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Applications & Redeterminations

Applications & Redeterminations. John Spears IL Dept. of Healthcare & Family Services 10/2014. Outline. Overview of the Medicaid Application Process Using the ABE System What to have handy Registering as a Community Provider Registering the Applicant as a User

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Applications & Redeterminations

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  1. Applications & Redeterminations John Spears IL Dept. of Healthcare & Family Services 10/2014

  2. Outline • Overview of the Medicaid Application Process • Using the ABE System • What to have handy • Registering as a Community Provider • Registering the Applicant as a User • Authorized Representatives • Completing the Application • Uploading Documents • Finalizing the Application • Redeterminations 2

  3. Basic Application Process ABE application submitted DHS Office registers application DHS Office requests any additional proof Eligibility Determined Notice of Decision sent 3

  4. ABE - Application for Benefits Eligibility Apply for medical, SNAP or cash benefits online Upload verification documents with app Partially complete and save – return later Automatically referred to correct state office Usually takes 30-45 minutes to apply Abe.illinois.gov 4

  5. Things you want to have on hand Income information Resource Information Immigration information for individuals who are not U.S. citizens Completed Form 3654 (for CCP cases) or any other documents you want to upload Information does not have to be uploaded but may reduce state processing time 5

  6. Navigating the ABE System 6

  7. ABE Homepage 7

  8. Starting an Application 8

  9. Register as a Community Provider 9

  10. Entering Your Agency Information 10

  11. Setup Your Agency Passcode 11

  12. Community Partner Registration 12

  13. Application Status 13

  14. Start an Application 14

  15. Create a Personal Account Each application needs a separate account 15

  16. Setup the Individual’s Password 16

  17. Error Messages 17

  18. Account Confirmation User ID – at least one capital letter, one number, no special characters, 8-16 characters long ex: John0220 – name, birth date Password– at least one capital letter, one lower case letter, one number, no special characters, 8-16 characters long, cannot reuse name ex: Js02208420 – initials, birth date and last 4 SSN 18

  19. Fraud Reminder 19

  20. Application Assistance 20

  21. Approved Representatives 21

  22. Applying for Medical Programs 22

  23. Applicant Information 23

  24. Where does the Person Live? 24

  25. 25

  26. Income Entry 26

  27. Resource Entry 27

  28. Resource Questions 28

  29. Types of Resources 29

  30. Resource Detail Questions 30

  31. Resource Detail Questions 31

  32. Resource Review 32

  33. Medical Expenses 33

  34. Additional Information 34

  35. 35

  36. 36

  37. ABE – Upload Documents Provides the ability to upload the 3654 online, as well as other supporting documents needed for the application. 37

  38. Submitting Documents 38

  39. 39

  40. ABE Issues 40

  41. ABE Resources – hfs.illinois.gov 41

  42. DHS Resources 42

  43. Illinois Medicaid Redetermination Project (IMRP) • Reviews all medical only cases • Seniors (including long term care) • Persons with disabilities • Families • Pregnant women • ACA adults • Does not review cases with SNAP or cash. These are still handled by the local DHS office • SPD cases with SSI only income are auto-rede’d 43

  44. IMRP Process Renewal Notice mailed to client notifying them that rede is coming in about 2 weeks 2 weeks later, rede form mailed to customer with 22 working days to return Rede can be returned by mail in the enclosed, post-paid envelope or faxed Case canceled if not returned and no response from consumer/rep Include proof of income or any other changes Special central rede unit reviews the rede and updates case. 44

  45. Rede Tips Keep the address updated. Return the rede by the due date Call IMRP to request a replacement if the form is lost/not received. Fax the rede and proofs, if possible. The rede automatically loads to the person’s case (no possibility for human error). Include proof of income/expenses in the latest 30 days or any information that has changed (state will electronically review SSA/SSI). 45

  46. IMRP Questions • Contact the IMRP • 1-855-HLTHYIL (1-855-458-4945) • TTY: 1-855-694-5458 • If a case is canceled for not responding to the rede, send the rede as soon as possible and the case will be reviewed for reinstatement • Cases can be reopened for 2 months following the cancelation (without having to reapply). 46

  47. Questions? 47

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