Basic Health Plus (BH Plus) Medical
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Basic Health Plus (BH Plus) Medical


Revised March 25, 2011



What is Basic Health (BH)?

 

What is BH Plus?

 

How do I screen a BH Plus AU?

 

How do I process a BH Plus AU?

 

How are shared BH Plus AU case actions coordinated between MEDS and the local CSO?

 

What alerts are generated on a BH Plus AU?

 


 

What is Basic Health?

 

·         The Basic Health (BH) Program provides affordable health insurance to Washington residents.  BH is administered through the Washington State Health Care Authority (HCA).  See EAZ Manual – Medical Assistance Programs – Family Medical Programs – Clarifying Information - Basic Health (BH) and BH Plus.

 

What is BH Plus?

 

·         BH Plus is Categorically Needy (CN) medical (F06) for the children of BH members.  BH Plus provides children receiving CN medical with more coverage than the BH adult members.  See EAZ Manual – Medical Assistance Programs – Family Medical Programs – Clarifying Information - Basic Health (BH) and BH Plus.  

 

·         Medical Eligibility Determination Services (MEDS) staff determines the eligibility for children in BH Plus.

 

·         When a client has BH Plus, a [Y] displays in the BHP Plus field on the MISC screen. 

 

·         The worker of record for a BH Plus case can be found in the User field on the MISC screen.

 

How do I screen a BH Plus AU?

 

1.    To screen a BH Plus AU, follow the instructions in How do I screen F06 medical?

 

How do I process a BH Plus AU?

 

·         To process a pending BH Plus AU:

 

1.    Follow the instructions in How do I process a pending F06 AU?

 

2.    During Option O – Interview, on the MISC screen:

 

o    Enter [Y] – Yes in the BHP Plus field.

 

o    Enter the [4 letter user id] of the assigned BH Plus worker in the User field.

 

3.    Complete the processing continuing to follow the instructions in How do I process a pending F06 AU?

 

How are shared BH Plus AU case actions coordinated between MEDS and the local CSO?

 

·         Users should be aware of how the case action being processed on a shared BH Plus AU affects eligibility.

 

·         For more information about shared cases see:

 

o    Shared Cases by More Than One CSO.

 

o    EAZ Manual – Medical Assistance – Family Medical Programs – Shared Case processing/Transfers.

 

·         If an action causes changes to a shared BH Plus AU in the ongoing month, the DONE screen displays one of the following soft edits:

 

o    Edit 1737 - PLEASE ALERT OWNING USER AS DISPLAYED ON ‘STAT’  

 

o    Edit 1738 - PLEASE ALERT MEDS USER AS DISPLAYED ON ‘MISC’.


NOTE:

Non MEDS users should not remove the [Y] in the BHP Plus field on the MISC screen.


What alerts are generated on a BH Plus AU?

 

·         Alert 404 – ANOTHER CSO UPDATED SHARED AU is generated in overnight batch when action is taken on an AU which is linked to an active AU in another office.

 

o    This alert generates when a MEDS user updates a BH Plus AU that is “owned” by another office.

 

·         Alert 405 – CSO UPDATED BHP PLUS AU is generated in overnight batch when action is taken on an AU that is linked to an active BH Plus AU.

 

o    This alert is sent to the CSO 076 user assigned to the AU and displays regardless of which office “owns” the AU.

Modification Date: March 25, 2011