medicaid eligibility and patient liability determinations - Kymmis.com

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LOC passing to DCBS workers SHP’s, our PRO, receives the request for LOC and makes the medical determination. For the following Once LOC is approved it passes to KAMES: • NF/PRTF/Free Standing Facility • HCB Waiver, and • Model Waiver II For all other’s the LOC passes when a service is PA’ed.
The LOC passed to KAMES includes: • The admit dates; • The date LOC was met; • The provider number; and • The date it was passed to DCBS.
Page 1 and 2: MEDICAID ELIGIBILITY AND PATIENT LI
Page 3 and 4: Medicaid Application Process Kentuc
Page 5 and 6: Federal Eligibility groups • Mean
Page 7 and 8: Eligibility Systems • KAMES-Kentu
Page 9 and 10: Basic Medicaid Eligibility • Must
Page 11 and 12: Medicaid Financial Eligibility For
Page 13 and 14: Look Back Rules With the passage of
Page 15 and 16: Spousal Impoverishment Rules Income
Page 17 and 18: Cost Share Rules • When receiving
Page 19 and 20: Income limits for LTC • Under the
Page 21: Active member’s with a new LOC Fo
Page 25 and 26: LOC for SSI recipients There are va
Page 27 and 28: LOC for an SSI recipient What can y
Page 29 and 30: LOC for non-SSI Active Members If t
Page 31 and 32: LOC for non-Medicaid individuals
Page 33 and 34: LOC for non-Medicaid individuals Th
Page 35 and 36: PATIENT LIABILITY DETERMINATIONS Th
Page 37 and 38: • For example. Undue Hardship - M
Page 39 and 40: Frequent Problems and Resolution
Page 41 and 42: Frequent Problems and Resolution

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