Approvals - MEDS/CDB - Prior MEDS/CDB Record(s)

When entries are made in CalSAWS to approve a case and/or person, it is programmed to generate the appropriate Add (EW20 and/or FX20) transactions to the MEDS Network. MEDS/CDB receives the Add transaction(s) and reactivates the recipient’s record.

Note: An HX20 batch transaction is sent from CalHEERS to MEDS for individuals who initiate their MC application thru CoveredCA website and are conditionally eligible for MAGI MC.

Previous MEDS/CDB Record with Pseudo MEDS-ID

If the recipient has a prior MEDS/CDB record with a pseudo MEDS-ID, to successfully ‘capture’ or ‘locate’ that record, follow the steps below:

  • If the applicant/recipient provides the SSN, DO NOT enter the SSN during Application Registration or Data Collection. Complete CIN Clearance ensuring that the record with the Pseudo Number is selected. After the approval is successful in MEDS, enter the SSN provided by the client.

Note: For MAGI cases you may enter the SSN in CalSAWS for batch update to CalHEERs and MEDS while beneftis are still pending EDBC run.

  • If no SSN is provided, the SSN field must be left blank (CalSAWS does not allow the entry of a Pseudo Number).

For received ERD on an individual with SSN that was already entered in CalHEERS (CH) (CalSAWS has no SSN). Take the following steps only when the CalSAWS case is in pending status:

  • Use the CalSAWS/MEDS CIN that is linked to pseudo and enter SSN in CalSAWS to match CH. Send MAGI Eligibility Determination Request (EDR) to CalHEERS. (Do not accept and save EDBC results.)
  • After receiving successful Determination of Eligibility Response (DER), remove SSN from CalSAWS to match MEDS. Send another MAGI Eligibility Determination Request to CH for SSN removal. These steps MUST BE COMPLETED IN THE SAME DAY.
  • If an individual was approved with SSN in CalSAWS/CH and an approval transaction was rejected due to pseudo in MEDS, type SSN into MEDS to ensure the SSN is not being used by another person/county prior to submitting an SCD 1296 to request an EW10 transaction to change from pseudo to SSN and/or activate the individual in MEDS.

Previous MEDS/CDB Record with SSN

To ensure that the prior MEDS/CDB record is ‘located’ or ‘captured’, when the prior record MEDS-ID is an SSN, the SSN from the prior MEDS/CDB record must be entered in CalSAWS/CalHEERS for the Add transaction(s) to be successful.

Thorough ID’ing an individual by name, address, and/or whole case search must be completed to select the correct CIN during Person Clearance process.

Related Topics

Individual File Clearance

Approvals - General Information

Approvals - MEDS/CDB - No Prior MEDS/CDB Record(s)

 

 

AP19 Transactions to MEDS

Benefit Identification Card (BIC) Issuance

250% Working Disabled Program Approval