retroactive medical
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retroactive medical


Revised June 20, 2014



NOTE:

For information on processing MAGI retro medical see Retroactive MAGI Medical.  


Who is eligible for Retro medical?

 

How long is the Retro medical certification period?

 

How do I initiate Retro medical?

 

How do I process the Retro medical benefit months?

 

How do I finalize Retro medical benefits? 

 

How do I authorize Retro medical benefits when the Retro Medicaid Copy function isn’t available for the AU I am working on?

 



Who is eligible for Retro medical?

 

·         Clients who are eligible for certain medical programs. See EAZ Manual – WAC 388-416-0010 Medical certification periods for recipients of cash assistance programs, WAC 182-504-0020 Certification periods for the noninstitutional medically needy (MN) program, and WAC 182-519-0110 Spenddown of excess income for the medically needy program #3.

How long is the Retro medical certification period?

 

·         Retro medical can be approved for up to three months prior to the application month. See EAZ Manual – WAC 182-504-0015 (#9) Certification periods for categorically needy (CN) scope of care medical assistance programs and WAC 182-504-0025 Medicare savings program certification periods.

How do I initiate Retro medical?

 

To initiate Retro medical, take the following steps:

 

1.      On the AMEN  screen, enter Option W – Retro Medicaid Copy

.

o        Enter the AUID in the AU ID field.  Press <Transmit> and the Retroactive Medicaid Copy - RMCO screen displays. 

 

2.      On the RMCO screen, enter [Y] in the Continue field.  Press <Transmit> and the AMEN screen displays.

 

How do I process the Retro medical benefit months?

 

To process a retroactive Medicaid application, take the following steps:

 

1.      On the AMEN screen:

 

o        Select Option R – Interim/Hist Change.

 

o        Enter the AUID in the AU ID field. 

 

o        Enter one of the retro months [MM YY] in the Benefit Month field.

 

o        Press <Transmit>.

 

o        Review and update case information as needed.  Confirm and commit data. 

 

2.      Repeat Step 1 for the remaining Retro months.

 

How do I finalize Retro medical benefits? 

 

1.   On the AMEN screen:

 

o        Select Option X – Finalize RETRO Medicaid.

 

o        Press <Transmit> and the Finalize Retroactive Medicaid - FRME screen displays.

 

o        Press <Transmit> and the ELIG screen displays.  Confirm eligibility for all benefit months and finalize.  Press <Transmit>. 

 

How do I authorize Retro medical benefits when the Retro Medicaid Copy function isn’t available for the AU I am working on? 

 

·         The user must screen in a new AU with a three month spenddown base period to cover the retro medical months.  See Spenddown Processing. 

 

Modification Date: June 20, 2014