Report a Change in an Application

Use this guide to report a change in an application for healthcare assistance.

 

From the Home Page access the Admin Dashboard screen and click on the Manage an Individual Account link.

 

 

At any point during the process, the application can be saved and exited.

 

 

Process Steps

To report a change:

1.        Click on the Manage an Individual Account link in the Individual Administration section on the Admin Dashboard screen.

 

·         The Account Search screen is displayed.

 

2.        Enter the search criteria for the account:

 

a.     Select Individual from the Role drop-down menu.

 

b.    Enter the account holder’s first name in the First Name textbox.

 

c.     Enter the account holder’s middle name in the Middle Name textbox.

 

d.    Enter the account holder’s last name in the Last Name textbox.

 

e.     Enter the account holder’s date of birth in the Date of Birth textbox in the format MM/DD/YYYY.

 

f.     Enter the account holder’s social security number in the Social Security Number textbox in the format XXX-XX-XXXX.

 

g.    Enter the account number in the Account ID textbox.

 

h.     Enter the Application Received Date from and the Application Received Date to fields in the format MM/DD/YYYY or select them from the calendar.

 

3.        Click the Search button.

 

·         Accounts that match the search criteria are displayed.

 

4.        Select the radio button adjacent to the account which application is to be updated.

 

5.        Select View Account from the Admin Functions drop down menu and click Submit.

 

·         The Administrator View of Individual Account Dashboard is displayed.

 

6.        Click the Report a Change in Household or Income link in the Quick Links section of the Admin View of the Individual Account dashboard.

 

·         The Application Review screen is displayed.

 

7.        Click the Edit Information link under the information to be updated. Options are:

 

a.     Financial assistance option information

 

b.    Contact information

 

c.     Family members information

 

d.    Household tax information

 

e.     Access to other health insurance information

 

f.     Family member information: with access to update personal information, special circumstances information and employment status information for each of the household members.

 

At this point the system navigates directly to the screen where the information to be updated is located. Once changes have been made, the user clicks Next through the application until reaching the Eligibility Determination screen. 

 

All data fields are already populated with information originally entered. Only changed information must be updated. Some fields, such as primary applicant’s date of birth and Social Security Number, are populated and cannot be changed.

 

Depending on the information that needs updating:

8.        Select the radio button to update if “the applicant and members of the household can get help paying for health insurance.”

 

9.        Select from the drop down menu the type of coverage requested, if needed:

 

a.     Health Insurance and Dental Insurance

 

b.    Only Health Insurance

 

c.     Only Dental Insurance

 

10.     Update the number of people, including the primary applicant, living in the household, if needed.

 

11.     Click Next.

 

·         The Your Information – Your Family Members screen is displayed.

 

12.     Update the following information for each household member for whom assistance is requested in the respective textboxes, if needed:

 

a.     Name

 

b.    Gender

The Social Security Number and Date of Birth fields are prepopulated and are unavailable for updating.

13.     Change the radio button selection to update if the member of the household is applying for medical health insurance, if needed.

 

14.     Click Next.

 

·         The Contact and Personal Information - Primary Applicant screen is displayed.

 

15.     In the Contact Information Section, update the following information for the primary applicant, if needed:

 

a.     Primary phone number and type

 

b.    Secondary phone number and type

 

c.     Email address

 

d.    Preferred method and time of contact

 

e.     Preferred languages read and spoken

 

16.     In the Address section, update:

 

a.     Home address

 

b.      Select the radio button to indicate if the appliacnt’s mailing address is the same as their home address.

The account holder’s home address is prepopulated for the primary applicant.

 

If there is more than one applicant, the Contact and Personal Information – Secondary Applicant(s) screen is displayed and information for the secondary applicant(s) is entered.

 

17.     In the Personal Information section:

 

a.     Update Ethnicity and Race from the drop down menus, if needed.

 

b.    Change the radio button to indicate if the applicant is currently pregnant (this question is only displayed for female applicants), if needed.

 

18.     In the Incarceration Status section, indicate if the applicant is currently incarcerated.

 

19.     In the Citizenship Information section, change the radio button to indicate if the individual is a US citizen or national, if needed. If the applicant is not a US citizen or national:

 

a.     Change the radio button to indicate if the applicant has lived in the US for any length of time since 8/22/1996, if needed.

 

b.    Change the radio button to indicate if the applicant has an eligible immigration status, if needed.

 

20.     In the American Indian/Alaskan Native section, update the radio button to indicate if the individual is an American Indian or Alaskan Native. If the applicant is an American Indian or an Alaskan Native, if needed:

 

a.     Change the radio button to indicate if he/she is a member of a federally recognized tribe. If yes, select the name of the tribe from the drop down menu, if needed.

