Missouri Department of Social Services - User Assistance Team Roles and Responsibilities

Missouri Department of Social Services presents the roles and responsibilities of the User Assistance Team (UAT) which provides support to healthcare providers in completing and submitting MAGI applications. The UAT assists in electronic application submission, documentation handling, and reporting processes. Organizations interested in participating can email DSS for information. The presentation also covers the Virtual IVR Process background and the benefits it offers to healthcare providers.

• Missouri Department of Social Services
• User Assistance Team
• MAGI applications
• Virtual IVR Process
• Healthcare providers

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1. User Assistance Team User Assistance Team Roles and Responsibilities A Presentation of the Missouri Department of Social Services Brian Kinkade, Director 1

2. Table of Contents Table of Contents Page 2 User Assistance Team Page 3 Virtual IVR Process Page 6 Submitting Electronic Applications Page 20 Submitting Supporting Documentation via emal Page 26 Submitting Monthly Reports of Aging and Problem Applications Page 31 Are these arrangements permanent? Page 34 List of Resource Centers Page 36 Monthly Report of Applications Processed Page 41 2

3. User Assistance Team The UAT is staffed by employees of the Jefferson City Processing Center MAGI Mission provide support to Missouri s health care providers (hospitals, clinics, FQHCs, Local Public Health Agencies, physicians offices) as they complete and submit MAGI applications Four legs of support: Electronic application Submitting supporting documentation via email Monthly report of old and problem applications Virtual IVR Process The following schematic depicts the various roles and responsibilities of the User Assistance Team 3

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5. What to do if you want to participate? First, send an email to DSS indicating that your organization will submit applications electronically where possible. Second, direct the email to dwight.fine@dss.mo.gov Third, DSS will send you information as to how to take advantage of this process 5

6. Virtual IVR Process Background Process 6

7. Background on IVR Over the past few years, the Family Support Division (FSD) offered health care providers access to an Interactive Voice Recognition (IVR) service which allowed health care providers to inquire of FSD s eligibility determination computer as to the status of pending Medicaid applications of their patients. This service provided information that was of value to both providers and their patients by Ensuring that applications for patients who appear to be eligible for Medicaid get filed and processed; and, Expediting the completion of pending Medicaid applications. 7

8. Background on IVR FSD s IVR system informed providers of the following: Whether a patient had filed a Medicaid application; When the application was filed; Whether supporting documentation was required to complete the application; and, if so, What documentation is required to complete the processing of the patient s application? 8

9. Background on IVR At this point the new Missouri Eligibility Determination and Enrollment System (MEDES) does not provide updates to FSD s IVR system for patients who are determined eligible for Medicaid coverage pursuant to Modified Adjusted Gross Income (MAGI) rules. In order to make access to this information available to providers FSD has formed this Virtual IVR team Providers are not expected to have executed an IM 6AR in order to take advantage of this service so long as queries are limited to the following: 9

10. How Virtual IVR Works The following questions will be answered by the Virtual IVR staff: Has the patient filed a MEDES application? What is the status of the application? pending, approved, denied What supporting documentation is required in order to process the application? Income, Identity, Citizenship 10

11. How Virtual IVR Works Definitions related to status of the application Pending if Found in MEDES Found in VFR, but not in MEDES Approved if MEDES indicates approved MXIX indicates coverage Denied if Health Benefits Case is closed; and, MHN Health Benefits case (Application Case) main-tab has denied status 11

12. Steps for using Virtual IVR? First, Send an email or place a call to your Virtual IVR contact. Provide the following information: Name of client Date of Birth of client Social Security Number of client and/or DCN of client Date of application if available For newborns: Mother s name Newborn s name Newborn s date of birth 12

