455: CITIZENSHIP UNABLE TO VERIFY VIA SSA CROSS MATCH

DESCRIPTION

This alert generates to the supervisor of CSO 127 – Citizenship Unit when the SSA cross match returned verification code is:

·         B – SSN is verified, there is no indication of death, and the allegation of citizenship is not consistent with SSA data.

·         D – SSN is verification, there is indication of death, and the allegation of citizenship is not consistent with SSA data.

This alert generates daily when the following conditions are met:

·         Client status is A – Active or P – Pending. If the client is in pending status, the second line of the alert displays “PENDING CLIENT”;

·         Client Citizenship code is C – US Citizen, N – US National or R – US Born Child of Refugee;

·         Client Citizenship verification code is NOT T2, T3, T4, EW or FV with an identity valid value V or E; and

·         Client Financial Responsibility code is:

o    RE – Recipient

o    RM – CA Ineligible Person Receiving MA Only

o    RN – CA Sanctioned Receiving MA Only/FAP Recipient

o    RC – Recipient of Cash Only

o    PN – Pending or blank

·         The client does NOT have a TPL carrier code MEDA or MEDB.

·         Med Coverage Group code is NOT:

o    Blank

o    M99 (Psychiatric Indigent Inpatient Spenddown)

o    D01 (FC/AS/JRA/SSI CN), D02 (FC/AS/JR Medical), D26 (Washington Apple Health Post-Foster Care Coverage)

o    S01 (SSI Categorically Needy)

o    S03 (Qualified Medicare Beneficiary (QMB), Medicare Savings Programs)

o    S04 (Qualified Disabled Working Individual)

o    S05 (Specified Medicare Beneficiary (SLMB), Medicare Savings Programs)

o    S06 (Qualified Individual (QI-1)

o    W01 (ADATSA Cash Medical)

o    W02 (ADATSA Medical Only)

o    W03 (Detox Medical Care Services)

o    L01 (SSI Long Term Care)

o    L21 (SSI CN Waiver or Hospice)

o    F05 (Newborns) and

o    G01 (Med Care Svc Unemployed/GA Unemployed/GA Regular/GA-A/B/D) with Program Type code U (GA Unemployed).

 

PROCEDURE

1.    Review the case and request verification of citizenship and identity, if needed.

o    For more information, see Citizenship and Identity Verification for Medicaid.

 

DISPOSITION

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