Act on Tasks - Appeals

 

Use this guide to act on appeals. A worker can only act on an MCI task if it has been assigned to them.

 

 

 

 

From the Home Page access the Admin Dashboard screen Click the Tasks tab and then, the View My Tasks button.

Process Steps

 

To act on an appeal:

 

1.      Click on the Tasks tab in the Admin Dashboard screen.

 

·        The Tasks tab is displayed.

 

2.      Click the View My Tasks button to only display tasks assigned to you.

 

Tasks that are assigned to you are displayed when you click on the View My Tasks tab. To assign an appeal to yourself refer to the Assign Tasks user guide.

 

3.      To locate the appeal, browse through the tasks list or use the search procedure by entering the task’s search criteria:

 

a.      Enter the first name of the primary applicant of the account associated with the appeal in the First Name textbox.

 

b.      Enter the middle name of the primary applicant of the account associated with the appeal in the Middle Name textbox.

 

c.      Enter last name of the primary applicant of the account associated with the appeal in the Last Name textbox.

 

d.      Enter the account holder’s zip code in the Zip Code textbox.

 

e.      Enter the account ID of the account associated with the appeal in the Account ID textbox.

 

f.       Select Appeal from the Type drop-down menu.

 

g.     Select the appeal’s status from the Status drop down menu. Options are:

 

                                                    i.     New

 

                                                   ii.     Review – In Progress

 

                                                  iii.     Documentation Requested

 

                                                 iv.     Closed – Dismissed

 

                                                   v.     In Progress – Hearing Scheduled

 

                                                 vi.     Re-Opened

 

                                                vii.     Appeal Denied

 

                                               viii.     Appeal Granted

 

                                                 ix.     Withdrawn

 

h.      Select the appeal’s priority from the Priority drop-down menu. Options are:

 

                                                    i.     High

 

                                                   ii.     Medium

 

                                                  iii.     Low

 

i.       Enter the name of the worker who last acted on the appeal in the Name of Worker textbox.

 

j.       Enter the ID of the worker who last acted on the appeal in the Worker ID textbox.

 

k.      Check the box(es) to select the Eligibility Results of the account. Options are:

 

                                                    i.     Medicaid

 

                                                   ii.     QHP/APTC/CSR

 

                                                  iii.     Mixed Household

 

                                                 iv.     Not Determined

 

None of the fields to enter/select search criteria is mandatory; however, at least one must be selected or entered for the search to be completed.

 

 

4.      Click the Search button.

 

·          Appeals that match the search criteria are displayed for review.

 

5.      Click the Appeal link under the Type column for the appeal to be acted on.

 

·          The Update an Appeal screen is displayed.

 

6.      In the Update an Appeal section:

 

a.      Check the box next to the name of the household member(s) for whom the appeal is being updated.

 

b.      Enter a reason for the appeal in the Appeal Reason textbox.

 

c.      Select the radio button to update if expedited hearing is needed.

 

d.      Select the radio button to update if telephonic hearing is needed.

 

e.      Enter an explanation for the appeal in the Explanation for Appeal textbox.

 

7.      Upload supporting documentation for the appeal request, by clicking the Browse button in the Upload Document section, if needed.

 

·        A browse window is displayed to select the documents from local files.

 

8.      Select the document category from the Document Category drop-down menu.

 

9.      Click the Upload button.

 

10.   Update a hearing date in the Hearing Date textbox, if needed.

 

11.   Update the hearing time from the Time drop-down menu, if needed.

 

12.   Update the appeal number in the Appeal Number textbox, if needed.

 

13.   Update the appeal location in the Location textbox, if needed.

 

14.   Update additional notes in the Worker Notes textbox, if needed.

 

15.   Select the new appeal status from the Change Status To drop-down menu, if needed. Options are: Documentation Requested, Closed – Dismissed and In Progress – Hearing Scheduled.

 

16.   Select the new appeal type from the Change Type To drop-down menu, if needed. Options are: Appeals and Expedited Appeals.

 

17.   Click the Submit button.

 

·        The Tasks tab is displayed.

 

Results of the Procedure

 

The appeal is updated.