13. What You Need To Do? Second, Triage Your Request as Follows: Request for Status of Application You simply want to know whether an application has been filed, and, if so, what is the status of the application. EMERGENCY COVERAGE NEEDED This is used only for those cases where care is needed immediately, inpatient stays or prescriptions are needed immediately. BACKDATING This is to be used when an individual s coverage on MXIX did not go back to the date of application. PQ This is to be used when the individual s regular coverage start date is correct but prior quarter coverage was requested and not reflected on MXIX. HIGH RISK PREGNANCY Patient has risk factors indicating a high risk pregnancy. OLD APPLICATION Application is more than 30 days old. Presumptive Eligibility/TEMP Coverage Applicant has gaps between PE/TEMP coverage and start date for Medicaid coverage. 13

14. What You Need To Do? In the case of an email, include the following on the subject line: Triage classification Patient name Subject line would appear as follows: Subject: PQ for John Doe Application In the body of the email indicate how the: Application was submitted: Online; or, Paper application submitted: Walk in at Name of County FSD Office Mail Supporting documentation was submitted: Via email; Fax; or, Mail 14

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16. What Happens Next? Third, Your Virtual IVR Contact will: Search for an application in MEDES and the worksite and ITRACKR. Answer the basic IVR questions for you either on the phone or via return email. Confirm the Triage status you indicated in the Subject line. In addition two other triage categories are available to the Virtual IVR staff: APPLICATION NOT PROCESSED VERIFICATION 16

17. What Happens Next? Your Virtual IVR contact will send an email to FSD.MEDES@dss.mo.gov sharing the results of their Triage of your request. Fourth, User Assistance Team in Jefferson City will: Assign your request to a queue so that the underlying application will be processed; Process electronic applications and supporting documents within 5 7 working days if appropriate Resolve any technical issues that may be impacting a pending application; and, Provide feedback if you have submitted an IM 6 AR with the patient s application or supporting documentation 17

18. Support Staff for Virtual IVR Process Hospital and Hospital Systems Danny Evans Danny.J.Evans@dss.mo.gov (573) 751-9023 Federally Qualified Health Centers and Clinics Amber Gonzales - Amber.M.Gonzales@dss.mo.gov (573) 751-9007 Local Public Health Agencies and Physicians Offices Dwight Fine dwight.fine@dss.mo.gov (573) 526-3288 Kim Evans, County Manager, Jefferson City Processing Center - Kim.R.Evans@dss.mo.gov 18

19. Additional Services Available to Partners The User Assistance Team provides the following additional services to Partners: Expedited processing of electronic applications; Expedited processing of supporting documentation submitted via email; and, Reviewing and processing applications, as appropriate, submitted on your Monthly List of Aging Applications. The following schematic depicts the various roles and responsibilities of the User Assistance Team 19

20. Submitting Electronic Applications Sign and Submit Tips for using MEDES 20

21. www.mydss.mo.gov Applications entered electronically are in the MEDES system once Sign and Submit is completed No faxing, no scanning, no dropping the application off at the nearest office Quicker processing fewer opportunities for delay in processing 21

22. Tips for Using MEDES If applicants have lost their Medicaid coverage do not answer YES to the question that asks if the applicant lost insurance coverage. Answering YES to that question will cause the individual to be required to provide proof of loss of insurance. That question is intended to be used to determine whether the applicant has lost private or group health insurance coverage. If female applicants do not mark YES on the Family Planning question the MEDES system will not evaluate such applicants for Extended Women s Health Service coverage. 22

23. Tips for Using MEDES Make sure to answer YES to the question that asks whether the applicant wants coverage for the children and the other parent even though they may already have active Medicaid coverage. Answering YES to this question on the on-line application allows MEDES to move the whole family over to MEDES from the FAMIS legacy system. If someone in the household is being claimed on taxes by another person who does not live with the family, please capture as much information about that tax filer as possible. This facilitates the correct computation of household income. 23

24. Tips for Using MEDES It is helpful if you list all individuals living in the tax filing household even if coverage is not being requested for such individuals. Again, this facilitates the correct computation of household income. Please do not submit applications for Emergency Medical Care for Ineligible Aliens (EMCIA) before the month of the baby s birth. Applications submitted prior to the birth month will be rejected. Simply, you can t apply for EMCIA coverage until the month of birth. 24

