Approvals - General Information

MEDS-ID (SSN)

This is the PRIMARY identifier in the MEDS Network.
When the MEDS Network receives an Add transaction from CalSAWS/CalHEERS, a MEDS and/or CDB record is established for the person. MEDS/CDB activates the record(s), using the Social Security Number (SSN) contained on the person’s SSN Detail page in CalSAWS, or on the Household Members page in CalHEERS, as the PRIMARY ID.

MEDS-ID (Pseudo)

When an Add transaction is generated by CalSAWS/CalHEERS and the SSN field on the SSN Detail page or on the Household Members page contains no SSN, MEDS/CDB searches for a prior record on the database. If a prior record in a pseudo number is located and there is a match in the COUNTY-ID (excluding Aid Type and FBU), the MEDS/CDB record is reactivated using the prior pseudo number. If no prior record is located, MEDS/CDB activates a new record, assigning a pseudo number as the PRIMARY ID.

Currently, Pseudo Numbers cannot be entered in CalSAWS. It is therefore important that the record with the CIN (Client Index Number) attached to that Pseudo Number be selected during CIN Clearance process.

COUNTY-ID

This is the SECONDARY identifier in the MEDS/CDB Network.
When the MEDS Network receives an Add transaction from CalSAWS, and the transaction contains no SSN, the system searches the MEDS COUNTY-ID Cross-Reference file for a match in COUNTY-ID (excluding Aid Type and FBU), to locate the prior MEDS/CDB record. This file clearance search helps to prevent duplicate records.
If, as part of the file clearance process, a match is found for the COUNTY-ID sent in our transaction (excluding Aid Type and FBU), MEDS/CDB will reactivate the prior record with the same pseudo number.
If no match in COUNTY-ID (excluding Aid Type and FBU) is found, MEDS/CDB will activate a NEW record, assigning a pseudo number as the PRIMARY ID. If this recipient has a prior MEDS record in a different COUNTY-ID, a duplicate MEDS/CDB record is created due to Agency error.
If an initial approval transaction (HX20) is from CalHEERS, the COUNTY-ID is sent to MEDS as the following format, County ID-Aid Code-9-CIN (43-M1-9966670-7-7A).

CIN (Client Index Number)

The CIN is a unique statewide identification number assigned by the SCI to an individual. The CIN is used to uniquely identify individuals in SCI for tracking purposes and to store demographic information associated with an individual such as name, DOB, and SSN.

Prior Records - Persons With SSNs

For MEDS/CDB to successfully ‘capture’ or ‘find’ a prior MEDS and/or CDB record, the approval or restoration transaction MUST always contain both the same SSN and birthdate as the prior MEDS/CDB record, EVEN IF THE SSN AND/OR DOB ON THE PRIOR MEDS/CDB RECORD IS INCORRECT.
If an approval/restoration is generated in the CalSAWS via nightly batch or if an initial approval for MAGI Medi-Cal (MC) in CalHEERS, and the DOB and/or SSN is CHANGED at the same time, the Add transaction(s) will reject at MEDS/CDB. The recipient’s MEDS and/or CDB records will not be activated. The recipient will not receive the Medi-Cal benefits to which they are entitled. If the person is also in receipt of CalFresh, their CDB record will not reflect current participation in the CalFresh program.
If the SSN and/or DOB on the MEDS/CDB record is incorrect, the EW MUST USE THE INCORRECT INFORMATION IN MEDS AND WAIT UNTIL THE APPROVAL/RESTORATION IS RECORDED IN MEDS before correcting the information in CalSAWS/CalHEERS and MEDS.

Note: If CalSAWS and CalHEERS have incorrect DOB and/or SSN and MC eligibility is pending for failure to e-verify DOB/SSN, the EW may need to correct DOB/SSN in MEDS first prior to authorizing the case.

Refer to Birthdate/Name/Gender Corrections and MEDS-ID/SSN Changes of MEDS HB Chapter 3 for procedures to change SSN and/or DOB in MEDS/CDB.

Prior Records - Persons With Pseudo Numbers

If the prior MEDS/CDB record has a pseudo number for the MEDS-ID, the MEDS Network cannot locate the record when approval action via CalSAWS/CalHEERS is taken, UNLESS:

The DOB on our transaction matches the DOB on the prior MEDS/CDB record, AND
The correct record containing the matching CIN from the prior record is selected during Person Clearancee, OR
The COUNTY-ID sent in our transaction MATCHES EXACTLY one of the COUNTY-IDs contained in the recipient’s COUNTY-ID Cross-Reference file on the MEDS Network (excluding Aid Type and FBU).

