WAG 06-27-01-a Initial Eligibility

PM 06-27-01-a

IES Process

In IES, the application will show as:

  • "Application Pending" prior to actually submitting the application on the Application Summary screen.
  • "Application Complete" when the application is submitted from the Application Summary screen. Once the application is submitted, a record is sent from IES to MMIS to start the medical coverage.

All active DCFS cases will appear in IES as an "Application Complete."  DCFS cases appear in IES with an application # instead of an IES case number.

The application will not be retained in IES until the address screen has been completed. If the transaction is interrupted prior to completing the address screen, start the transaction over.

Register Application

The sections below correspond to IES screens and the fields requiring entries.

Register Application-Application Screen

Use Register Application to open a DCFS medical case. There is no actual application used to authorize medical coverage. Eligibility is provided by an interagency agreement.

Field Name Entry
Date Received Date of the transaction
Source Select "Fax In" from the drop down options
Primary Applicant Name of child/youth receiving DCFS services

Register Application-Address

Field Name Entry
Address Fields Address where the child/youth is living. The address entered is where the medical card will be mailed.

Register Application-Type

The application type will default to DCFS application based on the worker being logged into the DCFS office. The application number will appear on the following screen after the Application Type screen.

Register Individual-Individual

The child/youth's name will be auto-populated under Individual Name. Enter the Gender and Date of Birth. Enter the SSN, Race and Ethnicity if known.

Register Individual-Summary

The child/youth's demographic information from Register Individual-Individual screen may be updated by clicking the Pencil icon under the Action heading. Only one child/youth may be on a DCFS case. In a situation involving sibling children, open a separate case for each.

Register Application-Clearance Results

Clearance results are not available in the DCFS driver flow.  Obtain necessary clearances from IES Data Exchange  or from the PACIS (BlueZone) interfaces as needed.

File Clearance-Results

IES checks the database for potential matches for the child/youth entered. Review potential matches carefully to determine if a potential match is the same individual as the child/youth entered for the application.

DCFS Individuals-Details

Information entered on the Details screen populates a report sent to DCFS on a weekly basis.

Field Name  Entry Required
SSN If entered on the Individual screen, it auto-populates in a protected field
US Citizen Select Yes or No
Non-Citizen Status Select Yes or No
State of Residence Defaults to Illinois.  Select the appropriate state from the drop down list if needed.
Existing RIN IES assigned RIN
Temporary RIN Enter the Temporary RIN if assigned.  The Temporary RIN will override the Existing RIN and update MMIS when the application is submitted from the Application Registration Summary screen.  Allow two business days for MMIS to update.
DCFS ID Enter the DCFS ID. Enter the leading zeroes.
Verification Select from the drop down list the verification obtained for each of the fields in this section.

Entry in the Facility/Provider Information section is not needed.

DCFS Eligibility-Details

The Eligibility Information section is where the type of DCFS coverage and dates of eligibility are entered.

IV-E Eligibility Select No, Pend or Yes from the drop down list.  If Yes, enter the Date Determined.
DCFS Medical Category Select the DCFS category from the drop down list.
Medicaid Eligible Select Yes or No. 
No Longer with DCFS reason Leave blank.
Determine Eligibility for Former Foster Care Leave blank.
Determined Eligibility for Continuous Eligibility Leave blank.
Out of State Placement Select Yes or No. If No, select the state of placement from the drop down list.
Eligibility Begin Date For the initial authorization, enter the date medical coverage is to start.  For all other changes, enter the date of the change.
Eligibility End Date Enter the End Date if canceling the DCFS case.  Enter the date the medical eligibility is to end.  Medical coverage always ends prospectively.  Do not enter a retroactive date.

Generate a medical card by selecting Yes or No from the drop down list. The medical card will be mailed to the child/youth at the address listed on the address screen. Select the reason for the medical card request and the date requested. Select Add. IES will retain a history of the medical cards generated.

Example: A child, Ben, is taken into protective custody over the weekend on June 9th.  The DCFS worker enters Ben's information in Application Registration as a new case. The Eligibility Begin Date is the day in which Ben was removed from the home (June 9th).

DCFS Registration-Summary

IES provides a summary of the registration. Review, click Assign, then Submit. IES will display a confirmation message that the registration is complete. When the registration is complete, the DCFS case is active. IES will display the active case as "Application Complete."

If the submit action is not taken or fails, the IES will display the case as "Application Pending."