FORM 360C (CENTRAL NOTICE) FORM 360 (MANUAL NOTICE) FORM 458 (MANUAL NOTICE) FORM 458SP (MANUAL NOTICE) FORM 458LTC (MANUAL NOTICE) FORM 360B (MANUAL NOTICE) FORM 360KC (CENTRAL NOTICE)
Cash Approvals (No Spenddown in Backdate Months) Approval processed through IPACS and criteria in WAG 17-02 met.
Cash Approvals (Spenddown Month in Backdate Period) Approval processed through IPACS and criteria in WAG 17-02 not met. Supplement to Form 360C (complete for back-date months only).
All Cash Denials Denials processed through AIS. Denials processed through IPACS.
Regular Medicaid Approval-Original Request Did Not Include Cash Approval processed through AIS. Approval processed through IPACS.
Regular Medicaid Approval-Original Request Included Cash Approval processed through AIS. Approval processed through IPACS.
Spenddown Approval-Original Request Did Not Include Cash Approval through AIS or IPACS.
Spenddown Original Request Included Cash Approval processed through AIS or IPACS. Advise the applicant the reason for cash ineligibility. Attach to Form 360 to advise applicant of spend-down approval.
Medicaid Denials Denial processed through AIS. Denial processed through IPACS.
Long Term Care Approvals and Denials Denial processed through AIS. Approvals processed through AIS or IPACS and denials processed through IPACS.
RRA Cash/Medical Approvals Processed through IPACS and criteria in WAG 06-01-09 met. Processed through IPACS and criteria in WAG 06-01-09 not met. Processed through IPACS and criteria in WAG 06-01-09 not met.
RRA Cash/Medical Denials Processed through AIS. Processed through IPACS (Cash). Processed through IPACS (Medical).
All Kids Share, All Kids Premium, and All Kids Rebate Approvals Approval processed through AIS or IPACS.
All Kids Share, All Kids Premium, and All Kids Rebate Denials Denials processed through AIS or IPACS.