5075            MEDICAID RECIPIENT IDENTIFICATION CARD

 

5075 A.       ISSUING MEDICAID TO ELIGIBLE RECIPIENTS

 

There are four ways that the Department issues written documentation that a recipient is eligible for 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 the provider needs to submit a claim 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. Beginning January 2014, each person approved for Medicaid will receive a Medicaid

      Recipient Identification (ID) card.  Children enrolled in Medicaid in ARIES or receiving Denali KidCare through EIS will receive a Denali KidCare card while adults will receive a Denali Care card.   This card can be used for health care and certain medically 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. 

 

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

 

   Cards should also be reissued for the following circumstances:

 

  1. Cards are not issued to recipients eligible for retroactive Medicaid or SLMB coverage.

 

2. NON-STANDARD SYSTEM ISSUED RECIPIENT IDENTIFICATION CARD

 

A non-standard Recipient Identification card (traditional Medicaid coupon) 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, waiver screening, or Chronic and Acute Medical Assistance (CAMA).  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 ARIES or EIS, a Field Benefit Issuance can be printed at any DPA 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 ARIES looks different than a Field Benefit Issuance printed from EIS. 

 

MIMI                   MEDICAL INSURANCE MANUAL ISSUANCE          082913 11:29

                                                                   KARLA-TRAIN 

   RECIPIENT                                D.O.B.           ELIG  PGM/  RE-   

     I.D.         RECIPIENT NAME           MM DD YY SEX      CODE MEDSB SRCE(S)

   600084539 POTTS            DALIA        01 30 92  F        50 ME  TO Y      

                                                                                

   600084541 POTTS            IRIS         06 15 97  F        20 ME  AF Y      

                                                                               

   600090173 POTTS            SHRUB        08 03 71  M        20 ME  AF Y       

                                                                               

                                                                               

                                                                               

 BAGONIA     POTTS          *****************************                      

 102 A ST                   *THIS AUTHORIZATION GOOD FOR*    VILL: K02         

 ANCHORAGE      AK99501     * BENEFIT MONTH 0812 ONLY!  *    DIST: 083         

                            *****************************                      

                                                                               

 SPECIAL INFORMATION (OPTIONAL)                                                

                                                                                

                                                                               

                                                                               

 AUTHORIZATION SIGNATURE:                                DOCUMENT#  M0221381   

               ***  S T A T E   O F   A L A S K A  ***   ISSUANCE INDICATOR: F 

 

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 ARIES looks different than a Manual Benefit Issuance printed from EIS. 

 

  1. A Manual Benefit Issuance for a recipient eligible for any category of Medicaid or CAMA that is

      assigned for the Care Management Program can only be printed by Xerox State Healthcare, LLC.  A Manual Benefit Issuance can be requested on behalf of the recipient by contacting the Xerox Care Management Coordination Line at 907-644-6842. 

 

5075 B.       AUTHORIZED REPRESENTATIVE

 

If an authorized representative (e.g., a public guardian) requests the Recipient Identification Card to be sent to him or her, the caseworker must enter the authorized representative's address in the mailing address field on the EIS Address (ADDR) 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 ADDR and the recipient's address in the Medicaid benefit address field on the ADD2 screen.

 

5075 C.       USING THE IDENTIFICATION CARD

 

The recipient must be advised that it is their responsibility to:

 

1.    Present a current Recipient ID Card when each medical service is received;

2.    Ensure that the medical provider they choose is an enrolled provider in the Alaska Medicaid Health Enterprise;

3.    Ensure that the service they are receiving is covered by Medicaid;

4.    Be prepared to present proof of their identity;

5.    Guard their Recipient ID Card to prevent use by unauthorized persons; and

6.    Pay for any medical services for which a Recipient ID Card was not properly presented.

 

 

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MC #58 (12/13)