Once the Eligibility Counselor confirms the member’s DOB, Workflow will populate
Participation Statement?
Confirm the home address and select the Yes radio button in the
Address Verification
Educate the members on financial
implications of not recertifying on
time
Eligibilty Conselour Responsibilities
EC Special Handling
Language Selection
Once VOI has been successfully confirmed, the EC will them be prompted to educate the member or POA
of the
reason for call
After the participation statement, the EC will be prompted to confirm the member’s
Address Verification?
Ask the member if this is where they receive their mail
contact
Send an Eligibility Counselor
Package (ECP) containing an
Authorization of Assistance (AOA)
form and any required Statespecific Authorized Representative
(AR) form
Inform the member
After the language selection, the EC initiates the first portion of the Verification of Identity (VOI) process –
confirming member’s First and Last Name
During this portion of the flow, the EC initiates the first portion of the Verification of Identity (VOI) process –
confirming member’s First and Last Name
Greeting and program intro
is the set amount of time after the due date during which the recertification process can be completed by the member without losing their Medicaid/MSP benefits.
Grace period?
reflect the resent package as well as the delivery method selected. If all information is correct,
the EC will read the script
Summary
Ensure that members understood
the message
Assist members with the
recertification process
Clicking on any of the hyperlinked words throughout the interview will bring up the
Ease Glossary
If the EC selects Mail or FedEx they will be
asked to confirm/correct the applicants
address but this option option should only be used once
approved by management team
Fedex
Right after updating the contact information, Workflow will prompt the Eligibility Counselor to confirm or ask the member’s
Marital Status?
:the case will remain “In Progress” until the member returns the signed AOA
Status tab
Assists Already
Enrolled members
with recertification
After completing the renewal form, the EC will be prompted to ask the member how they would prefer to receive their renewal form – Mail, Email, Fax or FedEx (only when justified). ▪ Workflow will also show the last method the member chose to receive their package.
Package Delivery Options
In what tab An EC will have the ability to correct a package with or without having the member on the phone
My assignments
The Eligibility Counselor will share with the member the next steps regarding the completion of their
Renewal Status?
the EC will inform the member of the importance to send back the AOA.
closing
The grace period chart
allows the Eligibility
Counselor (EC) to see
the redetermination
grace period. This chart
is provided by
Government Relations
(GR).
Nonworkable Cases/Grace Period
In the event the member calls in after the EC has already completed the renewal form and sent it out to the member or state, the EC will see the following verbiage during the
Reason for call
: in what tab a summary of the Workflow interview will be stamped in to show what took place on the call
tracking