The presumptive eligibility (PE) processes will continue to operate with CoreMMIS. Advocates and Qualified providers (QPs), will use the new Portal to submit PE applications beginning February 13, 2017.
Functionality for processing PE applications will remain available throughout the transition to CoreMMIS and the Portal. The transition of processing PE applications from Web interChange to the Portal will occur between 12 midnight and 6 a.m. on February 13, 2017. When the Portal begins processing PE applications, this functionality will be disabled in Web interChange.
Although PE applications will continue to process, the transition may affect eligibility verification processes in the days immediately preceding implementation. Members determined presumptively eligible during the transition period (between 12 midnight and 6 a.m. on February 13, 2017) will continue to receive an eligibility approval letter, which should be honored as proof of eligibility. Please RE-VERIFY eligibility for members served during the transition time frame after CoreMMIS is implemented. Please contact your manager if discrepancies are identified.
Presumptive eligibility RID numbers assigned differently with CoreMMIS
With CoreMMIS implementation, PE members may be assigned RID numbers with the “600” or “550” PE prefix or RID numbers with a “100” or “120” prefix, depending on the member’s circumstances.
- PE members already in IndianaAIM with a 600 or 550 RID number when CoreMMIS is implemented will be
converted automatically to CoreMMIS with their PE RID numbers.
- New PE members enrolled after CoreMMIS implementation will receive a 600 or 550 PE RID number UNLESS the system finds an existing RID number for that individual from an earlier IHCP enrollment. In these cases, the preexisting RID number for the individual will be assigned and printed in the presumptive eligibility determination letter; these PE members will not receive new 600 or 550 PE RID numbers.
- If more than one pre-existing RID number is identified for a newly applying PE member, the member will be assigned a new 600 or 550 PE RID number.
For members receiving the 600 or 550 PE RID numbers, the PE RID number will be linked to the IHCP enrollment RID number when the member completes an Indiana Application for Health Coverage and is officially determined eligible for IHCP coverage. Providers should bill with whatever RID number is assigned, per the eligibility verification system.
When checking eligibility, it will be very important to pay attention to what program the individual is showing eligible for as PE members may now have “100” or 120″ prefixes.