MC RD is NOT Returned

If after the two required contacts the client still has not returned the MC RD forms or provided the requested information, an adequate and timely discontinuance NOA must be sent to the client for failure to complete the redetermination process. The discontinuance action is effective on the last day of the month the RD is due, provided a timely NOA can be issued to the client. The NOA must explain the reason for termination and have the 90-Day Cure Period information.

If the client provides the requested information before the discontinuance action, the discontinuance must be rescinded.

Note: The MEDS termination code will be auto-generated when the client fails to complete the RD process.

Automated Reminder Notice

CalSAWS will auto trigger the “Medi-Cal Reminder Notice” (CSF 164) following the renewal packet generation month. A second reminder notice will be sent later in the same month.

ExampleExampleThe MC RD is due in September. The MC RD packet is sent to the client in July. If the MC RD packet is not received, CalSAWS will auto-generate the CSF 164 and send it to the client in August. The client will receive a subsequent reminder notice later in the month of August.

Automated Reminder Calls

Following the automated BRE run, cases that did not successfully auto renew will receive an automated outbound reminder call made to the Home Telephone number. This call reminds the clients who have not returned their RD packet or provided the information requested of their RD packet due date. [This information is being validated by the CalSAWS MC Facilitator, updated guidance TBD]

The reminder call(s) will be placed to the Day Telephone for LTC cases.

Message

The first automated outbound reminder call will occur on the 22nd of the month before the RD due month and will state:

This is an important reminder for [1] [2]. A redetermination packet was mailed to you a few weeks ago. Please return the completed forms and the required verification or call us with the information in order to continue receiving your benefits. If you have already returned your forms, please disregard this call. Thank you.

This message will repeat.

This is an important reminder for [1] [2]. A redetermination packet was mailed to you a few weeks ago. Please return the completed forms and the required verification in order to continue receiving your benefits. If you have already returned your forms, please disregard this call. Thank you.

The second automated outbound reminder call will occur on the 5th of the RD due month and will state:

This is a second reminder for [1] [2]. A redetermination packet was mailed to you several weeks ago. Please return the completed forms and the required verification or call us with the information in order to continue receiving your benefits. If you have already returned your forms, please disregard this call. Thank you.

This message will repeat.

This is an important reminder for [1] [2]. A redetermination packet was mailed to you several weeks ago. Please return the completed forms and the required verification or call us with the information in order to continue receiving your benefits. If you have already returned your forms, please disregard this call. Thank you.

[This information is being validated by the CalSAWS MC Facilitator, updated guidance TBD]

Missing or Invalid Telephone Numbers

An exception report will be produced for cases which the automated outbound reminder call was not made due to missing or invalid telephone numbers. These cases will be mailed a reminder notices. Central Support Services will generate and mail these notices. The mailed notice states the following:

Your Medi-Cal redetermination is due this month. We have not received your redetermination packet. Please send your redetermination forms that were mailed to you last month if want to keep your Medi-Cal.

If you have already provided your Medi-Cal redetermination forms for this month please disregard this notice.

Thank you.

Automated Reminder Text Messages and Emails

Text Messages

Similar to the automated reminder calls, the first automated reminder text message is sent on the 22nd of the month before the RD due month. The message states:

Reminder for [Client’s Name]. Pls return the completed forms sent to you few weeks ago plus required verifications to keep receiving your benefits.

The second automated reminder text message is sent on the 5th of the RD due month. The message states:

2nd Reminder for [Client’s Name]. Pls return the completed forms & required verifications sent to you a few weeks ago.

Emails

The first automated reminder email message is sent on the 22nd of the month before the RD due month. The message states:

Notification for: [Client’s Name]. This is an important reminder for [Client’s Name]. A Medi-Cal recertification form was mailed to you a few weeks ago. Please return the completed forms and the required verification or call us with the information at the number indicated on the forms in order to continue receiving your benefits. Disregard this message if you have already returned your forms or otherwise contacted our office. Thank you.

The second automated reminder email message is sent on the 5th of the RD due month. The message states:

Notification for: [Client’s Name]. This is the second reminder for [Client’s Name]. A Medi-Cal recertification form was mailed to you a few weeks ago. Please return the completed forms and the required verification or call us with the information at the number indicated on the forms in order to continue receiving your benefits. Please disregard this message if you have already returned your forms or otherwise contacted our office. Thank you.