Presumptive eligibility definition

Presumptive eligibility means children and pregnant women who have applied and appear

Presumptive eligibility means limited period of managed care program eligibility for individuals who are categorically related to certain eligibility groups listed in OAC 317:35-6- 38(a)(1)(A)(i) through (vi) and are also determined by a qualified hospital, on the basis of preliminary information provided by the applicant on a completed HPE application, to be eligible for managed care program services.

Presumptive eligibility means the process established pursuant to 42 CFR 435, Subpart L by which individuals can be determined presumptively eligible for the plan and receive temporary health coverage until official eligibility for the plan is determined by the division.

Examples of Presumptive eligibility in a sentence

• Presumptive eligibility determinations made by qualified hospitals.

• Presumptive eligibility ends when a determination of ongoing eligibility is made or, on the last day of the month following the month the presumptive eligibility determination is made, if an application for ongoing Medicaid coverage is not filed.

• This could apply to a member who had other IHCP coverage and transitioned into the HIP program, a member who was previously covered under Presumptive eligibility, or a member who has earned rollover as a result of the POWER Account reconciliation process.

• Presumptive eligibility may be determined on the basis of individual life circumstances.

• Presumptive eligibility screening for an uninsured patient should be completed as soon as possible after receipt of medically necessary services and prior to the issuance of any bill for those services.

More Definitions of Presumptive eligibility

Presumptive eligibility means that a person is presumed to be eligible on a temporary basis based on information provided.

Presumptive eligibility means eligibility granted for Medicaid Covered Services as specified in administrative regulation as a qualified individual based on an income screening performed by a qualified provider.

Presumptive eligibility means a period of eligibility for medical services based on self-declaration that the individual meets the eligibility criteria.

Presumptive eligibility means temporary eligibility for Medical Assistance as determined by participating hospitals in accordance with these regulations.

Presumptive eligibility means eligibility for Financial Assistance determined by reference to Presumptive Eligibility Criteria demonstrating financial need on the part of a Patient.

Presumptive eligibility means a period of up to 72 hours after an individual is found to be in crisis and during which the individual is presumed to be eligible for crisis stabilization services that will be reimbursed by the department.

Presumptive eligibility means a period of time during which a child may receive CHIP benefits based on preliminary information that the child meets the eligibility criteria.