Page 49

Official source

MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 101 – Coverage Groups and Processing Applications and Reviews P a g e | 49 Effective Month: September 2023

101.06.02 CONCLUDING THE INTERVIEW At the conclusion of the interview, the applicant or his representative must understand the following: • Additional information the applicant must provide or actions he must take for eligibility to be determined. • Actions the agency must take to determine eligibility. • Notifications required, including a written notice of approval and the issuance of Medicaid or CHIP cards or a denial notice and/or the right to appeal any decision. • Redeterminations, i.e., annual eligibility reviews for children and annual or more frequent reviews, if necessary, for adults. 101.07 STANDARDS OF PROMPTNESS Eligibility must be determined within the appropriate timeframes for the program type as discussed below. If there is a delay in processing, the reason must be clearly documented in the record. 101.07.01 REGIONAL OFFICE RESPONSIBILITIES Each regional office must have controls in place which ensure timely application processing at all staff levels, including sufficient time for supervisory review and corrections. Applications should generally be processed in the order in which received, taking into consideration promptness and delay in receipt of verifications, and in some cases, urgent need. Under no circumstances should an application be approved without the proper verifications and documented eligibility for each applicant.

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Page 49

Official source

MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 101 – Coverage Groups and Processing Applications and Reviews P a g e | 49 Effective Month: September 2023

101.06.02 CONCLUDING THE INTERVIEW At the conclusion of the interview, the applicant or his representative must understand the following: • Additional information the applicant must provide or actions he must take for eligibility to be determined. • Actions the agency must take to determine eligibility. • Notifications required, including a written notice of approval and the issuance of Medicaid or CHIP cards or a denial notice and/or the right to appeal any decision. • Redeterminations, i.e., annual eligibility reviews for children and annual or more frequent reviews, if necessary, for adults. 101.07 STANDARDS OF PROMPTNESS Eligibility must be determined within the appropriate timeframes for the program type as discussed below. If there is a delay in processing, the reason must be clearly documented in the record. 101.07.01 REGIONAL OFFICE RESPONSIBILITIES Each regional office must have controls in place which ensure timely application processing at all staff levels, including sufficient time for supervisory review and corrections. Applications should generally be processed in the order in which received, taking into consideration promptness and delay in receipt of verifications, and in some cases, urgent need. Under no circumstances should an application be approved without the proper verifications and documented eligibility for each applicant.