Adding an Authorized Representative for MO HealthNet for the Aged, Blind, or Disabled Applicant/Participant

TO ADD AN AUTHORIZED REPRESENTATIVE FOR AN MHABD APPLICANT/PARTICIPANT

Step 1:

Fastpath to FAMISPAR/FM0D.

 

Step 2:

Type in the customer’s Social Security Number (SSN) or DCN in the corresponding field and press Ctrl.

 

Step 3:

Type an ‘S’ on the Com line in front of the appropriate ADM Eligibility Unit (EU) in the repeating group.

 

Step 4:

Fastpath to the Select ADM Authorized Representative screen by typing SELADMAR/FMNH.

 

Step 5:

Tab to the EU field. Prompt out and select the appropriate ADM EU.

 

Step 6:

Tab to the DCN field. Prompt out and select the appropriate participant’s DCN.

 

Step 7:

Press F14=ADDREP  

 

Step 8:

Tab to the Primary field. Indicate with a Y or N if this Representative is the applicant/participant’s Primary Representative and press Ctrl.

Note: Enter the Primary Representative first. A Primary Representative must be designated for any application/active case with at least one Representative, with the exception of Representative Type ARI. Only one Representative may be Primary. This field indicates which Representative will receive copies of notices sent to the participant. (See IM-116, 07/17/2020 for additional information about the Primary Representative)

Note: Representative Type ARI (Authorized Release of Information) cannot be a Primary Representative.

 

Step 9:

If the Representative is an individual, tab to the Name field and enter the Representative’s full name.

 

Step 9a: If the Representative is a Provider or an Outside Agency (OA), either:

• • • • Type the organization’s DVN in the DVN field;
      • Prompt out and search for the organization’s DVN in the DVN field; or
      • Type the organization’s Name in the field to the right of the DVN field.

Note: See DVN Guide for instructions on searching, creating and updating a DVN

 

Step 10:

Tab to Representative Type. Prompt out and select, or type the appropriate Representative Type.

 

Step 11:

Tab to Opt Out. This field is optional, and indicates if the Representative would like to Opt Out of Robo Calls. Enter ‘X’ if the Representative would like to Opt Out. Leave the field blank if the Representative does not opt out of Robo calls.

 

Step 12:

Tab to Contact by Email. This field is optional, and indicates if the Representative would like to be contacted by email. (Marking ‘Y’ does not guarantee communication by email. It only authorizes email contact when that option is available.)

 

Step 13:

Tab to Representative Role. Prompt out and select, or type the appropriate Representative Role.

Note: APP is no longer a valid Role type for MHABD programs. APP has been replaced with APO.

 

Step 14:

Tab to Id Email. This field is optional. If an email address is provided, enter the address here.

 

Step 15:

Tab to Identity Verification. Prompt out and select, or type the appropriate verification code.

Note: CS is acceptable identity verification for MHABD programs for all Representative types except OA. OA Representatives must provide identification.

 

Step 16:

Tab to Phi Permission. Enter ‘Y’ if Section 2 of the IM-6AR is completed and signed, or if the appointed Representative is a spouse, attorney, attorney-in-fact, guardian, conservator, or court appointed public administrator.

 

Step 16 a: Enter ‘N’ if Section 2 of the IM-6AR is not signed and the Representative is not one of the types listed in Step 16.

Note: Entering N in this field does not prevent mail being sent to the Representative if they are marked as Primary.

 

Step 17:

Tab to Begin Date. Enter date IM-6AR or other documentation was received appointing the Representative.

Note: The begin date does not limit the Representative in assisting with prior quarter benefits. This date may be as much as 90 days in the past, but must be the date the document was received by FSD.

 

Step 18:

Tab to End Date. If the Representative Role is APO (Application Only), FAMIS will enter an end date when the application is authorized. See Note in Step 20 if a hearing is requested after the authorization or Cancel Rejection is needed.

Note: This date can only be the current date.

 

Step 18 a: Complete this field if an IM-6ARR or other documentation is received ending the Representative’s appointment. This date can only be the current date.

 

Step 19:

Tab to IM6ARR Recd. If an End Date is entered for a Representative Type other than APO, a Y must be entered here.

Note: IM-6ARR is the IM Authorized Representative Revocation form.

 

Note: A Representative must not be ended without documentation. If a Representative’s Type or Role was entered in error you will have to end date the Representative and enter Y for IM6ARR as Y. A comment MUST be made to explain why the Representative was ended with no IM6ARR.

 

Step 20:

Tab through Hearing Requested.

 

Note: If an APO Representative Role has ended and a hearing is requested on the application or Cancel Rejection is required, this field must be updated with a Y and the End Date removed. It does not apply to new Representative appointments. See Cancel Rejection and Hearing Requested User Guide – MHABD Authorized Representatives.

 

Step 21:

Tab to Authrep Shared Flag. If spouses are both requesting benefits and both appointed the same Representative, enter a ‘Y’ in this field. Both spouses must have signed the IM-6AR for this to be valid.

 

Note: If this field is completed, a duplicate screen will be created by FAMIS for the spouse, and a comment entered on this screen will carry to the spouse’s Representative as well.

 

Note: The copy created for the spouse will create with the Representative coded as N on primary. If both spouses have indicated the Representative should be primary, update the spouse’s FMNG screen.

 

Step 21 a: If both spouses are requesting benefits, and are not appointing the same Representative, enter an ‘N’.

 

Step 22:

Tab to Both Signed. If the previous field is ‘Y’, this field must also have a ‘Y’ entered. If the previous field is ‘N’ or blank, this field should also be N or blank.

 

Step 23:

Tab to Address. Enter the Representative’s mailing address in these fields. These fields are required.

 

Step 24:

Tab to Phone Number. Enter any Phone Numbers and corresponding Types provided by the Representative. At least one phone number is required.

Note: Preference for Call and Permission to Txt fields are optional, but if the information is available, enter it. The Permission to Txt field only applies to types marked as C (Cell) and T (Text Message).

 

Step 25:

Press Ctrl.

 

Step 26:

If multiple Representatives are appointed for an applicant/participant, press F10=CLEAR and return to Step 8.

 

Step 26 a: If a spouse has appointed different Representatives, press F21=RETURN and begin on Step 5.

 

Step 26 b: If in the controlled flow, press F9=FLOWFWD once all Representatives are entered.