Medical

Created on: 
Jan 25 2020
See ACES Screens and Online Pages for an example of pages or screens used in this chapter.

Tailored Supports for Older Adults (TSOA) Assistance Units (AUs) approve if over income and resources - Transportation for Disabled (TD) vehicle coded (PR 432636)

Situation:

In some situations TSOA AUs approve when over the income and resource standards and a TD vehicle type is coded. ACES incorrectly allows resource deductions even though the initial resource test fails. When this occurs, the system ignores the income and doesn't deny the AU for Reason Exceeds Income Standard (301).

Workaround:

At this time, please call IT Solutions Customer Support at (360) 664-4560, Option 2 for an appropriate workaround.

Medicare Buy-In Unit Cannot Update or Modify TPL Screen in ACES 3G (PR 422917)

Situation:

After the January 2018 ACES promote of Change Request 387494 - MEDICARE BENEFICIARY IDENTIFIER (MBI) - 3G/ACESONLINE MBI NUMBER FIELD, staff in the Medicare Buy-In Unit (MBU) could not update Third-Party Liability (TPL) information in ACES 3G. This adversely effects staff trying to process Medicare Savings Program (MSP) Assistance Units (AUs) when there is outdated or incorrect Medicare TPL begin or end dates that have a source code of MMIS/P1 Interface (MM).  This situation also affects staff who are trying to process Modified Adjusted Gross Income (MAGI) AUs. 

Workaround:

At this time, please call IT Solutions Customer Support at (360) 664-4560, Option 2 for an appropriate workaround.

ACES.online Premium Payment Status Page – The Last Payment Received Field Incorrectly Populates the Last Statement Generated Date (PR 451906)

Situation:

On the Premium Payment Status page in ACES.online, the Last Payment Received field incorrectly populates with the date the last statement generated. As a result, the Last Payment Received and the Last Statement Generated fields will have the same date, whether or not the client actually made a payment.

Workaround:

For authorized users, check the FSA payment system directly for accurate payment information.

Exception to Rule approved for Ongoing Additional Requirements (OAR) for recipient of SSI Related Categorically Needy (S02) medical.

Situation:

In some situations an Exception to Rule is approved for OAR for a client receiving S02 medical.

Workaround:

ACES doesn’t support OAR for clients receiving S02 medical.  An Automation Work Request (AWR) is needed for ACES to support this process.  At this time, please call IT Solutions Customer Support at (360) 664-4560, Option 2 for an appropriate workaround.

Authorizing Spenddown - No Edit Alerting User to Close an Active Qualified Individual (QI-1) (S06) AU (PR 413208)

Situation:

When applying medical bills/expenses to meet a spenddown liability and approve MN coverage w/ spenddown, and the recipient client has an active S06 AU, users don’t receive an edit alerting them to close the S06 AU.

If the S06 AU is left active after spenddown coverage is approved (S99/L99/P99/F99), the spenddown AU may close in overnight batch, then it cannot be reinstated or re-opened.

Workaround:

Before authorizing spenddown, check if the recipient client has an active S06 AU, and close the S06 AU for each benefit month the client will be active on the spenddown AU. You may need to start the spenddown authorization process to check the benefit start date, then back out of the spenddown authorization to close the S06 for the appropriate benefit months based on the spenddown medical start date with Reason Code 588 - Ineligible QI-1 Already Receiving MA.

NOTE: Clients can be active on S03/S05 AU with an approved spenddown. Also, non-recipient clients for spenddown can receive S06, such as a non-applying/ineligible spouse for spenddown.

When taking actions on a case that requires a Processing Alternative (PAL), please make sure to narrate your actions.

For any questions about this workaround, please contact IT Solutions Customer Support at (360) 664-4560, option 2.

See ACES Screens and Online Pages for an example of pages or screens used in this chapter.