501           MEDICAID RECIPIENT IDENTIFICATION CARD

501 A.      ISSUING MEDICAID TO ELIGIBLE RECIPIENTS

There are four ways that the Department issues written documentation that a recipient isIndividualized Supports eligible for APAAdult Public Assistance-related Medicaid coverage in a given month.  These documents inform the recipient and their health care provider of the recipient’s Medicaid identification number (e.g., 060000000 / 060100000), which is needed by the provider when submitting a claim for payment to Medicaid.  Many medical providers require written proof of Medicaid eligibility before they will provide service to an individual.  Any of the following documents will serve as proof of Medicaid eligibility:

1. Standard System Issued Recipient Identification Card

1. Children enrolled in Medicaid will receive a Denali KidCare card while adults will receive a Denali Care card.  This includes Medicaid cases authorized in both EISEligibility Information System and ARIESAlaska's Resource for Integrated Eligibility Services.  This card can be used for health care and certain medical related services only for the person named on the card. The coverage period is generally twelve months and is valid for the period shown on the front of the card as long as the recipient remains eligible.  Although the cards display Coverage Effective Dates, it is not a guarantee of coverage or eligibility. Each person approved for Medicaid will receive Medicaid Recipient Identification (ID) card.

2. Standard cards are mailed to recipients for the following circumstances:

• One card per recipient per authorized application
• One card per recipient per authorized month of retroactive Medicaid
• One card per new member add-on
• One card per recipient per authorized renewal

Cards can also be reissued for the following circumstances:

• Change in name
• Client identification number
• Date of birth
• Eligibility code
• Coverage effective dates or resource code
• Lost, stolen, or client request

3. Cards are not issued to recipients eligible for SLMBSpecified Low Income Medicare Beneficiaries coverage.

2. Non-Standard System Issued Recipient Identification Card

A non-standard Recipient Identification card has similar recipient and medical resource information as the standard Denali Care or Denali KidCare card but is used for a recipient whose Medicaid coverage is restricted to certain services, such as an exam for a blindness or disability determination, or waiver screening. This ID card contains a statement of the service limitation.  A provider may photocopy this card and submit it with their claim for reimbursement.
 

3. Field Benefit Issuance

Once Medicaid coverage has been authorized in ARIESAlaska's Resource for Integrated Eligibility Services or EISEligibility Information System a Field Benefit Issuance can be printed at any DPADivision of Public Assistance office.  A Field Benefit Issuance contains similar recipient and medical resource information as a standard system issued Denali Care or Denali KidCare ID card.  A Field Benefit Issuance is provided when the Denali Care or Denali KidCare Card is needed immediately, and the recipient cannot wait for mail delivery.  A Field Benefit Issuance printed from ARIESAlaska's Resource for Integrated Eligibility Services looks different than a Field Benefit Issuance printed from EISEligibility Information System.

Note:  

Do not F9 out of the MEMC screen on EISEligibility Information System unless you want to cancel the issuance.  You must always type in the "F" issuance indicator and press "Enter" to record the issuance so the recipient’s medical claims will be paid.  

4. Manual Benefit Issuance

1. A Manual Benefit Issuance is the only form of documentation that can be printed for aliens eligible for emergency treatment because coverage for this special category is not considered regular Medicaid.  Although similar to a Field Benefit Issuance, additional instructions must be entered in the Special Information field on the Manual Benefit Issuance to specify the covered dates of services. A Manual Benefit Issuance printed from ARIESAlaska's Resource for Integrated Eligibility Services looks different than a Manual Benefit Issuance printed from EISEligibility Information System.

2. A Manual Card for a recipient eligible for any category of Medicaid that is assigned for the Care Management Program can only be printed by Health Management Systems (HMS).  A card can be requested on behalf of the recipient by contacting the HMSHealth Management Systems at 907-644-6842.

501 B.      AUTHORIZED REPRESENTATIVE

If an authorized representative (e.g., a public guardian) requests the Recipient Identification card and notices to be sent to him or her, the caseworker must enter the authorized representative's address in the mailing address field on the EISEligibility Information System Address (ADDRAddress screen) screen.  To have the Medicaid ID cards mailed to the recipient and the notices mailed to the representative, the authorized representative's address must be entered in the mailing address field on the ADDRAddress screen and the recipient's address in the Medicaid benefit address field on the ADD2Address Screen Change Benefit Mailing Address screen.

501 C.      USING THE ID CARD OR MANUAL COUPON

The caseworker must advise the recipient that it is the recipient’s responsibility to:
 

1. Present a current ID card or manual coupon when each medical service is received;
2. Ensure that the medical provider they choose is an enrolled provider in the Alaska Medicaid program;
3. Ensure that the service they are receiving is covered by Medicaid;
4. Be prepared to present proof of their identity;
5. Guard their coupons to prevent use by unauthorized persons; and
6. Pay for any medical services for which an ID card or manual coupon was not properly presented.