Quick Eligibility

By default, the community module is setup to load the Quick Eligibility window automatically. When a user accesses the Community Module from the Internet, this screen will be displayed in order to avoid confusion with the login screen.

If a CareScope user with proper rights wishes to access the Community Module functionality available to him or her, they may click the Log Off button and then log on using their CareScope user ID and password.

The Quick Eligibility option will allow case managers and the general public to test criteria against eligibility requirements.

· If a user only needs to check what programs a client may be eligible for and what facilities provide them, then they can login as Guest.

· The user will be able to quickly determine what eligible programs a client is eligible for by entering in a small amount of information.

· The client does not have to already be in the CareScope system in order to determine their eligibility.

· The user will be able to refer a client to the facilities who provide the services under the eligibility programs.

· The system will automatically notify a user of a new referral via email, so that they can assign it to the appropriate caseworker.

Here is an example of how to enter criteria. Once the information is entered into the form, press the Check Eligibility button.

Once the results are displayed, the user can print the contact information for the programs for which he or she qualifies. The results page also provides explanations for why the user did not qualify for specific programs.

1. Setup the eligibility programs. Note: Make sure to assign the eligibility programs to facilities with which they are to be associated.

2. Setup the fields that will be used in Quick Eligibility. In CareScope, go to the Eligibility menu and select the Utilities option and choose Assign Quick Eligibility Fields. Then select all the fields you would like to use in Quick Eligibility and click Add. If selecting multiple fields, you can press the CTRL button and field at same time.

Note: Custom criteria fields can be used here too, but you need to set them up first and System menu – ‘User Defined Formats’.

1. Check the Use Referral Email Notification checkbox in System Setup, Global tab, Settings section. Note: Default is set to true, so initially should be checked.

2. For facilities wishing to receive referral emails, enter the email address in facility form, Contact tab using Email Address as the type.

2. Enter in the eligibility criteria for the client and then click the Check Eligibility button.

NOTE: If only interested in determining criteria for one specific program, then select the program name from the program drop down field and enter in the appropriate criteria fields. If interested in determining criteria for all programs, then do not select a specific program from the program field and enter in the appropriate criteria fields.

3. A client can be referred to one facility at a time by clicking the Select button next to the facility of the program to which you would like to refer a client. A user can refer a client to all facilities by clicking the Refer All button.

4. The eligible programs will be listed first. The programs for which the client is not eligible will be at the bottom of the list with first reason why the client is not eligible. To get a list of programs the client is eligible for, click the Print button beside the Refer All button. To get a list of the programs the client is not eligible for, click the Print button at the bottom.

5. Enter in the client information. NOTE: If this client is not in the CareScope system, a client record will be created with an incomplete status.

15. The system will display a message that says, "Referral(s) have been added for Client ID: #########, Name: Client Name."

16. An email will be sent to the email address that is setup in the Referral To facility’s contact record. Facilities must have an email address entered in their record and the checkbox allowing that email address to be used for referrals must be checked.

17. The main contact who receives the referral notice email will go into the Referral Center of the CareScope Community web module and assign the referral(s) to the appropriate case worker(s) and make any other necessary changes.

18. When the caseworker opens CareScope, they will see their open referrals in the Message Center. To access an open referral, they must double click it from the Message Center and make the appropriate changes to the referral before saving it.

· The Referral From drop down will only list the Facilities that the user can access. To see the facilities that a user can access, look at their staff form in CareScope. The primary will be the default facility for Referral From.

· The Referral To will only list the Facilities that the program is associated with. The facility selected from the search screen will be the one defaulted.

· More detailed information about the program is provided by clicking on the Program Name from the list of eligible programs.

· When doing a referral if Ownership checkbox is checked, then the Referral To facility will be added to the new client record as one of the facilities that they are assigned to even if the current user isn't associated with it. If Ownership is not checked and the current user is not associated with the Referral To facility, then the Referral to facility will not be one of the facilities that is assigned to the client.

· The system will check to see if a client already exists based on Last Name, First Name and Birth Date.

· In the eligibility program the system will insert the specific program referral i.e. Food Stamps, etc…

· If a client is referred for an eligible program, then an eligibility record is created in the main CareScope system for the client with the program or programs they qualified and the date qualified. Note: Their criteria is not added to the client record in CareScope, but the client’s eligibility record is flagged as a ‘Web Created’ record, so that if a user clicks on the ‘Update Eligible Programs’ button from the eligibility form this eligibility record will not be considered ‘Ineligible’.

· Any time a Print is done it opens the display of the report in Internet Explorer. To return to the previous screen (in Community) the user needs to click on the ‘back arrow’ in Internet Explorer. If they click on the ‘x’ it closes Internet Explorer and the Community application.

· When a referral is created an email is sent it will display a message that a referral email has been sent to the ‘Referral To’ facilities. Also, if there is an email failure where email is not sent due to SQL mail exception then an error message will be displayed of referral email failed. Note: To see these emails and messages the option in system must be checked.