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Status Not under consideration
Categories Income Support
Created by Erich SKelton
Created on Jan 13, 2022

RELATED IDEAS

Allow an Eligibility Decision to be Made for a Member with Household Member Evidence End Date

An issue exists where a decision is not able to be made on a case if a member has a household member evidence end date that is less than the date of application processing. This is Curam OOTB behavior, however, if a member becomes deceased and the system adds household member evidence end date to a case, a posthumous decision is still needed for a member to assess coverage they were eligible for up until their date of death.

This also causes an issue for when a member leaves the home for a medical facility and is technically out of the household. An ‘issue’ in Curam will be raised for the worker to add an end date to the household member evidence. Once this household member evidence is added to the case and that end date is before the application processing date, an eligibility determination is unable to be made.

Customer Name South Carolina
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  • Guest
    Reply
    |     May 25, 2022

    Hi Erich,

    We have not received the additional information we previously requested from you that would allow us to fully understand and evaluate your enhancement request. Since we have not received the information within the 30-day timeframe, we are closing this request.

    If you can provide the additional information in the future, please open a new enhancement request and we will be glad to review. We do appreciate the time you take to share your ideas with us and utilize your inputs to improve our product offering.

    Thank you,

    Sheryl Brenton, SPM Product Management Team

  • Guest
    Reply
    |     Jan 28, 2022

    Hi Erich,

    We have reviewed your enhancement Idea and would like to gather some further information from you in order to help us better understand your business problem.

    Can you provide answers to the following questions please?

    (Q1) For the Normal Flow – DOD ABD use case that you provided, we think there may be a few typos. Can you confirm whether it was meant to read as follow?

    1. An aged member submits an application for Medicaid services with an application date of 11/1/2021.
    2. The member becomes deceased on 12/21/2021.
    3. The worker processes the application on 1/10/2022.
    4. The system updates the household member evidence end date of 12/21/2021 based on the member’s date of death.
    5. The worker applies changes on all pending evidences that were updated throughout the application process.
    6. The worker clicks ‘Check Eligibility’ from the Income Support application display menu.
    7. The system shows the ABD eligibility period through 12/21/2021 (DOD).
    8. The worker clicks on Ready for Determination from the Income Support application display menu.
    9. The worker clicks on Authorize from the Income Support application display menu.
    10. The worker selects the ABD coverage type Display List Actions Menus and selects Authorize.
    11. The worker selects the primary client from the Authorize modal and clicks Authorize.
    12. The client is authorized and receives coverage from 11/1/2021 through 12/21/2021 in the ABD payment category.

    (Q2) As related to Step 4, do you have custom processing in place that updates the household member evidence end date automatically when a DOD is entered for the client?

    (Q3) You mention the following: "When the system requires workers to remove Household member end dates to be able to make a decision for clients, this could lead to incorrect determinations in the future and increased costs associated with these determinations." Is this in reference to a workaround you have found? Can you provide further details about exactly what steps you are using as part of your workaround?

    (Q4) Can you confirm that the Normal Flow – DOD ABD use case that you provided represents the behavior that you would like to occur, and that what you see as the business problem is that you need to perform a workaround in order for the system in step 11 to display the deceased client in the 'Select Primary Client' drop down in the Authorize modal?

    Please provide the requested information within 30 days so we may proceed with our evaluation. If we do not hear from you within that timeframe we will have to close the request due to insufficient information.

    Thank you,
    Sheryl Brenton, SPM Product Management team
    Note: We have improved your RFE experience and transitioned to an Ideas Portal provided by our trusted business partner Aha!
    Additional details can be found here.

  • Guest
    Reply
    |     Jan 17, 2022

    Hi,

    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 in order to complete our evaluation, we will send you a request for more information.

    Thank you,
    Sheryl Brenton, SPM Product Management team

    Note: We have improved your RFE experience and transitioned to an Ideas Portal provided by our trusted business partner Aha!
    Additional details can be found here.