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Participant Screening SOP

NOTE: The following guidelines should be utilized to screen calls in any situation the IVR would not have already screened the call.

 

Call Screening General Information #

A caller’s identification must be verified prior to releasing information on a specific case.  Most income maintenance information is confidential, and only authorized individuals may receive confidential information.

      • The IVR now clears the participant for FSD. Since the IVR clears the participant and verifies their identity, there is no need for the worker to reverify or clear the participant a second time.
      • Interpreter calls will not be screened in the IVR and staff will need to screen prior to releasing case specific information.
      • If there is not a screen pop for the screening, staff will need to screen the call prior to releasing specific information.
      • Caller identity verification is not required to provide general program information.

Call Screening: Disconnected Call Callbacks/Interpreter Calls #

    1. If a call disconnects and staff call the participant back, they must ask the participant to provide the information to verify their identity.  For example, Staff should ask “What is your date of birth” and not “We have your date of birth as mm/dd/yyyy, is that correct?”
    2. Staff are required to verify the identity of the participant they are speaking with.
        1. Identity can be verified by:
            1. Social Security Number or DCN
            2. OR
            3. Date of Birth and current address on file
    3. If Caller does not have a SSN and cannot provide DCN, BPT will attempt to verify caller using DOB and address
        1. If Caller states their DOB, but not their current address, case specific information can still be given
        2. If Caller cannot verify DOB, BPT will only give general information.
            1. General information is defined as information that can be found online or in policy manuals without the use of a DCN or SSN.
        3. If Caller says that DOB or SSN is different than the one in the system, the BPT will attempt to verify the correct information using MODL, IBTH or IIVE and update SUPD if participant ’s statement is not questionable.
            1. For FAMIS cases, if information participant provides does not match MODL, IBTH or IIVE, generate a FA-325 Request for Information.
            2. For MEDES cases, if information provided does not match MODL, IBTH or IIVE, generate an IM31A using instructions found in IM Resources.
    4. Calls will be received from, (but not limited to):
        1. Participant
        2. Participant’s spouse
          1. A participant spouse will be screened the same as a participant, unless the spouses are separated. If spouses are separated the spouse will need to be listed as an authorized representative and screening procedures for an authorized representative will be followed.
        3. Authorized representatives
        4. Public Administrators
        5. Other State Agencies
        6. Medical Providers
          1. Medical providers will need to be listed as an authorized representative for case specific information to be released and screening procedures for an authorized representative will be followed.
        7. Parent of Disabled Children
        8. Nursing Homes
          1. Nursing home facility will need to be listed as an authorized representative for case specific information to be released and screening procedures for an authorized representative will be followed.
        9. Presumptive Eligibility Providers
          1. PE providers will need to be listed as an authorized representative for case specific information to be released and screening procedures for an authorized representative will be followed.
        10. HUD
          1. HUD will need to be listed as an authorized representative for case specific information to be released and screening procedures for an authorized representative will be followed.
        11. Social Security Administration
          1. Social Security Administration will need to be listed as an authorized representative for case specific information to be released and screening procedures for an authorized representative will be followed.

 

All Tiers Screening Process #

 

Participant Calls #

The following information will only need to be asked if the IVR did not screen the call or the call was disconnected and staff completed a call back to the participant.

Step Action Tips/Notes
1

Greeting

Identify yourself and the organization. Example: “Thank you for calling the Family Support Division this is (your name). May I have your name and DCN or Social Security Number please?”

NOTE: Staff must ask for the participant’s name, DCN or SSN to verify their identity. If participant does not have a SSN and does not know their DCN, staff must verify DOB and address.
2

What is your date of birth?

NOTE: Staff must ask the participant for this information. If participant was unable to provide SSN or DCN and cannot provide DOB information, staff can provide general information only.  No case specific information can be released.

FAMIS: SCMBR(FM0E) or INHOME (FM0L) to verify DOB

MEDES: Verify DOB listed on the right of the Search Results
3

What is your address?

 

NOTE: The Staff must ask the participant this information to make sure the system is up to date, however, participant does not have to answer this question for the Staff to provide case specific information if their identity was verified by SSN/DCN or DOB.

FAMIS:   Changing a mailing address could affect MOHealthNet coverage types.  If participant (or spouse) is active VENDOR coverage, an email should be generated to the Vendor unit handling the case.  Staff should NOT change the address.   MEDHIST should be reviewed prior to address changing. SCMBR (FM0E), PRSNDTL (FM0I) or ADRES (FM1G).  If system information is different than what participant provides, update system.

MEDES: Verify address in Search Results.  If system information is different than what participant provides, use the Address Change on Integrated Case guide to update the address.
4

What is a good number for us to have on file to contact you? Would you like to receive text messages, email or phone call notifications from us?

