|
Effective: February 1, 2008 |
|
|
07.15.05ar2 - Application Signature (Archive) |
Archived: July 1, 2009 |
Specific signatures are required to consider an application complete. This section provides policy on who is required to sign an application and what to do if a signature is missing.
Client Unable to Provide Signature.
Require signatures from the following people:
l Applicants age 18 and older who are requesting health care for themselves.
n When only one spouse of a married couple is applying for coverage, do not require the non-applying spouse’s signature.
n When adding a new household member who is requesting coverage, require the signature of the new person if he or she is age 18 or over.
Reminder: Be sure to provide the new applying member with a copy of their Rights and Responsibilities (DHS-4163).
l The primary applicant under age 18, including emancipated minors, for households consisting only of people under age 18 who are applying on their own behalf.
l One parent, stepparent, guardian or relative caretaker for households consisting of adults and children who are applying only for the children under age 18.
Example:
John and Barbara apply for health care for themselves and their twins, age nine. John completes and signs the application.
Action:
John has signed the application for himself and their children. Barbara must also sign the application because she is applying for coverage for herself.
For MA, approve eligibility for John and the children. Pend Barbara’s MA application until her signature is obtained.
For MCRE, approve eligibility for the children because only one parent has signed the application. Pend eligibility for John and Barbara because Barbara’s signature is missing, and the All or Nothing Rule requires both parents to enroll if eligible.
l Authorized representatives.
Note: Do not require the authorized representative’s signature to consider the application complete if all required applicants have signed. However, the person cannot serve as an authorized representative without signing the application.
Client Unable to Provide Signature
People who are mentally competent but unable to sign the application due to physical or other limitations may sign by making a distinct mark, such as an ”r;X”. Two witnesses must sign and date the application to verify that the person making the mark is indeed the person who is applying.
When a required signature is not provided, follow these steps:
1. Pend applications for applicants who are required to sign the application but have not done so. Pend unsigned MA/GAMC applications on PND2 in MAXIS until the end of the processing period.
2. Send the HCAPP Signature Page (DHS-3417A) with the Request for Signature Letter (DHS-3555) to obtain the missing signatures.
3. Deny eligibility for applicants who are required but did not sign the application and did not return the DHS-3417A by the end of the processing period.
See the following for more information: