Students identified on the Medicaid Biographical Non-Match Report as
either a "Near Match",
“Multiple Matches Found" or “Match Not Found" are possible
Medicaid Matches. The school district/§4201
school/county should review each group as indicated below to determine if this
information (CIN) is related to their students. The final decision to
determine if the Medicaid client and the student are the same person lies with
the school district/ §4201 school/ county, not the state.
(a)
NEAR-MATCH: (Students
identified as possible matches).
1)
The
students whose biographical data are identified as Near Matches are students
whose date of birth and gender match exactly and whose:
a)
First
3 letters of the last name match, and
b)
First
2 letters of the first name match.
2)
The
near match report contains the following information:
a)
Line
1 contains the biographical information the school district/county/§4201 school
submitted for matching.
b)
Line
2 contains the Near Match indicator.
c)
Line
3 contains the:
·
Medicaid
CIN,
·
provider
number of any other school districts /§4201 schools/counties that also
submitted this student for matching,
·
exact
spelling of the Medicaid client,
·
top
line of the MMIS begin/end eligibility
dates (Note-addition eligibility before the begin date could exist) and,
·
SSI
indicator (if SSI is indicated, SSI consent would be needed).
3)
If
you are unable to determine if the student listed is the same student, contact
DOH staff or the parent/guardian for additional information (CIN/county of
residence) to help you determine if the student listed is your student.
4)
If
you determine that your student is listed on the report, submit, as a
demographic "ADD", the name, date of birth, and gender exactly as they appear on Line 3 of the
report.
(b)
MULTIPLE MATCHES FOUND:
(Students identified with more than one CIN).
1)
More
than one CIN is on the report because the biographical data submitted matches
the biographical data on file for more than one CIN.
2)
The
multiple match report contains the following information:
a)
Line
1 contains the biographical information the school district /§4201
school/county submitted for matching.
b)
Line
2 contains the Multiple Matches Found indicator.
c)
The
subsequent lines contain the:
·
Medicaid
CIN,
·
provider
number of any other school districts /§4201 schools/counties that also
submitted this student for matching,
·
exact
spelling of the Medicaid client,
·
top
line of the MMIS begin/end eligibility dates and
·
SSI
indicator (if SSI is indicated SSI consent would be needed).
3)
If
you are unable to determine if the student listed is the same student, contact
DOH staff or the parent/guardian for additional information (CIN/county of
residence) to help you determine if the student listed is your student.
4)
If
you determine that your student is listed on the report, submit, as a
demographic "ADD", the name, date of birth, gender, and CIN exactly as they appear on the appropriate
line (3, 4, and 5) on the report.
(c)
MATCH NOT FOUND: (Students
whose biographical data submitted was not matched against the DOH eligibility
file and did not fit the criteria as a Near or Multiple Match).
1)
These
students may need to be reviewed for name spelling, date of birth and/or gender
errors (date of birth and gender must match exactly).
2)
If
you determine that your student is listed in error on the Match Not Found
section, just submit the correct name, date of birth, and gender per
your software system requirements.
3)
If
a brother or sister is matched as a Medicaid client to a CIN, then you should
look into why the student in question was not a match.
(a)
If
you have an appropriate CIN for a student, but the student does not appear on
the complete student eligible list
1)
Submit
the name, date of birth, gender, and CIN as a demographic "ADD"
(according to your software requirements).
2)
This
information must be submitted exactly as listed on the eMedNY or an
inconsistent data error message will be generated and it can create a claiming
problem.
(b) You can then submit any
appropriate claim after entering the appropriate CIN information.