 

b.    Change the radio button to indicate if he/she has ever gotten service from Indian Health Service, tribal program, or urban Indian health program, if needed.

 

c.     Change the radio button to indicate if he/she is eligible to get services from the Indian Health Service, tribal health programs, or urban Indian health programs through a referral from one of these programs.

 

21.     Click Next.

 

·         The Special Circumstances screen is displayed.

 

22.     In the Disabilities and Disabilities Services section, change the radio button selection to indicate if the individual is physically ill, incapacitated, blind or disabled, if needed. If the applicant has a disability:

 

a.     Change the radio button selection to indicate if the disability will prevent the applicant from working at least 12 months or result in death, if needed.

 

b.    Change the radio button selection to indicate if the applicant is active with the Office of Rehabilitation Services or Services for the Blind, if needed. 

 

c.     Change the radio button selection to indicate if the applicant has applied for SSI or Social Security Benefits (RSDI), if needed.

 

23.     In the Disabilities and Disabilities Services section, change the radio button selection to indicate if the individual needs help with activities of daily living, if needed.

 

24.     In the Additional Questions section, change the radio button selection to indicate if the individual was in the Rhode Island foster care system on his/her 18th birthday, if needed.

If the applicant selects Yes to any of the disability questions, his/her status is updated to “Potentially Eligible for Traditional Medicaid.” The applicant’s name is added to a batch report that is sent to the InRhodes system for complex Medicaid eligibility determination

 

25.     Click Next.

 

·         The Current Job and Income screen is displayed.

 

26.     In the Current Job and Income section:

 

a.     Change the radio button selection to indicate if the applicant is currently employed, if needed. If yes, an Employer Information section is displayed:

 

                                          i.    Update the employer name.

                                         ii.    Enter the employer identification number (EIN)

                                        iii.    Enter the employer address.

                                        iv.    Enter the wages/tips before taxes.

                                         v.    Select the frequency of tips.

                                        vi.    Enter the average number of hours worked.

 

27.     Select the radio button to indicate if the data above is based on information from documentation/external sources and entered by the worker.

 

28.     If needed, enter additional remarks in the Worker Income Note field. Notes entered are displayed in the Notes History box. Click the View link to read the full text of the existing note(s).

To add another employer, click the Add Another Employer button.

 

29.     Change the radio button selection to indicate if the applicant is currently self-employed. If yes, enter the Type of Work and the Net Income for the Past Month in the respective textboxes.

The income entered in the Current Wages and Tips or the Gross Monthly Self-Employment Income fields is always used to determine eligibility for Medicaid.  Current income is used to determine Medicaid eligibility even if an amount is entered in the Total income field.

 

When an amount is entered in Total income, it is used to determine APTC/CSR eligibility. Current Wages and Tips or the Gross Monthly Self-Employment Income is used to determine APTC/CSR eligibility only when the Total Income field is left blank.

 

 

30.     In the Other Sources of Income section, change the radio button selection to indicate if the applicant has other sources of income to report, if needed. If the applicant has other sources of income to report:

 

a.     Update the type in the Income Type drop down menu, if needed

.

b.    Update the amount in the How Much? text box, if needed.

 

c.     Update the frequency in the How Often? drop down menu, if needed.

 

31.     In the Deductions section, change the radio button selection to indicate if the applicant has deductions to report, if needed. If the applicant has deductions to report:

 

a.     Update the type in the Deduction Type drop down menu.

 

b.    Update  the amount in the How Much? textbox.

 

c.     Update the frequency in the How Often? drop down menu.

To add additional deductions, click on the Add Another Deduction Type button

32.     If the applicant reported being an American Indian or an Alaskan Native, an American Indian/Alaskan Native Income section is displayed, if needed.

 

a.     Select the checkbox(es) to indicate if any of the income reported comes from these sources:

 

                                          i.    Per capita payments from the tribe that came from natural resources, usage rights, leases or royalties

                                         ii.    Payments from natural resources, farming, ranching, fishing, leases, or royalties from land designated as Indian trust land by the Department of the Interior (including reservations and former reservations)

                                        iii.    Money from selling things that have cultural significance

 

b.    Update the amount in the How Much? textbox.

 

c.     Update the frequency in the How Often? drop down menu.

 

33.     In the Total Income section, update the estimated income in the year of coverage.  

If the applicant is requesting Medicaid, the income entered in the Current Income field is used to determine his/her Medicaid eligibility. If the applicant is applying for QHP/APTC, his/her estimated yearly income entered in the Total Income field is

used to determine his QHP/APTC eligibility.

