End Stage Renal Disease (ESRD) Medicare

What is ESRD Medicare and what assistance DHS can offer

Process for Closing Medical (Death)

Process for closing medical on reason of death.

Social Security Early Retirement and Categorical Relationship

Impact of Early Retirement on Eligibility

BIL: Buy-In History Inquiry Transaction Codes

List of transaction codes under “TRANS CODE” for BIL

How to Certify QI-1

QI-1 can be certified effective three months prior to the month of application, if all factors of eligibility were met all three months. For additional information regarding factors of eligibility for QI-1, refer to article ABD: Qualified Individuals – Group 1 (QI-1). If all factors of eligibility were NOT met prior to month of application, […]

Citizenship and Identity Verification

What is acceptable verification of identity and citizenship?

PACE – Services Provided by PACE

Services provided by PACE

PACE – Eligibility Requirements

Eligibility Requirements for PACE

Buy-In – Medicare Buy-in Problems and Solutions

If there are any issues with the Buy-In, look over the following items to verify that they are correct on the case: Certification period 12 months Claim number on Bendex (Block B07) Medicare cards are now issued with a new Medicare number that is unique to the beneficiary instead of using SSN-based Health Insurance Claim […]

How to Code Third Party Liability (TPL)

Information regarding Third Party Liability (TPL) needs to be coded on the TPL tab in FACS so that the Oklahoma Health Care Authority (OHCA) can make sure the private insurance covers their part before OHCA pays anything on a bill. Make a copy of the insurance card so the information from that card can be […]