25. Tips for Using MEDES Make sure that applicant s who answer YES to the question Are you a state employee? are in fact state employees. Some people read this question to mean that they currently hold a job or are employed within the boundaries of the State of Missouri. This question is not designed to determine whether you hold a job or are employed with the boundaries of the state. This question is designed to determine whether the applicant is on the payroll of the State of Missouri. 25

26. Submitting Supporting Documentation via email Process Email Cover Sheet 26

27. Submitting Supporting Documentation via Email We are pleased that you are committed to using our new electronic application process for submitting Medicaid applications to the Family Support Division. As you know we are establishing an email portal that you can use to submit supporting documentation for the applications that you submit electronically. When submitting supporting documentation through FSD.MEDESHOSPITALS@dss.mo.gov we suggest that you: Submit supporting documentation for only one application per email Include the applicant s last name and DCN and/or SSN on the subject line Include FSD s standardized cover sheet as a part of the supporting documentation Encrypt the application when submitted by email 27

28. Submitting Supporting Documentation via Email You may use the Department of Social Services encryption service when submitting encrypted emails. There are directions on the DSS web site about how to send us an encrypted email. The link is http://dss.mo.gov/encrypt.htm. You will need to follow the third set of instructions on the page. Commonly required supporting documentation includes: Proof of identity which can be documented by submitting a copy of the applicant s drivers license. Proof of income which can be documented by submitting a copy of the applicant s pay stubs. (5 pay stubs required when paid weekly and 3 pay stubs required when paid every two weeks.) 28

29. Submitting Supporting Documentation via Email The email address will be continuously monitored by the User Assistance Team staff. Staff will: Open emails as they arrive Identify the applications associated with the emails Affix the supporting documentation to the appropriate application Determine whether all required supporting documentation has been provided Request any additional supporting documentation that is required: Acknowledge receipt of the email Send notices to the applicant Send copies of the notices to the provider submitting the application when supported by the Curam software Adjudicate applications as appropriate within 5 business days 29

30. Submitting Supporting Documentation via Email FSD.MEDESHOSPITALS@dss.mo.gov VERIFICATI0N COVER SHEET Date: ______________________________ Facility: ____________________________ Contact Name: ______________________ Contact Number: ____________________ Applicant s Name: ___________________ Date of Birth: _______________________ Social Security Number:_______________ DCN (if available):____________________ Immediate Medical Emergency? ________ 30

31. Submitting Monthly Reports of Aging and Problem Applications Format Process 31

32. Submitting Monthly Reports of Aging Applications 30-Day Report Format* Head of Household Name DCN and/or SSN DOB Application Date (If available) Comments *For newborns: Parent name, newborn s name and date of birth 32

33. Submitting Monthly Reports of Aging Applications Submit Monthly Reports via email to FSD.MEDES@dss.mo.gov Submit Monthly Reports on a spreadsheet 33

34. Are these arrangements permanent? Back to IVR Additional functionalities should eliminate need to: Submit Supporting Documentation via email Submit Monthly Reports of Aging and Problem applications (backdating, PQ, etc.) 34

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36. FSD Resource Centers List of locations 36