Or if participant already has these options entered staff can say:

I see you are set up to receive notifications from us by (text, email, call).  Is that still your preference?

 

NOTE: The Staff must ask the participant this information however, participant does not have to answer this question for the Staff to provide case specific information. This ensures their phone number is up to date.

FAMIS: PRSNDTL (FM0I) to verify phone number.  If system information is different than what participant provides, update system. Permission to text settings

  • Type C, Permission to Text Y–sends call and text reminders to cell phone
  • Type C, Permission to Text N— Sends a call only; no text reminders.
  • Type T, Permission to Text Y—Sends reminders by text only; no reminder calls.
MEDES: Click on name in Search Results.  Phone number and email will be at the top under the person’s name. If system information is different than what participant provides, use the Address Change on Integrated Case guide to update the address.

 

Auth Rep and Third-Party Calls #

    1. When a participant calls and asks Staff to talk to someone else on their behalf (without an AuthRep form on file), Staff should advise the participant a three-way call by the participant can be completed if the third party IS with the participant, either by a three-way call the participant has completed, or the participant should use speaker phone and remain near in order for Staff to speak to someone else on their behalf.
    2. If a three-way call is placed by the participant, the Staff may speak with the third party as long as the participant remains on the phone.
    3. For calls where participant ask staff to speak to their interpreter, staff should follow the Language Line SOP.
    4. For Authorized Representatives, see Information Request from Authorized Representative for more information
    5. If an Authorized Representative is calling about more than one participant, Staff will provide information available on each participant.
Step Action Tips/Notes
1

Greeting

Identify yourself and the organization.

Example: “Thank you for calling the Family Support Division this is (your name). May I have your name and DCN or Social Security Number please?”

NOTE: Staff must ask for the participant’s name, DCN or SSN to verify their identity. If participant does not have a SSN and does not know their DCN, staff must verify DOB and address.
2

Verify at least last 4 of SSN and DOB or DOB and DCN.

FAMIS Instructions:

AUTHREP-

If there is an end date listed the person calling is no longer an autrep and a new authrep form needs to be submitted.

In order for authorized representatives to receive case specific information about a FS case the SUB PRG on AUTHREP must say “FS”.

SCMBR(FM0E) or INHOME (FM0L) to verify DOB

MEDES Instructions:

Review Client Contact tab for notes regarding authorization

NOTE: A company name can be listed without a specific person’s name attached.

Also check all scanning systems if nothing in MEDES/FAMIS for authorized representative form.

NOTE: The spouse of a participant may receive information on a case, as long as the spouse is listed as part of EU on EUMEMROL for that case.  In this circumstance the spouse would need to be verified like a participant.
3

What is your address?

 

FAMIS:   Changing a mailing address could affect MOHealthNet coverage types.  If participant (or spouse) is active VENDOR coverage, an email should be generated to the Vendor unit handling the case.  Staff should NOT change the address.   MEDHIST should be reviewed prior to address changing. SCMBR (FM0E), PRSNDTL (FM0I) or ADRES (FM1G).  If system information is different than what participant provides, update system.

MEDES: Verify address in Search Results.  If system information is different than what participant provides, update system if Staff has been trained.  If Staff has not been trained, notify the participant to contact 855 373 9994 to get the address updated. Include information in the note.

NOTE: The Staff must ask the participant this information however, participant does not have to answer this question for the Staff to provide case specific information if their identity was verified by SSN/DCN and DOB.
4

What is a good phone number for us to have on file to contact you?

 

NOTE: The Staff must ask the participant this information however, participant does not have to answer this question for the BPT to provide case specific information.

FAMIS: PRSNDTL (FM0I) to verify phone number.  If system information is different than what participant provides, update system. Permission to text settings

  • Type C, Permission to Text Y–sends call and text reminders to cell phone
  • Type C, Permission to Text N— Sends a call only; no text reminders.
  • Type T, Permission to Text Y—Sends reminders by text only; no reminder calls.
MEDES: Click on name in Search Results.  Phone number and email will be at the top under the person’s name. If system information is different than what  participant provides, update system if Staff has the training.

 

Parents of Disabled Child (MEDHIST Codes for these cases DCNS, DCSD, DCVNDH, DCIMR) #

Step Action Tips/Notes
1

Greeting

Identify yourself and the organization.

Example: “Thank you for calling the Family Support Division this is (your name). May I have your name and DCN or Social Security Number please?”

 
2

What is your

  • Name
  • Date of birth and
  • Social security number?

What is your child’s

  • Name
  • Date of birth and
Social security number or DCN?

