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Effective: December 1, 2006 |
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07.30ar1 - Case Notes (Archive) |
Archived: July 1, 2009 |
Case notes are an important part of determining eligibility. They become part of the permanent record and can be viewed by all users statewide.
MinnesotaCare (MCRE) Case Notes.
MMIS does not retain case history. This must be documented through case notes.
Include the following information:
l Household’s choice of enrollment site.
l Household composition and household size.
l Household members requesting and/or not requesting MCRE coverage.
l A description of how current household income was verified and calculated.
l Document whether household income is below 150% FPG, 175% FPG, and 275% FPG.
l Other health insurance coverage including:
n Current access to ESI.
n Begin and end dates of other coverage.
n Begin and end dates of access to ESI.
n Whether ESI access was verified.
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 wait 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 Employment.
n Insurance.
n Pregnancy and births.
n Deaths.
n Name changes.
n Benefit set.
n Major program.
n Any other factors affecting eligibility.
l How and when changes were verified for factors requiring verification.
l Managed care health plan changes.
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/income determinations.
n Lump sum information.
n Deeming issues.
n Use of disregards, such as the earned income disregard, pickle disregard, etc.
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 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.