M E M O R A N D U M

IM-28 02/19/03 PREMIUM AND SPENDDOWN INVOICE SCREEN, MPNI


SUBJECT:
PREMIUM AND SPENDDOWN INVOICE SCREEN, MPNI
DISCUSSION:
The MPNI inquiry screen has been developed to provide information regarding invoices for MC+ CHIP premium, Medical Assistance for Workers with Disabilities (MA-WD) premium and Medical Assistance Spenddown cases.  The screen will be available 02-18-2003 for those who are able to access the MSPI screen.  A sample copy of the MPNI screen is attached.

To access the screen, type MPNI and enter.  It will give a message: PLEASE ENTER VALID CASE ID. Type M1 and the eight digit DCN. Sample: M199999999.  For couple cases, you must enter the case head DCN.

The screen contains the following fields:

Case ID:  Type of Assistance and case head DCN 

Last Coverage Date:  Last date client is covered for services until a more current invoice is satisfied.

CASE STATUS:  Status in the premium invoice system

Pending:  invoices created but has taken no action to pay or present bills.

Active:  invoices created and have paid premium amount or presented bills.

Closed:  no longer receiving invoices.

Note:  if recipient is active then for some reason is closed, then reopened, the case status will be pending until another invoice is paid or bills presented.

Current Program:  The program recipient is currently receiving invoices for.  If status is closed, program will reflect recipient's last participation. 

Operator ID:  Used by DMS.

Next Notice Type:  The type of action or notice that is due next for the recipient:

Recurring Closing:  If next month's coverage is not paid in advance; the client's lock-in (MSPI) will be closed at the end of the current month.

Initial Invoice:  First invoice for new or re-opened cases.

Recurring Invoice:  Regular monthly notice for an on going participant in the premium invoice system.

ACH Confirmation:  Notice that premium amount has been withdrawn from recipient's bank account.

ACH Insufficient/Return:  Notice automatic bank withdrawal was insufficient or returned.

No Invoice:  A spenddown case is still active, but the state has ceased to send written invoices to the recipient.  This would occur after 6 consecutive months of no action (payment or presentation of bills)-figured using last coverage date. Programming has not been completed for this.

Final Invoice:  For MAWD, a recipient will receive a final written notice after 3 consecutive month's of non-payment---figured using last coverage date.  Programming has not been completed for this.

Final Closing:  Notice that a recipient's premium and IM case (eligibility) has been closed.

PGM:  Program for which that invoices applies.
SP - Spenddown
MW - MAWD
CH - CHIP
Invoice Type/Num:  Type of invoice code and the invoice number, the codes are:
R - for recurring
I - for initial
A - no invoice sent, but client must present bills to receive coverage.
Invoice Date:  For MAWD and spenddown this is the month covered by invoice. For CHIP it is the month the invoice was sent. 

INV Status:  Status of invoice

OPEN:  no action has been taken to satisfy the invoice.
PAID:  invoice has been paid.
BILLS:  invoice satisfied by presenting bills.
INSUF:  insufficient payment.
ELG CLS:  pending invoice closed due to a loss of IM eligibility.
CLS:  other close.
Premium Amount:  Amount of spenddown, MAWD or CHIP premium needed to satisfy the invoice.
If ADJ is shown, premium or spenddown amount has been adjusted. Once an invoice has been created it will only be adjusted if it is for a future month and the amount due is being decreased due to a change entered in IMU5.
Notice Type:  Type of notice that has been sent to recipient.The notice types are listed above under Next Notice Type field.
Note: Invoices created for automated bank withdrawal recipients or for those being sponsored by another agency (Dept. of Mental Health, Dept. of Health, Missouri Kidney Program) will not show a notice type or date as the invoice is not mailed to the client.
Notice Date:  Date notice was created and mailed to the client. 

ID:  Used by DMS.

NECESSARY ACTION:
  • Review this memorandum with appropriate staff.
DS
Attachment
Distribution #6 

IM-27
[ 2003 Memorandums ]
IM-29