NOTE: If their name is not listed as in the household on SCMBR Staff cannot release case specifics to them including that the child is active on a case.

VIEWREL to verify the person calling is the child’s parent. SCMBR to verify the parent is in the household, names of the parent and child, the date of births and SSN’s of both parent and child. 

FAMISPAR: Child’s name

SCMBR: Child’s date of birth, social security number, parent’s name, date of birth and social security number
3

What is your address?

 

NOTE: The Staff must ask the participant this information however, participant does not have to answer this question for the Staff to provide case specific information.

FAMIS:   Changing a mailing address could affect MOHealthNet coverage types.  If client (or spouse) is active VENDOR coverage, an email should be generated to the Vendor unit handling the case.  Staff should NOT change the address.   MEDHIST should be reviewed prior to address changing. SCMBR (FM0E), PRSNDTL (FM0I) or ADRES (FM1G).  If system information is different than what client provides, update system.

MEDES: Verify address in Search Results.  If system information is different than what participant provides, use the Address Change on Integrated Case guide to update the address.    If Staff has not been trained, notify the client to contact 855 373 9994 to get the address updated. Include information in the note.
4

What is a good phone number for us to have on file to contact you?

Would you like to receive text messages, email or phone call notifications from us?

Or if participant already has these options entered staff can say:

I see you are set up to receive notifications from us by (text, email, call).  Is that still your preference?

NOTE: The Staff must ask the participant this information however, client does not have to answer this question for the Staff to provide case specific information.

FAMIS: PRSNDTL (FM0I) to verify phone number.  If system information is different than what client provides, update system. Permission to text settings

  • Type C, Permission to Text Y–sends call and text reminders to cell phone
  • Type C, Permission to Text N— Sends a call only; no text reminders.
  • Type T, Permission to Text Y—Sends reminders by text only; no reminder calls.
MEDES: Click on name in Search Results.  Phone number and email will be at the top under the person’s name. If system information is different than what client provides, use the Address Change on Integrated Case guide to update the address.

 

State Workers (Missouri and out of state) #

Step Action Tips/Notes
1

Greeting  

Identify yourself and the organization.

Example: “Thank you for calling the Family Support Division this is (your name). May I have your name and DCN or Social Security Number please?”

 
2

Missouri Workers:

Participant’s:

  • Name,
  • Date of birth and
  • Either the full DCN or
  • The full social security number

Out of State Workers:

What is your

  • Name,
  • State you are from and,
  • Agency you are from

NOTE: This information will go in the EUMEMROL comment.

What is your  participant’s

  • Name,
  • Social security number and
  • Date of birth
  • Which programs has the client applied for in your state?

After providing information to the OOS worker you will need to ask some follow up questions.

  • If there are still active cases be sure to ask the out of state worker for:
    • Participant’s current mailing address and phone number
    • Ask if the entire household moved
  • If not, which members DID move?

If the address or phone number needs to be updated be sure to update it.

For a list of agencies considered MO State Workers access: http://www.mo.gov/search-results?mode=people

Definition of an Out of State Worker– An Out of State Agency from a state other than Missouri which administers the Food Stamp, Temporary Assistance and/or Medicaid programs.

FAMIS Instructions:

SCMBR- participant’s name, social security number and date of birth.

MEDES instructions:

Person Page

Evidence tab

 

Public Administrators #

Step Action Tips/Notes
1

Greeting

Identify yourself and the organization.

Example: “Thank you for calling the Family Support Division this is (your name). May I have your name and DCN or Social Security Number please?”

 
2 Public administrator must be established as the guardian/conservator.  Public Administrators can complete FS interviews and case inquiries on behalf of their clients.

AUTHREP to review if authorized rep. Check scanning systems for court appointed letter.

Check EUMEMROL notes on MHABD and FS cases on PA designation.

Check case.net at www.courts.mo.gov, search the client’s name and look for PR Guardian/Conserv-Adult under Case Type Location

Below is a link to all the Public Administrators in MO by County.    There will be many deputies not listed but we don’t maintain a list of those since those names change frequently.

https://www.mapainfo.org/directory-of-public-administrators

If PA needs to complete an interview, transfer to Application/Interview Team.

  • Transfer to Application/Interview Team.

If PA needs to complete multiple interviews:

Subject: PA Interviews/PA county name

Body: Contact information, participants’ name and DCN they would like to complete interviews for, best time for the interview to be scheduled, any specific questions that need answered.

  • BPT will contact PA by phone or email to schedule an appointment for the interviews requested.

General Questions and Inquiries:

Subject: PA Inquiries/PA county name

Body: Contact information, participants name and DCN, and question.

Complaints/Concerns:

  • Advise PA to contact the Customer Relations Unit 573-751-8959

 
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