Alert 268

ACES ALERTS


268: OPEN PREGNANCY MEDICAL


DESCRIPTION

 

This alert generates when the following medical coverage groups close for Reason Code 235 – Review Not Complete:

 

o    F01 (TANF)

 

o    F04 (Family Medical Categorically Needy)

 

o    F06 (Categorically Needy Children’s)

 

o    F07 (Children’s Health Insurance Program CHIP)

 

And the AU contains an active pregnant client with the following FINL RESP:

 

o     RE – Recipient

 

o     RM – CA Ineligible Person Receiving MA Only; or

 

o     RN – CA Sanctioned Receiving MA Only/FAP Recipient.

 

For more information, see Pregnancy Medical.

 

PROCEDURE

 

1.    Open the appropriate pregnancy medical program for the client.

 

2.    The pregnant client is entitled to continuous medical coverage thru the 60 day postpartum.

 

DISPOSITION

 

Enter [Y] in the D field and <TRANSMIT>.