To view a snippet video regarding Pended Segments, please click here.
A member can be put into a pended segment for the following reasons:
- Diligent Search
- Inpatient Stay
- Hospitalization or Inpatient Facility for Medical Treatment
- Hospitalization or Inpatient Facility for Psychiatric Treatment
- Detention or Juvenile Justice Facility
- Inpatient or Residential Facility for Detoxification or Chemical Dependence Treatment
- Nursing Home
- Waiting for Fair Hearing Judgment
- Post-Disenrollment Notice Period
How does a user put a member into a pended segment?
This applies to moving a member from enrollment to a pended segment and moving a member from one pend reason to another.
1. Go to the member's Segment tab in the record. Confirm the member has an open enrollment or open pended segment. (In other words, there can be no end date assigned to the segment.)
2. Click "Pend Segment" in the upper right-hand corner.
3. Choose the pend start date and pend reason.
4. Hit the "Pend" button.
How do you put a client into a pended segment from an existing pended segment?
This scenario is not as common, but is possible.
For example, if a member was placed into diligent search for a month and was found to be in an excluded setting the following month, a User may want to reflect this by pending due to other the following month.
Users can do this by going into the active segment and clicking on the Pend Segment button on the top right:
From here, Users can enter in the information needed to create a Pended Segment, which include the date the new Pended Segment stat date and the reason. Once saved, the back to back Pended Segments in the member's Segments tab will be viewable:
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