- TO:
- ALL COUNTY OFFICES
- FROM:
- ALYSON CAMPBELL, DIRECTOR
- SUBJECT:
- REVISED SPEND DOWN NOTIFICATION (IM-29(SPDN)) FORM
- Forms Manual Revision #6
DISCUSSION:
Effective January 24, 2013, a new version of the Spend Down Notification (IM-29(SPND)) form is available. Revisions to the form have been made based on recommendations from providers and staff. Revisions include:
CLARIFICATION OF WORDING
Changes include:
- The notification that someone has met spend down is now on the first page. A check box is added. All other sections of the form have been moved down to accommodate this change.
- Check boxes have been added to the partial payment and bills not used to meet spend down sections.
- Clarification of when the participant chooses to have allowable medical expenses exceeding their spend down amount applied to future months. The individual must designate a month(s) to apply owed medical expenses, or the expenses will be applied to the current month and that he/she may not change the month(s) once designated.
- The column heading "You Are Responsible For The Following Amount On Your MO Healthnet Coverage Start Date " is changed to "Amount Of Spend Down Met On Start Date ".
ADDITION OF A COLUMN FOR ENTRY OF PARTIAL PAYMENTS
A new column is added to the second table in this document to allow the eligibility specialist to enter the amount of a partial payment provided in addition to the allowable medical expenses provided by the participant and the amount of the spend down expense remaining in the month columns.
CHANGE IN FORMATTING
Changes were completed to allow for the automatic population of the participant's name and DCN on the Spend Down Option page when the eligibility specialist enters this information on page one and selects the "client info to envelope" on the add-ins tab.
NECESSARY ACTION:
- Review this memorandum with appropriate staff immediately.
- Immediately begin using the IM-29(SPND) with revision date 01/2013
- Discard older version of this form.
ATTACHMENTS:
MKS