*** The Health Care Programs Manual (HCPM) has been replaced by the Minnesota Health Care Programs Eligibility Policy Manual (EPM) as of June 1, 2016. Please refer to the EPM for current health care program policy information. ***
Effective: November 1, 2012 |
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07.30 - Case Notes |
Archived: June 1, 2016 (Previous Versions) |
Case notes are an important part of determining and documenting eligibility. They become part of the permanent record and can be viewed by all users statewide.
MinnesotaCare case notes must always be entered in MMIS, not MAXIS. MMIS does not retain case history, so case actions must be documented through case notes.
Include the following information:
l Use the header **MCRE Foster Care or Juvenile Residential Correctional Facility Child** if the case is that of a child who qualifies for MinnesotaCare for Certain Children Exiting Foster Care or a Juvenile Residential Correctional Facility.
l Household’s choice of enrollment site.
l Household composition and household size.
l Household members requesting or not requesting MinnesotaCare coverage.
l A description of how current household income was verified and calculated.
l Whether household income is at or below 200% FPG, 215% FPG, 250% FPG, and 275% FPG.
l A description of how assets were considered.
l A description of other health insurance and include, if applicable, the following:
n Current access to Employer-Subsidized Insurance (ESI).
n Begin and end dates of other coverage.
n Begin and end dates of access to ESI.
n Whether ESI access was verified.
n Underinsured children.
l Medical support issues, including decisions on good cause claims.
l Immigration documentation.
l Date a denied household member may be eligible in the future.
Example:
The Jones family drops coverage in October.
Action:
Document the four-month penalty period for coverage due to voluntary termination.
l Premium amount.
l Phone calls, office visits and correspondence with a client or authorized representative.
l Contacts with state staff, county staff or grantee agencies.
l Changes including:
n Household composition.
n Address.
n State residency.
n Income.
n Assets.
n Employment.
n Insurance.
n Pregnancy and births.
n Deaths.
n Name changes.
n Benefit set.
n Major program.
n The form of citizenship documentation.
n A household member’s temporary absences.
n Refund amount and contacts.
n Any other factors affecting eligibility.
l How and when changes were verified for factors requiring verification.
l Managed care health plan changes.
l Limited English Proficiency Applications with Multilingual Referral Line (MRL) service contact. Include the MRL service contact date, MRL liaison's name and contact information. For more information on MRL service contacts, see Date of Application.
l Any other information needed to document case history.
MAXIS does document case history. When writing case notes:
l Be clear.
l Be accurate.
l Be brief.
l Be appropriate.
l Begin each case note with a brief topic description.
l Do not detail information that is readily available on MAXIS screens.
Use case notes to summarize client contacts and to explain or elaborate on eligibility factors or changes, including but not limited to:
l Contact with the client, other state or county workers, third parties, etc.
l Household Composition.
n Explain relationships if there is unusual background information or relationships cannot be readily understood using information input into MAXIS.
n Note expected and reported changes in household composition.
n Document temporary absences and effect on eligibility.
l Assets. Note the following:
n Asset and income transfers.
n Unavailability determinations.
n Reasonable efforts to sell when appropriate.
n Expected and reported asset changes.
n How excess assets were reduced.
n Information on spousal asset assessments.
n Burial fund calculation description.
n Deeming issues.
l Income. Note the following:
n Expected and reported income changes.
n Employment changes.
n Sponsor asset and income determinations.
n Lump sum information.
n Deeming issues.
n Use of disregards, such as the earned income disregard, Pickle disregard, etc.
n Self-employment income calculations.
l Overpayments.
l Workarounds used.
l Non-routine use of FIAT.
l Eligibility calculations determined off of the system.
l Residence changes.
l Case or application transfer information. Including:
n Why the case or application is being transferred.
n Pending verifications or case actions.
n Unresolved IEVS matches.
l Extra Help application date.
Enter the following on the first line of a separate case note in MAXIS if the county agency receives Social Security Administration (SSA) data as a request for Minnesota Health Care Programs (MHCP): "APPL DATE OF [fill in date] BASED ON EXTRA HELP APPLICATION TRANSMITTED BY SSA ON [fill in date].”
l Basis of Eligibility.
n Include unusual information on a case-by-case basis.
n Expected changes in disability or pending disability.
n Waiver program information including the Long-Term Care Consultation (LTCC) date or home health care services begin date.
l Disqualifications.
l Reasons for closure.
l Receipt of assistance in other states.
l Nature and resolutions of emergencies.
l The form of citizenship documentation.
l Limited English Proficiency Applications with Multilingual Referral Line (MRL) service contact. Include the MRL service contact date, MRL liaison's name and contact information. For more information on MRL service contacts, see Date of Application.
Also see information on case notes in POLI/TEMP section TE2.08.094.