Presentation Title Month 2017 Margaret Schultze VDSS Commissioner

• Presentation Title • • Month #, 2017 Margaret Schultze, VDSS Commissioner World Wide Tour: Bridging the Gap Between Va. CMS and MMIS Jessica Annecchini, MA Consultant, VDSS Ruth Mulkey, Supervisor, Enrollment Unit, DMAS

2 Agenda Va. CMS Screens: Client Demographics Alien Third Party Resources MMIS Individual Details MMIS • Transaction Match. Title MMIS Case/Enrollee IDs in Presentation History Va. CMS • Va. CMS/MMIS Failures • How to Read Failures When to Send a Ticket Certification Period Override Month #, 2017 Margaret Schultze, VDSS Commissioner How to Resend Transactions Running RCR

Acronyms AC – Aid Category EDBC – Eligibility Determination Benefit Calculation EDG – Eligibility Determination Group MMIS – Medicaid Management Information System • Presentation Title NB – Newborn NPI – National Provider Identifier • Month #, 2017 QRG – Quick Reference Guide. Schultze, VDSS Commissioner • Margaret RCR – Retro Cancel Reinstate TPL – Third Party Liability Va. CMS – Virginia Case Management System 3

4 Va. CMS Screens Client Demographics • • • Alien • • Citizenship Verified Through Deemed NB NPI Type of Medical Assistance Mother Received or Expected to Receive at the Time of Child Birth Title • Presentation • Month #, 2017 Verification Source • Margaret Schultze, VDSS Commissioner Alien Category Foreign Passport Country of Issuance Emergency/Restricted Coverage Dates

5 Va. CMS Screens Third Party Resources • Carrier Code • Policy # • Ending Policies • Presentation Title Month #, 2017 Certification Period Override • • Margaret Schultze, VDSS Commissioner • If not updated by system can use this feature • Must know EDG# and Case#

Va. CMS Screens 6 MMIS Individual Details • • • The only place to make a new enrollee ID and case number for local agency Updates relationship • Presentation Title The ability to assign a new enrollee ID is only available the first time a case is authorized • Month #, 2017 MMIS Transaction History • Margaret Schultze, VDSS Commissioner • • • Shows failures Shows who authorized the case in some case actions Where you resend failures

Va. CMS Screens 7 Match MMIS Case/Enrollee IDs in Va. CMS • After individuals are authorized, this is the screen you can use to fix certain failures • This screen does a point in time • Presentation Titlematch with MMIS if information is changed to ensure it matches • Month #, 2017 • If you have • to. Margaret move. Schultze, someone from one MMIS to VDSS Commissioner another, you will have to go in MMIS first, then come to this screen

Va. CMS/MMIS Failures How to Read Failures • Hover failure code and text will appear • Selecting the Resend button will give more information on fix Top Failure Reasons Before authorization: • Presentation Title o Mother ID • Month #, 2017 o Language • Margaret Schultze, VDSS Commissioner o NPI After Authorization: o Valid Case/Enrollee ID o TPL failures o Possible Duplicates 8

Va. CMS/MMIS Failures 9 How to Resend Failures • • Click resend link Read fix suggestions and use Va. CMS and MMIS to fix issue May have to navigate to Match MMIS Screen first Always to go MMIS • Individual Details. Title to finish the resend Presentation When to Submit a Ticket • • Month #, 2017 When the resend does not complete • Margaret Schultze, VDSS Commissioner If the Match MMIS or MMIS Individuals screen do not update successfully If the failure that is before authorization cannot be cleared

Va. CMS/MMIS - RCR Running RCR 1 0 • Eligibility must be on current case and can only run up to 12 months in the past • Can be used for things like closure 12 in MMIS, gaps in coverage, and some failed transactions • Can only be performed Case Change/Closure • in. Presentation Title Case Action • On the Wrap Up - Run Eligibility Screen, enter a date in the “Run EDBC • Month #, 2017 From” field • Margaret Schultze, VDSSwill Commissioner • Changes that result in a change in AC be reflected in Eligibility Summary; changes that do not result in AC change or are higher to lower coverage, show authorization as “No Action Needed” • If resending a transaction you will have to complete an override and re-run eligibility exactly the same way

