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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 101 – Coverage Groups and Processing Applications and Reviews Page |226

Effective Month: December 2016 101.04.03 SUBMITTING AN APPLICATION AND APPLICATION FILE DATE An application for Medicaid may be filed in any of the following described submission methods. The application file date is the date a valid application form is received by the agency: • In person in any regional office, official out-stationed location or other location outside the regional office where eligibility staff are on official duty, such as a nursing home, hospital or other public facility. The filing date is the date received by the office or other location; • By mail in any regional office - o Applications received by mail which arrive after the end of the month, but were postmarked by the last day of the month will be considered to have been received by the regional office on the last day of the month in which they are postmarked. • By fax in any regional office. The filing date is the date received by the agency (central or regional office, whichever office first receives the application). An original signature is not required, • By on-line submission of the application to DOM. The filing date is the date received by the agency (central or regional office). An electronic signature is accepted for applications filed on-line with the agency. • By on-line submission of the application to the Federally Facilitated Marketplace (FFM), which is then transferred to DOM. The filing date is the date the application is received by the FFM. An electronic signature is accepted for applications filed on-line to the FFM. • By telephone via a telephonically recorded application process. The date of filing is the date the telephonic signature is recorded, which should be the date of the telephone interview. Telephone applications are conducted by central office staff completing the appropriate paper application based on applicant statements that are recorded, including the telephonic signature. When the application interview is concluded, the completed application form is forwarded to the appropriate regional office for processing. A request for a telephonic application received by a regional office must be referred to the central office in order for the interview to be recorded. Upon referral, central office staff will coordinate the telephone interview with the applicant.