Customer Contact Center Food Stamp/Family Medicaid Phase II ...

Call Center Food Stamp Phase II PG October 24, 2007
Adding and Deleting People
UPDATE REMARKS - REMA REMA
XXXXXXXXXXXXXXXXXXX NEWBORN REPORTED XXXXXXXXXXXXXXXXXX
DATE SGCC WORKED CASE: 8/20/2007 2:02:02 PM
DATE OF REPORT IS: 10/05/06
METHOD OF CONTACT (X )PHONE ( )FAX ( )MAIL ( )OTHER
CONTACT'S NAME/SOURCE: Margaret Simmons
NEWBORN'S NAME: Michael S. Simmons DOB:10/03/06 SEX: M RACE:B
ENUMERATED AT HOSPITAL? YES CONFIRMATION OF BIRTH? YES
IS BABY 2 MONTHS OR OLDER? NO IMMUNIZATION VERIFICATION? N/A
OTHER PARENT INFO: A/P’s Name Jack Owens
****************SEE DEM FOR DEPRIVATION****************
BIRTH MOTHER'S CURRENT MEDICAID COAS: N/A
A/R WOULD LIKE PERSON ADDED TO: FS(X ) TANF( ) MED( )
NEWBORN'S INCOME/RESOURCES: NONE
SFU ( )YES ( )NO ( X )NOT APPLICABLE
FAMILY CAP CHILD ( )YES ( )NO ( X )NOT APPLICABLE
IF NO, WHY NOT:
TYPE OF VERIFICATION:
FORMS SENT( )C173 ( )A130 ( )C809
03 More
SENT DATE:
DUE DATE:
REMARKS:
ENTER NAME, LOAD AND TEL #
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STAT A
• press enter to DEM1 for Michael
PG-11