Va. CMS/MMIS - RCR • Presentation Title • • Month #, 2017 Margaret Schultze, VDSS Commissioner 1 1

Va. CMS/MMIS Failures • Presentation Title • • Month #, 2017 Margaret Schultze, VDSS Commissioner 1 2

Resources QRGs: Reinstating a Program Retro Cancel Reinstate Changing a MA • Renewal Date. Title Presentation Preventing Common MMIS Transaction • Month #, 2017 Failures • Margaret Schultze, VDSS Commissioner MMIS Transactions - Resending 1 3

1 4 Questions • Presentation Title • • Month #, 2017 Margaret Schultze, VDSS Commissioner

• Presentation Title • • Month #, 2017 Margaret Schultze, VDSS Commissioner Contact Information: jessica. annecchini@dss. virginia. gov

WORLD WIDE TOUR: BRIDGING THE GAP BETWEEN VACMS AND MMIS • Presentation NAVIGATING INTitle MMIS • Month #, 2017 INFORMATION MEMBER MANAGEMENT • Margaret Schultze, VDSS Commissioner SYSTEM BPRO Spring Conference Roanoke, VA May 29 – 31, 2019

What Can A Worker Do in MMIS? • Edit/update Member and Case Information – Member/Case Demographics Screen – Citizenship, Identity, SSN, Address • Presentation Title • Move a Member from one case to another • Month #, 2017 • Conduct Inquiries • Margaret Schultze, VDSS Commissioner • Help Feature

MEMBER DEMOGRAPHICS – INQUIRY • Presentation Title • • Month #, 2017 Margaret Schultze, VDSS Commissioner

ELIGIBILITY DATA - INQUIRY • Presentation Title • • Month #, 2017 Margaret Schultze, VDSS Commissioner

SCREEN HELP • Presentation Title • • Month #, 2017 Margaret Schultze, VDSS Commissioner

• Presentation Title • • Month #, 2017 Margaret Schultze, VDSS Commissioner

SCREEN HELP – Hyperlink Level • Selecting the • Presentation Title hyperlink for the field • Month #, 2017 provides details of the Margaret Schultze, VDSS Commissioner data listed

CITIZENSHIP STATUS • Presentation Title • • Month #, 2017 Margaret Schultze, VDSS Commissioner

Citizenship Status • Presentation Title • • Month #, 2017 Margaret Schultze, VDSS Commissioner

CITIZENSHIP LEVEL • Presentation Title • • Month #, 2017 Margaret Schultze, VDSS Commissioner

Citizenship Levels • Presentation Title • • Month #, 2017 Margaret Schultze, VDSS Commissioner

IDENTITY • Presentation Title • • Month #, 2017 Margaret Schultze, VDSS Commissioner

Identity • Presentation Title • • Month #, 2017 Margaret Schultze, VDSS Commissioner

MMIS Coverage Correction Request Form Coverage Change Requested • Presentation Title • • Indicate the missing coverage needed to be entered Month #, 2017 Margaret Schultze, VDSS Commissioner. FPL STATUS Income < 100 % FPL “Y” or “N”

DMAS Enrollment Unit BROADCAST dated 3/26/2019 Corrective Information Related to MMIS Enrollment Unit staff has been diverted to process the following requests: • • • Presentation Title Urgent MMIS Coverage Corrections that can't be handled by the Regional Consultant; Same Day Voids; • Month #, 2017 Enrollment of pregnant women that can't be handled by the Regional Consultant; Patient pay corrections • Margaret Schultze, VDSS Commissioner

Where to Send Forms? § Coverage Correction Forms § enrollment@dmas. virginia. gov § Patient Pay Correction Forms § patientpay@dmas. virginia. gov § TPL Questions • Presentation Title § tplunit@dmas. virginia. gov § Buy-In Questions • Month #, 2017 • Margaret Schultze, VDSS Commissioner § medicarebuyin@dmas. virginia. gov

THANK YOU! • Presentation Title • Month #, 2017 Ruth Mulkey • Margaret Schultze, VDSS Commissioner Supervisor, Enrollment Unit (804) 786 -0328 ruth. mulkey@dmas. virginia. gov