Phone calls concerning the following issues should not be referred to DMS Recipient Services Information toll-free number:

Eligibility entries and corrections,

Managed care enrollment and disenrollments,

Lost Medicaid/MC+ cards,

Address changes

If a correction should be made with regard to a period of eligibility DFS staff is responsible for making this change.  Notify the recipient of the eligibility change in writing.  It is the responsibility of the recipient to notify the provider of coverage.  If the change can not be processed in the county office, contact Income Maintenance Program and Policy Unit for assistance.

Calls concerning moves between managed care counties and non-managed care counties and vice versa should not be referred to DMS.  Managed care enrollments and disenrollments are based on IMU5 transactions entered into the system.  Disenrollments are processed through an IMU5 transaction entered changing the residence county.  The move date entered Field 10B will be the date of the disenrollment.  Should corrections be required with regard to this date, contact Carol Wiles by email at WILEDHH.

DFS staff is responsible for requesting replacement Medicaid/MC+ cards by using MREP when a recipient reports a lost, damaged, or stolen card.  However, if a recipient contacts us about a card not working and we have determined eligibility is active and correct within our system, it would be appropriate to refer this individual to the Recipient Services Information toll-free number.

DFS staff should not advise recipients with regard to covered services.  These type of inquiries should be directed to Recipient Services.

Recipients contacting DFS staff concerning medical transportation should refer fee-for-services recipients to 888-863-9513 and managed care recipients to their MC+ managed healthcare plan.

Under no circumstances should we direct or encourage recipients to come to the DMS Premium Collections Unit in Central Office.  If recipients have questions about the premium payment, including how to expedite payment, direct them to the Premium Collections Unit at 1-877-888-2811. They are not set up to see recipients in person.

Because of the large volume of phone calls, it is important DFS staff cooperates by not making inappropriate contacts or referrals.

• Review this memorandum with appropriate staff.