107 Client Enrollment
Original Approval Date: May 19, 1999,
Revision Effective: June 17, 2015
Supersedes: #181
This policy is established to assure appropriate enrollment and management of clients into current Management Information (MIS) System.
It is important that enrollment and eligibility determination occur simultaneously and involve determining eligibility for services received by members paid for in part or wholly by the Tri-County Board. Upon enrollment a client will be assigned a unique client identifier (UCI) and be entered into the Board’s current MIS system. The UCI is a unique client ID number assigned to the client upon initial enrollment and will be used for claims adjudication and data reporting throughout the system by the ADAMHS Board.
Contract providers shall follow the Confidentiality Policies and Procedures prepared by the Tri-County Board prior to releasing information necessary for payment by the Board.
Enrollment will require the collection of a minimum data set to enroll a client in the system. Providers will furnish the necessary information to enroll the member to appropriate Board staff. These data elements are on the Enrollment (E-1) Form.
Board staff shall follow current guidelines and operating principles for residency determinations in order to appropriately enroll clients into the system.
The sliding fee scale per the Board’s current Allocation Manual will be used to determine the client’s level of financial eligibility for non-Medicaid services. Appropriate rider codes will be entered in the system based on the client’s financial eligibility so that claims will adjudicate properly.
Revision Effective: June 17, 2015
Supersedes: #181
This policy is established to assure appropriate enrollment and management of clients into current Management Information (MIS) System.
It is important that enrollment and eligibility determination occur simultaneously and involve determining eligibility for services received by members paid for in part or wholly by the Tri-County Board. Upon enrollment a client will be assigned a unique client identifier (UCI) and be entered into the Board’s current MIS system. The UCI is a unique client ID number assigned to the client upon initial enrollment and will be used for claims adjudication and data reporting throughout the system by the ADAMHS Board.
Contract providers shall follow the Confidentiality Policies and Procedures prepared by the Tri-County Board prior to releasing information necessary for payment by the Board.
Enrollment will require the collection of a minimum data set to enroll a client in the system. Providers will furnish the necessary information to enroll the member to appropriate Board staff. These data elements are on the Enrollment (E-1) Form.
Board staff shall follow current guidelines and operating principles for residency determinations in order to appropriately enroll clients into the system.
The sliding fee scale per the Board’s current Allocation Manual will be used to determine the client’s level of financial eligibility for non-Medicaid services. Appropriate rider codes will be entered in the system based on the client’s financial eligibility so that claims will adjudicate properly.
