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Medicaid programs, or if financial information in the case file is not reasonably current, verification of the additional or updated information must be requested from the household or obtained by the eligibility case manager before the exparte review is completed. It may be helpful to obtain a completed Medicaid redetermination form from the household to use as a tool in determining eligibility for other Medicaid programs. However, the household's failure to complete and return a completed Medicaid redetermination form in an exparte process is not a basis for denial of Medicaid benefits. If the case is found to be eligible for another Medicaid program during an exparte process, the "new" Medicaid program should be opened. The household must not be instructed or required to reapply for benefits before the "new" Medicaid program can be opened. Before opening a medically needy program, contact the client to determine if a need exists. If the household fails to provide proof of previously reported changes or the eligibility staff member is unable to obtain the verification independently, the exparte review is considered complete. Case note the exparte process and the outcome. PROVIDER NOTICE OF ELIGIBILITY DETERMINATION: Providers can bill and receive payment for services up to 365 days after the date Medicaid eligibility is authorized, or the date of services, whichever is later. When the 365-day billing window has expired (or is nearly expired) prior to Medicaid authorization, the eligibility staff member creates and sends the provider notice of eligibility determination notice to known providers. The provider notice of eligibility determination may also be used when eligibility is approved retroactively. Certain services (such as ambulance services or psych-related services) require pre- authorization. If Medicaid is not authorized prior to the date of service, a provider notice of eligibility determination notice is required for the provider to receive Medicaid payment. The notice is not completed when: 1. Medicaid was open at the time of service, but the provider failed to bill timely, or 2. The Medicaid client did not tell the provider he/she had Medicaid coverage when the services were provided. REAPPLICATION: When a case has been correctly closed and the effective date of closure has passed, a new application is needed to reinstate Medicaid coverage. Reapplications are processed in the same manner as original applications.