Effective 10/1- Process for working MAGI cases in EIS when ARIES won't wrap

Submitted by Clay Butcher on September 26, 2016 - 9:46am

Good afternoon, Everyone!

History: We have MAGI cases that cannot be worked timely in ARIES because of programming issues related to continued development and improvements of the system. Originally, the decision was made to work all MAGI cases in ARIES so they could easily be tracked and staff would become comfortable working in the new system. The exceptions to this was if the case was over 12 months old or a medically urgent need was not able to be processed in ARIES, these cases were then processed in EIS.

Issue: This decision has caused issues for clients and staff alike. With the further development of the ARIES R2 being placed on hold, DPA can no longer wait for these cases to process in ARIES when the case fails to wrap up.

Solution for Process: Effective October 1, 2016, if you have a case that cannot be completed in ARIES and it requires a help desk ticket be submitted that cannot be immediately resolved, process the case in EIS and complete the following steps:
1) Communicate with your ARIES lead to ensure a help desk ticket request is needed
2) Submit your email to the helpdesk and cc the ARIES Lead and supervisor; in this email staff will also add: Case worked in EIS.
3) Set a task in ARIES with the Help Desk ticket number and reason for the ticket
4) CANO in ARIES the reason for Help Desk ticket and include the ticket number as well and the EIS Case # for cross reference
5) Work the Manual Budget on the spreadsheet
6) Process the case for the entire household in EIS, follow the process used when processing urgent medical needs in EIS.

a. CARC EIS Case FSO – 5-5X

7) Enter a CANO in EIS that case has an open ticket in ARIES
8) Dispo case appropriately in PathO’s based on the determination
9) Sysops System Support Desk will “Reply All” when the ticket has been resolved.

a. The Lead will enter into the appropriate pathway to be claimed PathO’s as next
b. The lead worker will add to the remarks section in PathO’s: Helpdesk ticket, EIS Medicaid case

10) This PathO’s entry will be the flag to close the case EIS and rerun eligibility in ARIES

a. Remember to watch ME run date to decide EIS end month and ARIES start month.

11) To ensure this process is being done correctly and accurately, RCR’s and ARIES leads will spot check the cases that are worked in EIS as they will be in the MAGI med Carc: FSO- 5-5X, please follow the carc guideline to ensure these are carc’d to correct status of the case.

Projected outcome: By doing this, we hope to:

1. get customers their benefits sooner;
2. ensure staff touch the case once and be done;
3. diminish phone calls, faxes, and lobby traffic regarding delayed benefit delivery related to ARIES programming needs;
4. provide a way for managers/supervisors/case reviewers to easily identify why a case was worked in EIS instead of ARIES; and
5. continue to track where further development of ARIES needs to occur.

This business process has been developed to maximize your phenomenal efforts by providing Medicaid at the soonest moment for eligible clients. Reducing Medicaid benefit delivery timeframes will reduce additional backlog incurred due to phone calls and lobby traffic. Thank you for your patience and support as we continue to innovate and find ways to meet the increased need for basic services for our fellow Alaskans.

Sincerely,
Tammie and Aimee