When editing an individual's demographic information, you are able set up the Medicaid eligibility of that individual. This will allow you to easily control whether an individual's case notes are billable or not, regardless of what services your SSAs select when case noting on them.
Click the Add Entry button to add an entry. If the individual is Medicaid eligible, check the "Medicaid Eligible" box and set a Start Date. If you leave the End Date blank, that person will be eligible into the future. Note: You cannot set a start date before an individual's 3rd birthday.
If the individual is temporarily Medicaid ineligible, leave the "Medicaid Eligible" checkbox unchecked and select a reason from the Reason dropdown. These reasons are:
- Developmental Center
- ICFMR
- Incarcerated
- Juvenile Detention
- Medical Institution
- Nursing Home
Automatically Billing Back 180 Days
Once an individual leaves an ICF, for example, you can automatically bill 180 days prior to the exit. To do this, set an end date to the Medicaid Ineligible entry and check the "Billable 180 Days Prior to End Date" box. Once you do this, the system will automatically convert Allowable case notes to billable 180 days prior to the end date.