Worker Responsibilities:

Determining Best Estimates

1. Refer to Section M903 for information on determining best estimates.

Determining Countable Income

1. Refer to Section M901 to determine if income is countable.

Determining Countable Resources

1. Refer to Section M801 to determine if resources are countable.

Calculating Resource Transfer Penalty

1. Refer to Sections M803 and Section M804 for information on nonexempt resources and related penalties.

Accessing Waiver System to Determine Eligibility

1. Access the Medicaid Waiver System to determine status of the waiver process and verify the Clinical Eligibility requirement has been met.

Log into Medicaid Waiver System by Clicking on the "Waiver System" tab in ECOM or access at https://waivers.health.wyo.gov .

Enter your user name and password. Click on the "Log In" button.

Review the Confidentially Agreement, Check the box indicating that you agree, and Click on the "Continue" button to proceed. This agreement must be completed the first time you log into the system and is required again every 45 days.

2. Complete assigned tasks for applicants who are in the Medicaid Waiver System and meet the eligibility requirements.

Click on the "View" icon next to the Last Name. The system will take you to the next screen and prompt you on what action needs to be completed.

View , under Eligibility, a check mark by the Clinical Eligibility requirement.

The system will show Eligibility under Process and Financial Eligibility as the Status: Click on Has met the income and resource eligibility requirements. Click on "Save" and "Complete." This will complete the task and remove the case from your task list.

The system will communicate the eligibility determination and place the individual on a waiting list.

Pend the case in WES until a Plan Of Care is approved and a start date is provided through the Medicaid Waiver System.

Send a Pending Notice in WES when the individual meets all eligibility requirements

3. Complete assigned tasks for applicants who are in the Medicaid Waiver System and do not meet the eligibility requirements.

Click on the "View" icon next to the Last Name. The system will take you to the next screen and prompt you to complete the required actions.

View the Status, Financial Eligibility or Confirm Financial Eligibility : Click on Has been denied financial eligibility . Click on "Save" and "Complete." This will complete the task and remove the case from your task list.

The System will communicate the eligibility determination and notify the waiver program of the denial.

4. Complete a search for an existing waiver client who is being closed or an applicant who is on the waiting list who is being denied.

Click on the "Search Cases" tab.

Fill in any combination of information to find a client.

Click on the "Search" button.

Click on the "View" icon next to the client's name.

Click on the drop down menu to select a reason for accessing this case and Click "Save."

Enter closure or denial reason, the date the client was notified and the effective date of the closure or denial.

Click "Close."

5. Receive notification from the Medicaid Waiver System when an applicant has a funding opportunity.

Redetermine financial eligibility if 60 days has passed since initial application.

Access the Medicaid Waiver System.

View the Process, Funding Opportunity and Status, Confirm Financial, found under your assigned tasks. Click on Has met the income and resource eligibility requirements or Click on Has been denied financial eligibility . Click on "Save" and "Complete." This will complete the task and remove the case from your task list.

Notification will be sent from the Medicaid Waiver System with the approved Plan Of Care start date.

Authorizing Cases in WES

1. Complete updating resources and income in WES in the month of application and the first month of waiver eligibility forward to maximum benefit month.

Closing Cases

1. Finalize eligibility and close benefits in WES when the applicant is no longer eligible

2. Allow 15-day closure notice when an adverse action has occurred.

3. Access the Medicaid Waiver System to communicate the eligibility determination.