 

 

34.     Select the radio button to indicate if the data above is based on information from documentation/external sources and entered by the worker.

 

35.     If needed, enter additional remarks in the Worker Income Note field. Notes entered are displayed in the Notes History box. Click the View link to read the full text of the existing note(s).

 

36.     Click Next.

 

·         The Tax Applicant Information screen is displayed.

 

37.     Change the radio button selection to indicate if anyone in the household plan to file a Federal tax return next year. If yes, check the box(es) next to the name(s) of the member(s) of the household filing taxes.

 

38.     Change the radio button selection to indicate if anyone in the household be a dependent on someone else's return. If yes, check the box(es) next to the name(s) of the member(s) of the household that are on someone else’s tax return.

 

39.     Click Next.

 

·         The Access to Health Coverage screen is displayed.

 

40.     In the Insurance Access section, change the radio button selection to indicate if the applicant or any members of the household are offered coverage from a job. If coverage is offered, update the following information:

a.     Employer information

 

b.    Enrollment status

 

c.     Indicate who is the employee

 

d.    Employee contribution

 

e.     Name of the plan

 

f.     Employee premium and frequency

 

41.     In the Dental Insurance section, change the radio button selection to indicate if anyone in the household has access to dental insurance.

 

42.     In the Other Insurance section, change the radio button selection to indicate if anyone in the household has access to other insurance. If yes, select the appropriate option(s):

 

a.     Veterans Health Insurance

 

b.    CHIP

 

c.     Peace Corps

 

d.    Medicare

 

e.     Private/Other

 

f.     Americorps

 

43.     Click Next.

 

·         The Authorized Representative screen is displayed.

 

44.     Change the radio button selection to indicate if the applicant has an authorized representative. If the applicant has an authorized representative, update the representative’s information:

 

a.     Name

 

b.    Contact Information

 

c.     Contact Preferences

 

d.    Language Preferences

 

e.     Company name

 

f.     Organization ID

 

 

45.     Click Next.

 

·         The Application Review screen is displayed.

 

46.     Review the application and click Next.

 

·         The E-Signature screen is displayed.

 

47.     Review the text on the E-Signature screen with the applicant.  

 

48.     Ask the applicant or authorized representative to check the box to attest he/she is signing the application.

 

49.     Ask the applicant or authorized representative to enter his name and date in the respective checkboxes.

 

50.     Click Next.

·         A screen asking to proceed with the submission is displayed.

 

51.     Click Yes.

 

·         Application Submission Confirmation screen is displayed.

 

If the application is not ready for submission, it can be saved and exited. 

 

 

·         The application information is verified against external sources.

 

52.     If the application data is not verified, the Provide Additional Explanation/Documentation screen is displayed explaining what is required to complete the application.

 

a.     You can upload documents for each household member and each category in the Upload Document section.

 

53.     If the application data is verified, the Eligibility Determination screen is displayed. From here, users can proceed to buy healthcare and dental plans.

 

54.     Update the Plans on the Plan Summary screen, if needed and click <Next>.

 

a.     On the Choose a Plan for Current Year screen:

 

                                          i.    From the Left Hand Panel, click the Add Provider button from the Healthcare Providers section.

 

                                         ii.    Search for a Provider screen displays.

 

55.     On the Search for a Provider screen, enter the search criteria:

 

a.     First Name

 

b.    Last Name

 

c.     Facility Name

 

d.    City

 

e.     State

 

f.     Zip

 

g.    Click <Search>

 

h.     Search Results are displayed in a table.

i.      To view additional information about the provider, click the Provider Name hyperlink. Information will be displayed on the Provider Information screen.

 

56.     Select the provider you want to add by selecting the check box next to the provider name and click <Add Provider>.

 

·         Search for a Provider screen is displayed.

a.     Click the Back button.

·         Choose a Plan for Current Year screen is displayed with the selected providers added in the Healthcare Providers section.

 

57.     Click <Go To Dental> to display the Dental Health Insurance plans.

 

a.     Follow steps 71, 72, 73, and 74 to select dental health providers.

 

b.    Click <Next>.

 

·         The Select Your Primary Care Physician screen is displayed.

 

58.     On the Select Your Primary Care Physician screen:

 

a.     For each household member, select the Primary Care Physician from the drop-down options.

 

The Primary Care Physician drop-down is populated with the primary care physicians based on the selected provider.

In case you want to change the provider, click <Find a Provider>. This will take you to the Search for a Provider screen.

 

59.     Click <Next> to complete the enrollment.

 

 

Results of the Procedure

 

Application information is updated.