37. County Office Name Address City Zip Code Adair Kirksville Customer Service Center 1612 N. Osteopathy Kirksville 63501 Andrew Savannah Resource Center 106 N 5th St Savannah 64485 Atchison Rock Port Resource Center 101 Grant St Rock Port 64482 Audrain Mexico Resource Center 4690 S Clark St Mexico 65265 Barry Barry County FSD 208 East 8th Street Cassville 65625 Barton Lamar Resource Center 501 W 13th St Lamar 64759 Bates Bates County FSD 4 West Ohio Street Butler 64730-0032 Harbor Village Truman Dam Access Rd Warsaw 65355 Benton Warsaw Resource Center 1661 Hilltop Dr Warsaw 65355 Bollinger Bollinger County FSD 602 Highway 34 West Marble Hill 63764 Boone Columbia Customer Service Center 1500 Vandiver Drive, Suite 103 Columbia 65205-1227 St Joseph Resource Center 301 S Seventh St St Joseph 64501 Buchanan St. Joseph Customer Service Center 525 Jules Street St Joseph 64501 Butler Butler County FSD 1903 Northwood Poplar Bluff 63902 Caldwell Caldwell County FSD 400 West Berry Hamilton 64644 Callaway Fulton Resource Center 108 N Hospital Dr Fulton 65251 Camden Camden County FSD Cape Girardeau Customer Service Center 146 Rodeo Road Camdenton 65020 Cape Girardeau 220 N. Fountain Cape Girardeau 63701 Carroll Carroll County FSD 1303 North 65 Highway Carrollton 64633 37

38. Carter Carter County FSD HCR 2 Box 2270 Van Buren 63965 Cass Cass County FSD 2500 East Mechanic Harrisonville 64701 Cedar Cedar County FSD 112 RB Road Stockton 65785 Chariton Chariton County FSD 121 East Jackson Keytesville 65261 Christian Christian County FSD 4715 N Towne Center Drive Ozark 65721 Clark Clark County FSD 320 West Main Kahoka 63445 Clay Clay County FSD 7000 Liberty Drive Liberty 64068 Clinton Plattsburg Resource Center 108 Bush St Plattsburg 64477 Cole Jefferson City Customer Service Center 1716 Four Seasons Dr., Suite 104 Jefferson City 65101 Cooper Cooper County FSD 409 High Street Boonville 65233 Crawford Crawford County FSD 272 Cushing Road Steelville 65565 Everton City Hall 116 W Commercial Everton 65646 Dade Greenfield Resource Center 150 S Main St Greenfield 65661 Lockwood Library 721 Main St Lockwood 65682 Dallas Buffalo Resource Center 719 N Ash St Buffalo 65622 Daviess Daviess County FSD 201 Ash Gallatin 64640 DeKalb Cameron Resource Center 207 E McElwain Cameron 64429 Dent Dent County FSD 800 West Scenic Rivers Blvd Salem 65560 Douglas Douglas County FSD 603 NW 12th Ave, Bldg E Ava 65608 Dunklin Dunklin County FSD 1100 Hwy 25 S Bypass Ste 1 Kennett 63857 38

39. Franklin County FSD 1 Liberty Plaza 1108 Washington Square Shopping Center Union 63084 Franklin Washington Resource Center Washington 63090 Gasconade Gasconade County FSD 1008 Highway 28 West Owensville 65066 Gentry Albany Resource Center 809 N 13th St Albany 64402 APO (Aids Project of the Ozarks) 1901 E Bennett Springfield 65804 Bill's Place 424 E Commercial Springfield 65803 Burrell/Transitions 323 E Grand St Springfield 65807 Greene County FSD 101 Park Central Square Springfield 65806 Harbor House NAMI (National Alliance on Mental Illness) Neighborhood Center/Community Partnership 636 N Boonville Springfield 65806 1701 S Campbell Springfield 65807 Greene 330 N Jefferson Ave Springfield 65806 Rare Breed Youth Drop In Center 301 N Main Springfield 65806 Salvation Army 1707 W Chestnut Exwy Springfield 65802 Southwest Missouri Office on Aging 1735 S Fort Ave Springfield 65807 Springfield Affordable Housing Center 300 E Central Springfield 65802 Victory Square 1610 N Broadway Springfield 65803 Grundy Trenton Customer Service Center 2926 Oklahoma Avenue Trenton 64683 Harrison Harrison County FSD 2403 Vandivert Street Bethany 64424 Henry Henry County FSD 1661 North 2nd Clinton 64735 Hickory Hickory County FSD Dallas & Oak Streets Hermitage 65668 Holt Mound City Resource Center 514 State St Mound City 64470 39

