Policy Directive                                                                          Issuance Number: MS 08-09

Medical Services Policy Manual                                             Issuance Date:       05-29-08

From: Joni Jones, Director                                             Expiration Date: Until Superseded

Subj:  Closing ARKids A and B Cases

After discussion with Field Operations, Program Support Specialists and input from field staff, the following procedures have been developed to assist the county worker when closing an ARKids A (SOBRA Woman and Children) budget unit to open an ARKids B budget unit and vice-versa.  The procedures will help prevent billing problems that occur when changes to Medicaid dates are not submitted correctly to EDS as well as prevent inappropriate PCP closure.  These procedures reflect a three day process. This directive replaces the procedures outlined in Screen Message 1584 dated June 30, 2004. 

Closing ARKids A to Open ARKids B

When closing an ARKids A to open an ARKids B, an advance notice is required because it is a reduction in coverage.  For each child included in the ARKids B budget unit, the appropriate ARKids General Characteristic must be selected. The following are the required steps in completing this procedure.

§         Master Case Notebook Budget Units Tab - double-click on the SOBRA Woman and Children budget unit. 

§         Budget Unit Status - add a line of Closed with reason “Eligible in Another Category (085)” and save. 

§         Budget Summary Tab - click on the Budget Unit Size Comp button and enter the appropriate Medicaid end dates for each child and save. 

§         Submit the budget and close from the WAFM/WACE interfaces.

§         Register the ARKids B application (using the same budget unit).

§         Process a new budget with the appropriate members. 

§         In Budget Summary click on the Budget Unit Size Comp button.   Enter the appropriate Medicaid begin dates on the children (Medicaid begin date must be one day following the end date on the previous ARKids A) and zero out the end dates and save.

§         Wait two full days before submitting to prevent a billing error.

§         Submit the budget and reopen on the WACE interface using action type “Approved-Reopen of Existing” and reason “Approved Medicaid”.

Closing ARKids B to Open ARKids A

The following are the required steps in completing this procedure.

• Master Case Notebook Budget Units Tab - double-click on the ARKids B budget unit.

• Budget Unit Status - add a line of Closed with reason “Eligible in Another Category (085)” and save.

• Budget Summary Tab - click on the Budget Unit Size Comp button and enter the appropriate Medicaid end dates for each child and save. 

• Submit the budget and close from the WAFM/WACE interfaces.

• Register application for ARKids A (using the same budget unit).

• Process a new budget with the appropriate members. 

• Budget Summary - click on the Budget Unit Size Comp button and enter the appropriate Medicaid begin dates on the children (Medicaid begin date must be one day following the end date on the previous ARKids B) and zero out the end dates and save.

•  Wait two full days before submitting to prevent a billing error.

• Submit the budget and reopen on the WACE interface using action type “Approved-Reopen of Existing” and reason “Approved Medicaid”.

Other Changes to Medicaid Dates

A billing problem occurs when changes to Medicaid dates are not submitted correctly to EDS.  To prevent an error in billing it needs to be a three day process as follows.  

• Wait two full days (e.g. Monday 9:30 a.m. to Wednesday 9:30 a.m.)

• Enter the new begin date for Medicaid.

• The above action should be taken within the same month.  If actions will overlap into another month, do not begin the process until the following month.  PCP will remain in open status as long as this action is completed in the same month.

Inquiries to:    Judy Key, 501-682-8259

                        Carmen Banks, 501-682-8258

                        Carla Droughn , 501-682-8254

                        Dona Young, 501-682-1562  

                        Bernice Perkins, 683-4146