Updated Training for Expanded Eligibility Information
The response to recipient eligibility inquiries was expanded on November 2, 2014, to provide additional information, including the Recipient's Category of Eligibility code (COE) and County Code for each enrollment span included in the eligibility verification response. (The County Code will be returned with the Recipient’s primary Benefit Plan only). The changes are reflected in the response to all forms of recipient eligibility inquiry, including the Automated Voice Response System (AVRS), the secure Provider Portal, and the 270/271 X12 transaction.
As a result of these changes, the provider training materials related to recipient eligibility inquiry have been updated, including:
CBT - RCP 131 Viewing Recipient Information Eligibility Providers
PUG - RCP 131 Recipient Eligibility Verification