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Status Future consideration
Categories Social Program Management Platform
Created by Guest
Created on Jan 9, 2024

RELATED IDEAS

Incomplete Application Submissions for HCR

Both citizens and case workers must be allowed to submit applications for Medicaid with limited information and be allowed the ability to provide additional requested information in order for the system to determine eligiblity.

Customer Name South Carolina Department of Health and Human Services (SCDHHS)
Persona Based Summary

Currently, workers are not able to submit an incomplete HCR application which can cause delays in application processing timeliness.

Scenario:

  • Household of 4 (Mom, dad and 2 kids) applies via a paper application. Mom is the first person being entered, says yes, she has an SSN, but does not list it on the paper application.

  • Dad states he has income but forgets to list the frequency he receives the income.

  • WP IEG is started but the worker must select save and exit because they can’t get past the mandatory SSN information form mom without error messages.

  • Collateral contact is made to collect information.

  • If information is obtained, workers can continue with the IEG.

  • If not, a manual checklist notice is sent to the client.

    • A gap exists for tracking and denying these cases if the information is not returned.

    And

  • There is no way to deny an in-progress application, so the worker must withdraw or delete the application and send a manual denial notice.

Suggested Resolution:

In the application IEG, add a field to all mandatory questions that can be used to identify information that is missing from the paper application or information a citizen may not have readily available. If a that field is selected they will be allowed to continue through the application and submit it.

Once submitted, the system would create an application case recording all entered and missing information needed to determine eligibility. A checklist notice would be created with information needed for the missing mandatory fields and any OVs created by the application. A predetermined timer would be started which allows for tracking and application timeliness standard reporting.

The system would deny the case if the information was not received and send a denial notice.

If the information is returned, the system would allow a user to mark the application case as information received and provide an IEG script a worker can use to enter the missing information to complete the application.
Market Segment Health & Human Services
Type of Request Customer Requirement
Market Opportunity

Every market that uses Curam for Medicaid will benefit from having the ability to enter incomplete applications and be able to request needed info, and have the system deny if not received.
Usage frequency + #/type of users impacted

Any user that enters paper applications is impacted by this on a daily basis.
CURAM:Workarounds + Proposed Solution

Manual tracking of incomplete paper applications.

Manual requests for information being sent to citizens.

Manual denial notices need to be created if information is not returned.
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  • Admin
    Graham McCrindle
    Reply
    |     Feb 7, 2024

    Hi Melissa,

    We have reviewed your enhancement suggestion.

    Based on the information provided, our understanding of your request is as follows:

    • You want to enable Caseworkers to submit incomplete HCR applications to reduce delays in processing applications.

    The theme is aligned with our current multi-year strategy for our product, and we have accepted your suggestion as a consideration for a future release. Not all items under consideration will make it into a release. As plans are confirmed, you will be notified when a specific release includes this enhancement.

    Thank you for taking the time to share your ideas with us. We are committed to involving our users in building our product roadmap and appreciate your suggestions.

    Regards,

    Graham McCrindle, SPM Product Management Team

  • Admin
    Graham McCrindle
    Reply
    |     Jan 12, 2024

    Hi Melissa,

    Thank you for taking the time to share your ideas with us. We are committed to involving our users in building our product roadmap and appreciate your suggestions.

    We will review the information you have provided and get back to you within 30 days. If additional details are required to complete our evaluation, we will send you a request for more information.

    Thank you,

    Graham McCrindle, SPM Product Management Team