Adding a Newborn to an Integrated Case

 

When a baby is born to a mother receiving a qualified level of care, follow the steps below to add the baby to the Integrated Case.

 

Before adding the baby to the Integrated Case, check the Common Area to ensure the baby is known and has a DCN. Follow the directions in the Full DCN guide for instructions.

 

When the newborn is reported at the same time as other changes, review the information to determine if a 31A Request for Information will be needed to complete all actions. If a 31A will be required, for anything other than newborn’s tax status or SSN, actions will need to be completed following a two-day process.

    • Day 1
        • Complete all required steps to add the newborn to the IC
        • Finalize the actions to generate the 33A Approval Notice.
            • If a change of address is also reported, this must be completed when adding the newborn.
    • Day 2
        • Check MXIX to ensure the newborn’s coverage is active
        • Complete the other reported changes, leaving unverified evidence pending
        • Send the 31A for the necessary verification.

 

Tools: Medicaid Categories/Coverage Type with ME Codes and Processing Timeframes

 

TO ADD A NEWBORN TO AN INTEGRATED CASE

 

NOTE: The Newborn being added to the Integrated Case must have a DCN before being added. Follow the steps in the DCN Search Guide to see if the Newborn being added to the Integrated Case already has a DCN. If the Newborn does not have a DCN (determined after conducting a thorough search following each step) assign a DCN

 

    1. From the Integrated Case > Page Action menu
      1. Hover over Guided Change, the Add a Member … button should appear to the left
      2. Click Add a Member… The Add A Member Wizard opens
    2. Existing Participant
      1. Click Next

 

NOTE: Since the Newborn being added has never been in the household, the questions regarding Updating an Existing Case Participant do not apply.

 

    1. Enter Participant Details:
      1. Date Reported and Enter the date on which this person joined the household: These dates should match.

 

NOTE: If the baby’s birth is reported timely (within 10 days of birth), these dates will be the baby’s date of birth. If the baby’s birth in NOT reported timely, these dates will be the date the change was reported to FSD. It is NOT necessary to enter MOOEE for the newborn’s coverage to go back to the date of birth.

 

    1. Participant Details:
        1. If known to MEDES:
            1. Click the Search icon
            2. Type the baby’s first name, last name, birthday, gender
            3. Click the radio button next to the baby’s name
        2. If not known to MEDES in the Participant Details type: Baby’s first name, last name, date of birth, gender. This performs the same as Registering a Person in MEDES
    2. Address Details Does this person live with someone in the household?
        1. If Yes, click the dropdown in the Address Information section and select the correct address in the Address Information > What is this person’s address dropdown
        2. If No, click the dropdown in the Address Information section and select the person’s living arrangement:
            1. Homeless Out of State
                1. This opens the Temporarily Absent from State > Is this person living outside the state temporarily and have intentions to return? Select Yes or No
            2. Homeless State Resident
            3. In State Address
                1. This opens Residential Address > Enter Address Details of Household Member.
                    1. Enter the address.
            4. Out of State Address
                1. This opens Residential Address > Enter Address Details of Household Member.
                    1. Enter the address.
    3. Temporarily Absent from State > Is this person living outside the state temporarily and have intentions to return?
        1. Select Yes or No
    4. Application Details:
        1. Enter date this person joined the household – This must match the Date Reported Please refer to NOTE between Steps 3a and 3b above.
        2. Select reason for person joining the household – Click dropdown and select appropriate reason
        3. Is this person applying for assistance? – Click the dropdown and select Yes if benefits are being requested
        4. Click Next
    5. Enter Personal Information
        1. Click Next
    6. Enter Relationships. NOTE: DO NOT change the Relationship Start Date.
        1. Click Next
    2. Enter Tax Information
        1. If unknown, mark the Newborn as a Non-filer
            1. Ensure a thorough Note is added to Tax Filing Status evidence explaining the Newborn’s tax filing status is unknown and this is being entered to ensure coverage through the first year.
        2. Click Next
    1. Enter Income Details.
        1. If there is an additional income source click Add New Income. Once all Income evidence is entered, click Next
        2. If no, skip this step
        3. Click Next
    2. The popup box Are you transferring CEC (Continuous Eligibility for Children) eligibility for this individual from another IC? appears.
    3. Select checkbox next to ‘Check if you do not want to transfer CEC benefits from existing IC.
        1. Click Next
    4. Review Summary is correct
    5. Click Finish

 

You will then be taken to the Guided Change sub-tab; complete as directed below

 

    1. Click the Toggle next to Add a Member to add Disability evidence. Other evidences listed are not needed.
    2. Click the List Actions menu
    3. Click Mark Complete
    4. Click Yes

 

Add additional missing evidence for new participant

 

