DMAS MMIS Quarterly Training

DMAS MMIS Quarterly Training

Agenda • Retro-active Cancel Reinstate functionality • TPL-ending and deleting • Questions/Comments • Contact Information • After this Presentation: • Enrollment Issues • Q/A on other areas of concern

Retro-Cancel Reinstate • Accessible from the Enrollment menu • Two cancel reasons • 024 moving from limited coverage to greater limited coverage or full benefit • 032 moving between AG and LTC or moving from FAMIS to Medicaid • Correcting coverage more than a year in the past requires DMAS assistance

Use cancel reason 024 to move from Plan First to full Medicaid

Use cancel reason 024 to move from Plan First to full Medicaid continued… Select row to be canceled Enter cancel reason 024

Use cancel reason 024 to move from Plan First to full Medicaid continued… Key new aid category, application date, begin date, and reinstate reason then select ENTER to validate data

Use cancel reason 024 to move from Plan First to full Medicaid continued… Select Update to navigate to the Benefits screen

Use cancel reason 024 to move from Plan First to full Medicaid continued… Shortened benefit plans Screen shows the shortening of the benefit plans that existed under the previous AC and the newly created benefit plans under the new AC. Use Update to save.

Use cancel reason 024 to move from Plan First to full Medicaid continued… Saved benefit plans under the newly created eligibility segment

Use cancel reason 024 to move from Plan First to full Medicaid continued… 1. 2. 3. 1. Newly created eligibility segment 2. Shortened eligibility segment 3. Voided history row showing the coverage prior to the retro cancel reinstate transaction

Use cancel reason 032 to move between AG and LTC Medicaid

Use cancel reason 032 to move between AG and LTC Medicaid cont… Select row to be canceled Enter cancel reason 032

Use cancel reason 032 to move between AG and LTC Medicaid cont… Key new aid category, application date, begin date, and reinstate reason then select ENTER to validate data

Use cancel reason 032 to move between AG and LTC Medicaid cont… Select Update to navigate to the Benefits screen

Use cancel reason 032 to move between AG and LTC Medicaid cont… Shortened benefit plans Screen shows the shortening of the benefit plans that existed under the previous AC and the newly created benefit plans under the new AC. Use Update to save.

Use cancel reason 032 to move between AG and LTC Medicaid cont… Saved benefit plans under the newly created eligibility segment

Use cancel reason 032 to move between AG and LTC Medicaid cont… 1. 2. 3. 1. Newly created eligibility segment 2. Shortened eligibility segment 3. Voided history row showing the coverage prior to the retro cancel reinstate transaction

Use cancel reason 032 to move from FAMIS to Medicaid continued…

Use cancel reason 032 to move from FAMIS to Medicaid Select row to be canceled Enter cancel reason 032

Use cancel reason 032 to move from FAMIS to Medicaid continued… Key new aid category, application date, begin date, and reinstate reason and select ENTER to validate data

Use cancel reason 032 to move from FAMIS to Medicaid continued… Select Update to navigate to the Benefits screen

Use cancel reason 032 to move from FAMIS to Medicaid continued… Shortened benefit plan Screen shows the shortening of the benefit plan that existed under the previous AC and the newly created benefit plans under the new AC. Use Update to save.

Use cancel reason 032 to move from FAMIS to Medicaid continued… Saved benefit plans under the newly created eligibility segment

Use cancel reason 032 to move from FAMIS to Medicaid continued… 1. 2. 3. 1. Newly created eligibility segment 2. Shortened eligibility segment 3. Voided history row showing the coverage prior to the retro cancel reinstate transaction

TPL Updates • End date any coverage and or policy when no longer valid. When the policy is no longer valid, all coverage lines and the policy must be ended. • Delete any coverage or policy if either was added in error.

TPL Updates End dating a policy Select TPL Resource Select Change

TPL Updates End dating a policy continued…

TPL Updates End dating a policy continued… Key Member ID and select ENTER

TPL Updates End dating a policy continued…

TPL Updates End dating a policy continued… Key coverage end dates Key policy end date

TPL Updates End dating a policy continued… Screen after selecting ENTER to validate data. Select Update to save changes.

TPL Updates End dating a policy continued… Screen shot after data is saved.

TPL Updates End dating a policy continued… End dated coverage as seen on the TPL Summary screen.

TPL Updates Deleting a policy Select TPL Resource Select Delete

TPL Updates Deleting a policy continued… Key Member ID and select ENTER

TPL Updates Deleting a policy continued…

TPL Updates Deleting a policy continued… Key “..” in policy begin date Key “..” in coverage code

TPL Updates Deleting a policy continued… Screen shot after selecting ENTER to validate the data. Use Update to save.

TPL Updates Deleting a policy continued… After saving the changes the policy is set to a retired status.

TPL Updates Deleting a policy continued… Policy now appears on the TPL Retired Policies screen

Who to contact… • Policy Questions-the VDSS regional consultants • Enrollment issues- Enrollment@dmas.virginia.gov • Patient Pay issues-PatientPay@dmas.virginia.gov • Questions regarding MMIS WebEx or suggestions for future training- MMISwebex@dmas.virginia.gov

Questions or Comments

DMAS MMIS Quarterly Training