Tracking Medical Expenses and Pay-In Payments After Conversion (Go-Live)

Helping Families. Supporting Communities. Empowering Individuals.

HFS LogoIDHS Logo

Action Memo

10/23/17

Go-Live

At Go-Live, spenddown will be processed in the Integrated Eligibility System (IES). The Automated Spenddown System (ASDS) will no longer be available for processing spenddown.  October 2017 is the first month that spenddown can be processed in IES.  At conversion, spenddown that has been met for which future months in ASDS will show met up to December 2017 in IES.  Medical expenses used to meet spenddown for future months past 12/2017 will be added back as available expenses that may be used to meet spenddown for future months.  IES will automatically determine spenddown eligibility each month. This occurs two days prior to cut-off. 

IES will automatically transfer current bills, receipts and payments from ASDS to IES at conversion. Current means any expenses that are no more than 6 months old.

Mobius Report

Mobius report #82010501 will provide a record of medical expenses that are in ASDS at the time of conversion.  The medical expenses are listed by the county and the legacy case number on the Mobius report.  Use this report to retrieve available medical expenses when processing spenddown for any month prior to October 2017.

Meeting Spenddown for Months Prior to Go-Live After Go-Live

Meeting spenddown for any month prior to October 2017 will require a manual process.  Caseworkers will use the Mobius report, IES and HFS 2430ASP forms to determine available medical expenses to meet a customer's spenddown when requested.

  • When meeting spenddown for months prior to October 2017, log expenses used to meet spenddown on form HFS 2430ASP, Summary of Medical Expense-Spenddown. Scan and upload form HFS 2430ASP into the Electronic Case Record (ECR) in IES. Go to https://hfs.portal.illinois.gov/info/forms/Documents/hfs2430asp.pdf.   Before using expenses from the Mobius report to meet spenddown, review all HFS 2430ASP's that are in the ECR to prevent using a bill more than once.

Where to Upload HFS 2430ASP

See Create an IES Inbox Task and Upload a Document. Upload HFS 2430ASP as described below.

Request Action Upload a Document-Do not Create an Inbox Task
Document Category Medical
Document/Task Title Medical Spd
Route to Queue Changes/Misc

Example 1:  Customer requests medical coverage for April 2017.  Spenddown for April cannot be processed in IES and must be manually processed. Follow the steps below:

Step 1 Review Form 552 from Mobius to verify customer's spenddown amount for the month of request. 
Step 2 Review all HFS 2430ASPs that are uploaded in the ECR to avoid using duplicate expenses.
Step 3 Review the Mobius Report #82010501 for medical expenses that are potentially available to be used to meet spenddown for April. Review the medical expenses provided by the customer, Mobius Report and IES to determine which expense (s) to use to meet spenddown.
Step 4 Complete a new HFS 2430ASP with all the expenses listed in chronological order that were used to meet spenddown for April 2017.
Step 5 Complete and upload HFS 2958, Request for Correction/Addition to MMIS Eligibility File, and send to the Exception Processing Unit (EPU) to update eligibility in MMIS.
Step 6 Send manual notice HFS 458SP1, Notice Of Determination Of Monthly Spenddown Met/Unmet.
Step 7 Complete case comments.

Example 2:  On 11/15/17 customer sends in medical expenses and requests that her spenddown be met for July.  Follow the steps below:

Step 1 Review Form 552 from Mobius to verify customer's spenddown amount for the month of request. 
Step 2 Review the ECR/Form 2430ASPs for medical expenses already used to meet spenddown.
Step 3 Review the Mobius Report #82010501, the uploaded HFS 2430s, IES and medical expenses provided by the customer.
Step 4 Complete a new HFS 2430ASP with all the expenses listed in chronological order that are used to meet spenddown for July 2017.
Step 5 Complete and upload HFS 2958, Request for Correction/Addition to MMIS Eligibility File, and send to the Exception Processing Unit (EPU) to update eligibility in MMIS.
Step 6 Send manual notice HFS 458SP1, Notice Of Determination Of Monthly Spenddown Met/Unmet.
Step 7 Complete case comments.

Using Expenses from IES to Meet Spenddown for Months Prior to October 2017

When using expenses from IES to meet spenddown for any months prior to 10/2017, reduce client liability in IES on the bill by the amount applied to meet spenddown. 

Example 3:  Customer contacted the FCRC to request that her spenddown be met for September 2017.  Customer's spenddown is $50. 

Caseworker will perform the steps described in the above examples.  The only available receipt that the caseworker found was a receipt in IES dated August, 20, 2017 in the amount of $100 that is unused.  The caseworker will use $50 from the $100 receipt in order to meet the customer's spenddown and must reduce the client liability to $50 in IES. 

Spenddown History

Spenddown history prior to October 2017 will not be available in IES. Medical eligibility for months prior to Go-Live will be available only in MMIS.

Note:  Log any bill or receipt more than 6 months old that was not entered into ASDS prior to conversion on HFS 2430ASP and load into the Electronic Case Record (ECR) in IES.


[signed copy on file]

James T. Dimas

Secretary, Illinois Department of Human Services

Felicia F. Norwood

Director, Illinois Department of Healthcare and Family Services