NC DEPARTMENT OF HEALTH AND HUMAN SERVICES EIS MANUAL

ELIGIBILITY INFORMATION SYSTEM EIS 4900

------------------------------------------------------------------------

DATA ENTRY APPENDIX D à DATE SCREEN

------------------------------------------------------------------------

EIS 4900 – DATA ENTRY APPENDIX D - DATE SCREEN

I. GENERAL INFORMATION

II. ACCESS

III. CHANGES

IV. DISPOSING OF APPLICATIONS WITH DATE SCREEN ERRORS

V. DELETIONS

EIS 4900 – DATA ENTRY APPENDIX D - DATE SCREEN

REISSUED 05/01/09 CHANGE NO. 03-09

I. GENERAL INFORMATION

A. KEY THE DSS-8124 BEFORE YOU KEY THE DATE SCREEN.

B. YOU MAY KEY THE DATE SCREEN THE SAME DAY YOU REGISTER THE DSS-8124 OR AT A LATER DATE.

C. KEY THE DATE SCREEN BEFORE YOU KEY THE DSS-8124 TO DENY/WITHDRAW OR THE DSS-8125 TO APPROVE THE APPLICATION.

D. DO NOT KEY THE DATE SCREEN FOR THE FOLLOWING:

1. ADMINISTRATIVE APPLICATIONS (KEY Y ON THE DSS-8124 IN THE ADMIN FIELD) EIS automatically creates a Date Screen for an administrative application and displays a “Y” in the ADMIN field on the Date Screen.

2. SA APPLICATIONS

3. TRANSITIONAL APPLICATIONS (KEY Y ON THE DSS-8124 IN THE TRANS FIELD)

4. PRESUMPTIVE ELIGIBILITY (MPW)

5. APPLICATION TYPES "3" AND "7"

6. MRF, MSB, AND RRF APPLICATIONS

7. IAS AND HSF APPLICATIONS

E. YOU MUST KEY A DATE SCREEN FOR THE FOLLOWING:

1. APPEAL REVERSALS (STATE/COUNTY AND RSDI)

2. RETRO SSI APPLICATIONS

3. IMPROPER DENIALS/WITHDRAWALS/DISCOURAGEMENT

4. DEDUCTIBLE APPLICATIONS (WHEN YOU MUST SEND A
DMA-5099)

5. INCORRECT DENIALS

6. REQUEST FOR MEDICAL RECORDS FOR EMERGENCY DATES FOR NON-QUALIFIED ALIENS (WHEN YOU MUST SEND A DMA-5098)

7. RECEIPT OF FL2/MR2 (WHEN YOU MUST SEND A DMA-5098)

8. RECEIPT OF CAP PLAN OF CARE (WHEN YOU MUST SEND A
DMA-5098)

REVISED 5/01/09 CHANGE NO. 03-09

I.E. (CONT'D)

NOTE: EIS CREATES THE DATE SCREEN IF INDICATOR "N" OR "Y" WAS KEYED ON THE 8124.

9. REQUEST FOR CITIZENSHIP AND/OR IDENTITY DOCUMENTATION (WHEN YOU MUST SEND A DMA-5098)

10. NOTICE OF HARDSHIP WAIVER (WHEN YOU MUST SEND A DMA-5098, DMA-5099, OR DMA-5113)

11. REQUEST FOR NC HEALTH CHOICE ENROLLMENT FEE (WHEN YOU MUST SEND A NOTICE OF ENROLLMENT FEE)

12. APPLICANT REQUEST FOR ADDITIONAL TIME TO OBTAIN REQUIRED INFORMATION (WHEN YOU MUST SEND A DMA-5097)

13. REQUEST FOR (HCWD) HEALTH COVERAGE FOR WORKERS WITH DISABILITIES ENROLLMENT FEE (WHEN YOU MUST SEND A NOTICE OF ENROLLMENT FEE)

F. YOU MUST KEY TWO SEPARATE DATE SCREENS IF THE APPLICATION TYPE IS "4" OR "5".

1. Key one date screen for the Ongoing and key another date screen for the Retro.

2. EIS CREATES THE DATE SCREEN FOR MAD APPLICATIONS IF THE INDICATOR ON THE 8124 WAS KEYED AS “Y” OR “N”. If any additional information is needed, you must key this information on the date screen.

G. YOU CANNOT PLACE THE DATE SCREEN ON HOLD.

H. USE ONE OF THE FOLLOWING FUNCTION KEYS TO INDICATE YOUR NEXT ACTION.

1. ENTER à Tells the system you have finished the screen. The system will edit the screen for errors.

2. PF1 Deletes the date screen.

3. PF2 Moves you to the EIS INQUIRY MENU.

4. PF3 Moves you to the Application Process Menu.

I. You can key changes or any additional information to all applications as long as the 8124 denial/withdrawal or the 8125 approval has not processed overnight.

J. When keying updates for two-part applications, you must key separate updates to both parts.

REVISED 02/01/11 CHANGE NO. 03-11

II. ACCESS

A. To access the DATE SCREEN from the APPLICATION PROCESS MENU, move the cursor down to the FORM ID field to the right of "GO TO 8124 DATE SCREEN".

1. In the FORM ID field, key the application number with the "G" suffix.

2. In the RETRO/ONGOING IND field, key "R" or "O" as appropriate. Always key "O" for WORK FIRST.

3. Key the COUNTY NUMBER.

4. Press ENTER.

B. EIS displays the EIS 8124 DATE SCREEN.

1. Refer to EIS 2400,III, to determine the required information you must key for the Date Screen.

2. After you have keyed all appropriate information, press ENTER. If no errors, press ENTER or press the appropriate PF key to go to your next function.

NOTE: YOU MUST PRESS ENTER TO REGISTER THE DATE SCREEN. IF YOU PRESS PF2 OR PF3 PRIOR TO PRESSING ENTER, THE INFORMATION ON THE DATE SCREEN IS NOT REGISTERED.

REISSUED 02/01/11 CHANGE NO. 03-11

III. CHANGES

You may key changes or any additional information to all applications as long as the 8124 denial/withdrawal or the 8125 approval has not processed overnight.

IV. DISPOSING OF APPLICATIONS WITH DATE SCREEN ERRORS

A. DENIALS/WITHDRAWALS

The date screen may be corrected or updated the same day a denial/withdrawal application is keyed.

1. Re-enter the DSS-8124 and delete the denial/withdrawal information. Press PF4 to put the 8124 on hold.

2. Re-enter the date screen and key the updates.

3. Re-enter the DSS-8124 and re-key the denial/withdrawal information.

B. APPROVALS

The date screen may be corrected or updated the same day or a later day after the 8125 is keyed for the approval as long as the 8125 has not processed overnight.

1. Re-enter the 8125 and press PF4 to put the 8125 on hold.

2. Re-enter the date screen and key the updates.

3. Re-enter the 8125 and press ENTER to take it off hold.

V. DELETIONS

The EIS 8124 Date Screen can be deleted by pressing PF1 for all applications except MAD and administrative applications. Press ENTER a second time or press the PF key as indicated by the message displayed at the bottom of the screen. ALL MAD AND APPLICATIONS MUST HAVE A DATE SCREEN.