40. Howard Howard County FSD 103 Furr Street Fayette 65248-1069 Howell Howell County FSD 3415 Division Drive West Plains 65775 Iron Iron County FSD 202 Park Drive Ironton 63650 Jackson County East Jackson Office 201 East Partridge Street Independence 64055 Jackson County Fletcher Daniels Office 615 East 13th Street Kansas City 64106 Jackson County Fletcher Daniels Office 615 East 13th Street Kansas City 64106 Jackson Jackson County Midtown Office 4309 East 50th Terrace Kansas City 64130 Kansas City-Midtown Resource Center 4309 E 50th Terrace Kansas City 64130 Operation Breakthrough 3039 Troost Kansas City 64109 Jasper Joplin Customer Service Center 601 Commercial Joplin 64802-1353 Jefferson County FSD 10325 Business 21 Suite 100 Hillsboro 63050-3587 Jefferson Jefferson County FSD-Arnold Office 3675 W. Outer Road Arnold 63010-5232 Johnson Johnson County FSD 505-B N Ridgeview Warrensburg 64093 Knox Edina Resource Center Jim Sears Technical Bldg, Hwy 6 East Edina 63537 Laclede Laclede County FSD 2639 South Jefferson Lebanon 65536 Lafayette KC Region Nursing Home Office 736 S Business Highway 13 Lexington 64067 Lawrence Lawrence County FSD 1419 East Church Street Aurora 65605 Lewis Monticello Resource Center 500 South Washington, PO Box 66 Monticello 63457 Lincoln Lincoln County FSD 384 North Lincoln Drive Troy 63379 Linn Linn County FSD 103 Forest Drive Brookfield 64628 40

41. Livingston North Region Nursing Home Office 601 W. Mohawk Road, Suite B Chillicothe 64601 Macon Macon County FSD St Louis Region Nursing Home Office 1716-B Prospect Drive Macon 63552 Madison 413 Burris Fredericktown 63645 Maries Vienna Resource Center 205 Hwy 63 S Vienna 65582 Marion Hannibal Customer Service Center 3055 Holman Drive Hannibal 63401 McDonald Anderson Resource Center 929 N Highway 71 Anderson 64831 Mercer Princeton Resource Center 501 W Main Princeton 64673 Miller Specialized Nursing Home Pro. Unit #6 Industrial Drive Eldon 65026 Mississippi Mississippi County FSD 718 North Martin East Prairie 63845 Moniteau California Resource Center 104 N Gerhart Rd California 65018 Monroe Paris Resource Center 315 N Washington St Paris 65275 Montgomery Montgomery Resource Center 501 Niedergerke Dr Montgomery City 63361 Morgan Morgan County FSD 703 North Monroe Versailles 65084 New Madrid New Madrid County FSD 350 US Highway 61 Ste B New Madrid 63869 Newton Neosho Customer Service Center 201 North Washington Neosho 64850 Nodaway Maryville Customer Service Center 301 East Summit Drive Maryville 64468 Oregon Oregon County FSD Highway 19 South Alton 65606 Osage Linn Resource Center 63 Progress Lane Linn 65051 Ozark So Region Nursing Home Office Highway 160 West Gainesville 65655 Pemiscot Pemiscot County FSD 911 Highway 84 Caruthersville 63830 Perry Perryville Resource Center 12 E Wichern Rd Perryville 63775 41

