If a client receives a new Medicaid CIN, you may have to create a new record for the client in FCM. To view how to create a new record for a member who has a new CIN, please check out this snippet below:
Closing a Member's Segment Under the Inactive Medicaid CIN
The first thing that Users can do is reflect the member's "closure" under the inactive CIN's chart. Identify the last month the member had active coverage under the current CIN. The last day of that month will be the end date of the member's segment.
For example, if your member's Medicaid was inactive as of 6/1/2022, then your member's segment could look like: 1/1/2022 - 5/31/2022.
The End Reason Code that should be used is code 05 - Individual has new CIN
For members enrolled in Children's Health Home, entering the new CIN number, when ending the segment for the prior CIN, will notify the Capacity Management Team of this change, who will make adjustments to K-Codes accordingly--one less administrative step for our Users!
Choosing the End Date Reason Code - 05 will prompt a drop down menu to appear for the User to enter in the new Medicaid CIN number. Hovering over the Tool Tip will give Users an explanation and guidance on this data point:
From the State:
- Individual has a CIN change (05) - When a child has a CIN# change, MAPP HHTS requires that the member's segment under the old CIN# be end dated for the member and then a new segment be created under the member's new CIN#. When end dating the segment under the old CIN#, "segment end date reason code" of Individual has a CIN change (05) should be utilized and the new CIN# should be entered in the New CIN# field on the Tracking File Segment Records to connect the cases. The "segment end date reason code" of Individual has a CIN change (05) will flag the Capacity Management Team that the CIN# has changed, and the K-codes will be changed accordingly.
- NOTE: The UAS must be updated with the new CIN# at the same time to ensure connectivity with the new segment in MAPP HHTS and the UAS assessment record.
- The HH Care Manager will not have to send a separate secure file transfer (SFT) email through the Health Commerce System (HCS) to end the member's K-code
*To view the guidance from the State regarding code 05, please see the link here.
Users can utilize the Patient Flags option to note that the chart houses the member's inactive CIN.
Creating a New Segment Under the Active Medicaid CIN
Once the closure is reflected in the member's old chart, the User can move forward with documenting under the chart with the member's active Medicaid CIN.
Users can check to see if the record already exists in the entire FCM platform. To do this, click on the New Patient button on the top right corner of the Patient Search window:
Enter the Medicaid CIN and Create Chart. If the member chart exists in FCM, a message will pop up in red telling you that this record exists and under which organizations.
If this is the case, please follow the workflow for chart transfers linked here.
If the member chart does not exist, the system will prompt you to enter in the rest of the member's minimum required demographic data:
In order to identify the prior CIN in the new record to reference back to, you can add the member's prior CIN under "other patient details" on the new record. You can see these "other patient details" within the record itself (seen here) as well as when exporting a CSV from the main patient screen.
After creating the new member chart, the User can create a new segment the month following the inactive CIN's segment was closed, usually aligning with the month the member's current CIN was activated.
For example, your member's previous segment under the inactive CIN was 1/1/2022 - 5/31/2022. The segment under this active CIN can begin as of 6/1/2022.
We are unable to have documents and encounters automatically transferred over to the new record, however, if needed, Users can reach out to FCM for assistance with transferring a copy of the member's latest care plan and biopsychosocial comprehensive (native) assessment that were completed under the member chart with the inactive CIN number to help maintain the continuity of care. Additionally, if Users wish to bulk import encounters originally documented from the prior chart to the new chart, we do have an Encounter Importer article here for some guidance. Note, any PDFs that were uploaded to the member's chart in place of a live biopsychosocial comprehensive (native) assessment, can be re-uploaded by the CMA user into the new chart; this document is not transferrable through our current copy method.