAVINGS
d. EDUCATIONAL LEVEL
3. Update other information using the DSS-8125 or Name Change function if necessary. Refer to Making Changes To Active Cases, EIS 3101, for instructions.
III. KEY THE DSS-8125.
IV. OUTPUTS
When the DSS-8125 processes successfully, EIS produces the following:
A. A Case Profile is produced the night the transfer processes and is mailed to the county the following workday.
B. The aid program/category transfer is reported on the Caseworker Supervisor Report. The number of aid program/category transfers completed is determined from the WORKER NUMBER.
V. AUTOMATED NOTICES
A. General Information
1. EIS produces an automated notice (DSS-8110) the night the transfer to Pay Type 4 or 5 processes in the system unless “Y” is entered for “NOTICE OVERRIDE”.
2. The CHANGE CODE entered on the DSS-8125 determines the text of the notice.
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.
REISSUED 02/01/11 – CHANGE NO. 03-11
V. A. (CONT’D)
6. For transfers to payment type 5, EIS also produces a Notice of Transitional Benefits (DMA-5083) and encloses it with the DSS-8110. If you override the automated notice and send a manual notice when you complete a transfer to payment type 5, you must include the DMA-5083, Notice of Transitional Benefits, with the manual DSS-8110.
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 key it 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.
Example: A DSS-8125 indicating a transfer to Transitional Medicaid effective October 2003 and a timely reason code is keyed September 12, 2003. The eleventh workday is September 29, 2003. The keying deadline is September 25, 2003. EIS changes the effective date to November 2003.
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. Deleting the Action
Because the action does not actually process in EIS until the eleventh county workday, it is possible to stop the action. To do so, you must 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.
Delete the pending action using one of the following methods.
REISSUED 02/01/11 – CHANGE NO. 03-11
V. C.7. (CONT’D)
a. Delete the DSS-8125.
b. Submit a copy of the DSS-8125 you sent originally to request the change. Write “DELETE” in red across the top of the form; or
c. 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 NCXPTR FOR 24 WORKDAYS 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.
8. 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 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.