42. Pettis Pettis County FSD 808 Westwood Sedalia 65301 Phelps Rolla Customer Service Center 1111 Kingshighway, Suite A Rolla 65401-2922 Pike Pike County FSD 1610 Business Hwy 54 West Bowling Green 63334 Platte Platte County FSD 233 Marshall Road Platte City 64079 Polk Polk County FSD 2110 South Springfield Building 1 Bolivar 65613 Pulaski Pulaski County FSD 712 Historic 66W Waynesville 65583 Putnam Putnam County FSD 702 South 27th Street Unionville 63565 Ralls Monroe City Resource Center 1110 Hwy 24, Ste 16 Monroe City 63456 Randolph Randolph County FSD 1715 South Morley #B Moberly 65270 Ray Ray County FSD 901 East Lexington Richmond 64085 Reynolds Reynolds County FSD 2394 Highway 21 Centerville 63633 Ripley Ripley County FSD Rt. 2 Box 1143 Doniphan 63935 Saline Saline County FSD 1239 Santa Fe Trail, Suite 100 Marshall 65340-9115 Schuyler Lancaster Resource Center 209 E Washington St Lancaster 63548 Scotland Scotland County FSD #2 Child Support Lane Memphis 63555 Scott Scott County FSD 106 Arthur, Suite A Sikeston 63801 Shannon Shannon County FSD Hwy 19 S & Route F Eminence 65466 Shelby Shelby County FSD 306 East Main Shelbyville 63469 Crider Health Center 1032 Crosswinds Ct Wentzville 63385 St. Joachim and Ann Care Services 4116 McClay Rd St Charles 63304 St Charles St. Charles County FSD 3737 Harry S Truman Blvd, Suite 100 St Charles 63301 42

43. St. Clair Osceola Resource Center 285 SE 467 Rd, PO Box 574 Osceola 64476 St. Francois Park Hills Customer Service Center 140 Staples Drive Park Hills 63601 St. Genevieve Ste Genevieve Resource Center 583-B Ste Genevieve Dr Ste Genevieve 63670 South Lindbergh Resource Center 7545 South Lindbergh, Ste 110 St Louis 63125 St Louis County FSD St Louis County Jennings Service Center 9900 Page Avenue St Louis 63132 St. Louis 8501 Lucas & Hunt St. Louis 63136 St Louis County North Service Center 4040 Seven Hills Drive Florissant 63033 St Louis County South Service Center 7545 South Lindbergh Suite 110 St. Louis 63125 St Louis City Chouteau Midtown 3101 Chouteau St Louis 63103-2926 St. Louis City St Louis City Prince Hall Family 4411 N Newstead Avenue St Louis 63115 Stoddard Stoddard County FSD 401 Shawnee Bloomfield 63825 Stone Stone County FSD 30832 State Highway 413 Galena 65656 Sullivan Sullivan County FSD 309 East 3rd Street 2720 Shepherd of the Hills Expressway D-1 Milan 63556 Taney Taney County FSD Branson 65616 Texas Texas County FSD 16798 Oak Hill Drive, Suite 600 Houston 65483 Vernon Nevada Customer Service Center 621 East Highland, Suite 1 Nevada 64772 Warren Warren County FSD 513 West Booneslick Road Warrenton 63383 Washington Washington County FSD 10235 West State Highway E Potosi 63664 Wayne Wayne County FSD RT 2, Box 26351 Piedmont 63957 Webster Webster County FSD 222 Commercial Marshfield 65706 Worth Grant City Resource Center 108 E 1st St Grant City 64456 Wright Wright County FSD 1801 North Talcott Mtn Grove 65711 43

44. Updated Monthly Report of Applications Processed July 44

45. MEDICAID Applications Processed Apps Pending Apps Apps Total DATE Received Approved Rejected Processed MHN MEDES (MAGI) Jan/Feb 2014 32,853 7,456 3,215 10,671 22,182 8,384 4,113 Mar, 2014 23,454 12,497 21,669 9,999 4,509 April, 2014 17,680 14,508 24,841 8,772 4,508 May, 2017 12,018 13,280 18,081 June, 2014 12,634 9,603 5,204 14,807 13,818 July, 2014 16,618 10,243 6,951 17,194 13,242 FFM Transfers Jan, 2014 0 0 0 Feb, 2014 0 0 0 Mar, 2014 4,510 48 3,540 3,588 4,510 April, 2014 14,423 269 5,889 6,158 21,404 May, 2014 2,908 842 3,648 4,490 17,259 June, 2014 1,622 1,478 5,312 6,790 13,957 July, 2014 1,583 1,494 4,190 5,684 10,543 45