Newborn Application – Baby Not Living with Birth Mother

 

This document gives instruction regarding an application for Newborn coverage being received and the infant does not reside in the same household (Application Case or Integrated Case) with his/her birth mother and the birth mother was receiving an eligible Level of Care (LOC) and enrolled in a Managed Care plan at the time of the infant’s birth.

 

Determine if the Newborn was adopted or not and follow the appropriate set of instructions.

 

Application Received for Newborn in a Household That Does Not Include the Baby’s Birth Mother (Not Adopted)

When an application is received for a newborn in a household that does not include the baby’s birth mother (and the birth mother was on an eligible Title XIX Level of Care and enrolled in a managed care plan at the time of the baby’s birth) a Missouri Override (MOOE) must be entered to grant Newborn Coverage.

 

After finalization, an email must be sent to MHD.MCOPERATIONS@dss.mo.gov to have the Newborn connected to the mother’s managed care plan.

 

Please use the template below to ensure all information needed by MO HealthNet Division (MHD) is included.

 

The following infant is eligible for Newborn LOC but does not currently reside with his/her birth mother. Please connect the newborn to the birth mother’s managed care plan.
Newborn DCN
Newborn Name
Newborn DOB
Birth mother DCN
Birth mother Name
HoH DCN
HoH Name

 

NOTE: Salesforce Tickets are NOT needed for the MOOE for the situations above.

 

NOTE: If a tasks/inquiry is received that a newborn’s bills are not being paid; and the birth mother (who was on an eligible Title XIX LOC and enrolled in a MC plan at the infant’s DOB) and the infant and are on the SAME AC or IC when the Newborn LOC was approved, review the MCII screen to see if the auto connect failed in enrolling the newborn in the same managed care plan as the birth mother. If the auto connect failed, Sales Force tickets ARE needed in these instances.

 

Application Received for Adopted Newborn

When an application is received for an adopted newborn, born to a mother who received Title XIX at time of birth, register the application under the adopted parents and refer to the Adoption Review guide for instructions to submit the case for an adoption review.

 

Registering Newborn Only Application

When a Newborn, born to a mother who received Title XIX at time of birth, is adopted straight from the hospital and FSD has not received an address for the child and the adopted parents have not applied for the child, an application is to be registered under the Newborn to grant coverage the child is entitled to. Follow the below instructions to register the application:

    1. Register the application under the Newborn’s name.
        • If the Newborn’s address is unknown, use generic “General Delivery” for the street address, and the last known city/county of residence.
            • Use the city/county of the hospital the child was born in, if known, when residence is unknown.
            • Use the last known city/county of the birth parent when no other address can be located for the child.
        • Enter a Missouri Override (MOOE) to grant Newborn Coverage for the first year of life.
    2. Refer to the Adoption Review guide for instructions submit the case for an adoption review.
    3. Include a comment under the Newborn’s Person Page that the Child was released directly to the adoptive parents from the hospital and is entitled to newborn due to birth parent being eligible.