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Model Application Template for the State Children’s Health Insurance Program

Effective Date:

Approval Date: 8 • Provider bulletins that contain policy changes and clarification and claims processing updates are issued.

• Brochures and other information are distributed in local offices and to groups when presentations are made to community groups, other agencies, and professional organizations.

• News releases are issued regarding new initiatives and reports as well as when public hearings will be held. Several news releases regarding Kids Connection have been issued to date.

• The Health and Human Services System employs a full-time system advocate accessible through an 800 number to assist individuals with questions or concerns.

• The agency communicates with client advocacy groups, the Medicaid Medical Care Advisory Committee, the Client Advisory group, and the Physician/Office Staff Advisory group during the rulemaking process to address and obtain input regarding policy issues and agency procedures that impact clients and providers.

• A number of educational/promotional materials are utilized such as HEALTH CHECK posters, HEALTH CHECK video, provider training materials, local office training, and managed care enrollment materials.

• The Health and Human Services System has developed a web page that has information about the various programs and services provided by the System. The web page now has information on Kids Connection with plans to update the information as needed. The web site also has basic information about Medicaid program service coverage and application sites.

• The 800 numbers for agency access for information and for applications are currently listed on HCFA’s (CMS’) web site.

• The local HHSS offices accept mail-in applications for Medicaid eligibility.

• The agency utilizes outstationed eligibility sites in a number of hospitals where hospital staff complete the eligibility applications with patients and send them to the local HHSS office for eligibility determination. The local office staff liaisons with the outstationed eligibility providers regarding training and information and contract payment.

• There are currently 13 presumptive eligibility (PE) providers statewide where