Example: An Add (EW20) transaction is generated via CalSAWS. No SSN is present in the SSN field. The COUNTY-ID contained in our transaction is:

43-34-1B1D111-2-01

The recipient’s COUNTY-ID Cross-Reference file on the MEDS Network contains the following COUTNY-IDs:

19-30-A341967-6-05

17-34-4364545-1-03

43-37-1B1D111-0-01

Because the 14-digit COUNTY-ID (excluding Aid Type & FBU) sent in our transaction is the same as one of the COUNTY-IDs contained in the recipient’s Cross-Reference file, the MEDS Network is able to ‘locate’ the person’s prior MEDS/CDB record, despite our not sending an SSN (Primary ID).

Example: An Add (EW20) transaction is generated via CalSAWS. The record with the matching CIN and DOB from the client’s closed MEDS/CDB record is selected during Person Clearancee. The COUNTY-ID contained in our transaction is:

43-14-BB21211-0-02

The recipient’s COUNTY-ID Cross-Reference file on the MEDS Network contains the following COUNTY-IDs:

16-35-1045261-9-05

01-34-0899453-0-01

While the 14-digit COUNTY-ID sent in our transaction DOES NOT MATCH any of the COUNTY-IDs contained in the recipient’s Cross-Reference file, the MEDS Network is able to ‘locate’ the person’s prior MEDS/CDB because during Person Clearance, the record with the CIN attached to that Pseudo Number from the closed MEDS/CDB record is selected.

Time Limitations of Approvals

If the effective date for the approval is MORE THAN 8 MONTHS prior to the current MEDS month, only the months within the 8-month period will be accepted by MEDS. Approval transactions that are older than 8 months must be done via an online MEDS transaction generated by the MEDS Terminal Operator (MTO). Otherwise the Add (EW20) transaction for the prior month(s) will be rejected by MEDS.

Example: If December is the current MEDS month, and the effective date of the approval is March, the approval transaction would be accepted for May through December (8 months). The MTO must generate the transaction to approve March and April (month 9th and 10th).

Day 1: Complete the relevant Data Collection pages with March as the Effective Begin Date, run EDBC, and Accept and Save resultsresultsthe results.

Day 2: Submit a “Request for Online Transaction” (SCD 1296), requesting that the MTO generate a transaction to activate the months of March and April.

Approvals - SSN Erroneously Being Used by Another Person/County

To approve a recipient whose SSN is erroneously tied up on someone else’s MEDS/CDB record, follow the procedures listed below.

EWs should always run a query on each person’s SSN in MEDS PRIOR TO processing an approval transaction. This ensures that the SSN is not currently being used erroneously by another person, which in turn ensures that the transaction to MEDS/CDB will be successful. This query will also ensure we have not erroneously entered someone else’s SSN.

Note: If an SSN is verified and being used by another person in a different case in our county, the EW should request the SSN removal in CalSAWS/MEDS prior to entering the SSN into the correct case. A GadWIN ticket will not be needed.

If the SSN has NOT been entered into CalSAWS and CalHEERS:

Do not enter the SSN.
Use a new CIN for our client.
CalSAWS will generate an Add (EW20) transaction with no SSN, and MEDS will activate the client’s record with a Pseudo Number.
Open a GadWIN ticket requesting the MEDS Coordinator to release the SSN on MEDS. Attach all pertinent CalSAWS/CalHEERS and MEDS screens to the ticket along with a brief description of the problem.
Once the SSN has released, the EW will be notified via the ticket resolution. Update the SSN on the SSN Detail page.
For MAGI case, send MAGI Eligibility Determination Request (EDR) to CalHEERS for SSN update, run EBDC and Accept and Save results.
CalSAWS will generate an MEDS-ID Number Change (EW10) transaction to replace the Pseudo MEDS-ID with the SSN MEDS-ID. Check MEDS in two working days.

If the SSN has ALREADY been entered into CalSAWS and CalHEERS:

If the SSN is already present in CalSAWS and CalHEERS or approval is taken with the SSN and the transaction rejects due to SSN being used by another person/county, follow the procedures below:

Remove the SSN from the SSN Detail page.
For MAGI case send MAGI Eligibility Determination Request (EDR) to CalHEERS for SSN update, run EBDC and Accept and Save results.
CalSAWS will generate an Add (EW20) transaction with no SSN. MEDS will activate the client’s record with a Pseudo Number. If necessary, submit the SCD 1296 requesting EW20 online transaction to activate the client’s eligibility.
Submit a GadWIN ticket requesting the MEDS Coordinator release the SSN on MEDS. Attach all pertinent CalSAWS/CalHEERS and MEDS screens to the ticket along with a brief description of the problem.
Once the SSN has released, the EW will be notified via the ticket resolution. Update the SSN on the SSN Detail page.
CalSAWS will generate an MEDS-ID Number Change (EW10) transaction to replace the Pseudo MEDS-ID with the SSN MEDS-ID. Check MEDS in two working days.

Reminder: Prior to submitting a request to release the SSN, the EW must ensure verification of the SSN is on file. A photocopy of the Social Security card is NOT sufficient. Verification usually consists of either an official document/form (e.g., MC 194) from the Social Security Administration or a copy of the IEVS Applicant Abstract showing the SSN is validated.