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Status Not under consideration
Categories Verification Engine
Created by Guest
Created on Mar 6, 2017

RELATED IDEAS

Functionality to make eligibility for individual clients dependent on verification status

Existing verification configuraiton options are insufficient to meet our client's verification requirements. Requesting additional configurable option :

Functionality to make eligibility for individual clients dependent on verification status. For example, someone with an outstanding Citizenship Status verification should not prevent others MA-eligible clients from receiving eligibility; only the client with the outstanding Citizenship Status verification should be blocked from MA eligibility.

Customer Name Minnesota
  • Attach files
  • Guest
    Reply
    |     Sep 13, 2018

    Hi Sigitas,

    We have previously requested more clarifying information. Because the additional information was not provided within 30 days, this request has been closed.

    Thank you for your interest in the Cúram SPM product.
    Shane McFadden, Cúram SPM Product Management team

  • Guest
    Reply
    |     May 4, 2018

    Sigitas - is this still an issue - do you have an update?

  • Guest
    Reply
    |     Aug 3, 2017

    Sigitas - If I understand this RFE correctly, the issue here is around individual disposition, correct? You want to be able to process individuals in a product delivery case as soon as you get all of the required information (including verification) for eligibility, even if other individuals do not have all of the required information. Am I correct with this understanding?

  • Sigitas Jakucionis
    Reply
    |     Jul 27, 2017

    Our client is in fact reworking the reasonable opportunity periods (ROP) associated with verifications. However, based on our client's interpretation of the regulations for Medical Assistance, there are some verifications that apply to an individual client that are not subject to a ROP (in other words, eligibility and entitlement cannot be granted to the client until the verification is resolved):

    -Applying for SSN

    -Exempt from SSN

    -Death Discrepancy

    -Medicare Discrepancy



    Further, for the verifications that are subject to the ROP, we'd need a method for making a client ineligible once the grace period ends. For verifications like citizenship and immigration status, this would need to apply to an individual rather than to the entire household.

  • Sigitas Jakucionis
    Reply
    |     May 30, 2017

    Any updates?

  • Sigitas Jakucionis
    Reply
    |     May 30, 2017

    Any updates?

  • Guest
    Reply
    |     Apr 11, 2017

    Hi Nikita,

    Thank you for providing this information.
    We will look into this further and get back to you shortly.

    Thank you,
    Eloise O'Riordan, Cúram SPM Offering Management team

  • Guest
    Reply
    |     Mar 30, 2017

    We need to be able to make eligibility for individual clients dependent on verification status. Example scenarios include:
    1. Mother, Father, Child apply for insurance with discounts and are determined eligible for Medical Assistance. The Father's Citizenship Status couldn't be verified electronically by the SSA.
    2. A Citizenship Status verification is raised for the father; no verifications for Mother and Child.
    3. We should be able to create an Active Medical Assistance PDC on which the Mother and Child will be eligible. The father will be excluded until he provides proof of his citizenship status.

    Similar scenarios apply for other verifications that should be applicable to individuals rather than entire households, including:
    -SSN
    -State-specific verifications relating to residency status
    -Government-sponsored MEC
    -Incarceration
    -Lawful presence
    -Membership in a Federally Recognized Tribe

  • Guest
    Reply
    |     Mar 22, 2017

    Hi Sigitas,

    In order to evaluate your request, we require that you provide a more detailed description of the business scenario you are trying to support so that we can fully understand your requirements.

    If we do not receive this information within 30 days, this request will be closed.

    Thank you,
    Eloise O'Riordan, Cúram SPM Offering Management team

  • Guest
    Reply
    |     Mar 8, 2017

    Hi Sigitas,

    Thank you for your enhancement request.
    We require some further analysis to determine whether or not this enhancement can be considered in a future release.
    I will provide another response when our investigation is complete.

    Thank you,
    Eloise O'Riordan, Cúram SPM Offering Management team