    1. Add Demographics:
        1. Navigate to the Integrated Case(If necessary, refresh the screen to view the new member) >Evidence sub-tab >Dashboard folder
        2. Hover cursor over Demographics hyperlink > click the  Add Evidence icon
        3. Complete New Demographics required fields
            1. Received Date and Start Date: enter current date
        4. Click Save 
    1. Add Mailing Address:
        1. Hover cursor over Address hyperlink > click the Add Evidence icon
        2. Complete new Addresses required fields to add a mailing address
            1. Select only the new participant from the Case Participant field
            2. Select Mailing from the Type drop-down box
            3. From date will be the child’s date of birth
        3. Click Save 
        4. Complete CD1P Validation
        5. Click Save 
    1. Update the home address with the child’s date of birth if the birth was not reported timely
        1. Navigate to the Integrated Case> Evidence sub-tab >Dashboard folder
        2. Click on the Address hyperlink
        3. Click toggle new participant’ Home Address
        4. Click the List Actions menu
            1. Select Edit
        5. Edit the From date with the child’s date of birth, if the child’s birth was not reported timely
        6. Click Save 
    2. Add Application ID Number to the Application Details
        1. Navigate to the Integrated Case > Evidence sub-tab > Dashboard folder > Application Filer hyperlink
        2. Retrieve the Application ID
        3. Close the Application Filer page to return to the Evidence Dashboard
        4. Select the Application Details hyperlink
        5. Toggle open new participant
        6. Select the List Actions menu
        7. Select Continue Edit
        8. Enter the Application ID
        9. Select Save
    1. Add MO Medicare Self-Attestation evidence:
        1. Note: MO Medicare Self-Attestation evidence is not required for individuals with Newborn level of care if their SSN has not been provided.
        2. Hover cursor over MO Medicare Self-Attestation hyperlink > click the Add Evidence icon
        3. Complete the MO Medicare Self-Attestation evidence for the new participant
        4. Select SAVE
    2. Update Pregnancy evidence
        1. Follow direction in the End Pregnancy on an Integrated Case

 

NOTE: The above listed evidence is required; however there may be additional evidence needed based on the household circumstances

 

    1. Verify all Outstanding Evidence
        1. NOTE: Evidence that is verified with ’95 Day Reasonable Opportunity Period’ must be verified individually using the List Actions menu > click Add Proof.
        2. SSN: If SSN for newborn qualifying child is not provided, SSN may be verified through Reasonable Opportunity. Newborns are given 13 months minus 1 day from the date of birth to provide their SSN.  See Edit Reasonable Opportunity Evidence for instructions how to edit RO evidence.
        3. Citizenship: Citizenship for Newborn qualifying child do not require further citizenship verification as these children are deemed to have applied for and been found eligible to receive Medicaid benefits because of their mothers being active recipients at the time of birth, Citizenship maybe verified with Automatic State Agencies or IBTH (if data is present).
        4. Tax Status: If tax status is unknown, mark newborn as Non-Filer and verify with Other documentation, verified by caseworker.
            1. Note: If the tax filing status is not returned, the Newborn will not lose coverage as there is no open, pending verification, The Newborn’s coverage will be re-evaluated at age out.
    1. Search and Assign DCN for new participant
        1. Navigate to the newborn’s Person Page to confirm the DCN has transferred from the Common Area to MEDES. If no, see DCN Assignment/Transfer from Common Area.
        2. Add the Newborn’s middle name if known and was not added by the system as part of the guided change or via DCN Assignment:
            1. From the Newborn’s Person Page > Evidence sub-tab > Evidence folder
            2. Click List Actions menu next to Names
            3. Click Edit
            4. Enter the Newborn’s middle name in the Middle Name field
            5. Click Save
        3. Close the Person Page and return to the Integrated Case

 

    1. Send an IM-31A for the Newborn’s SSN and Tax Filing Status if unable to verify. Include a CS-201 if necessary.
        1. Note: To ensure both the 31A and 33A are generated, do not leave any evidence pending and send the 31A prior to finalizing the IC. If the 31A is sent after the IC is finalized, the 33A will not generate.
        2. Use the applicable verbiage below:
            1. Our office has received your request to add (name) to your active MO HealthNet case.
            2. Provide (name)’s SSN when you receive it
            3. Will (name) be claimed as a Tax Dependent? If so, by whom?
            4. Enclosed is a Referral/Information for Child Support Services (CS-201) notice. Because there is an absent parent(s) of a child living in your home, you are required to complete a referral form (CS-201) for each child without 1 or 2 parents living in the home. If you have Good Cause for not completing the CS-201, you much complete the Second Notice of Right to Claim Good Cause for Refusal to Cooperate in Child Support Enforcement (IM-2E Part 2) which you received with your Approval Notice (IM-33) and provide documentation. Good Cause and appropriate documentation are described on the IM-2E Part 2 form. Only one of the 2 forms (CS-201 or IM-2E Part 2) must be submitted.
            5. Please clearly add your DCN and name to all documents.
    1. Apply Changes; Check Proposed Determinations; Finalize Proposed Determinations
        1. NOTE: MEDES may generate an additional proposed determination, especially in cases with income changes, adding a person, or removing a person. If the system generated an additional proposed determination, you must run the Finalize Proposed Determination again.
    2. Make a comment on the HoH Person Page to include:
        1. Adding the baby to the Integrated Case
        2. Any coverage changes
    3. Review notice queue to make sure appropriate forms generated
        1. IM-33A: Generates for the approval of the newborn
        2. IM-31A: Generates for request of verification