Recipient File Application: Upon entering the system, select Recipient File Application to access the person’s public program eligibility information, including PMI, demographics, care coordinator, past and current public programs, spenddowns and additional care coverage.

• Enter X to the left of RECIPIENT FILE APPLICATION, then click Enter on the numeric keypad or Ctrl.

• Enter the letter I for Inquiry in the ACTION CODE field at the top of the screen and enter the appropriate information to look up a specific individual. You can search by Recipient ID or Personal Master Index (PMI), Social Security number (SSN), last name, first name and date of birth. CASE NUMBER will take you to a separate set of screens and is the fastest way to obtain a person’s current address and phone number if available. When using CASE NUMBER, only CASE NUMBER should be entered or the search will not work. When searching for a person, try several searches using various pieces of information, such as SSN, then name and date of birth, if SSN does not work. You should attempt at least two searches before determining a person is not listed in MMIS.

For PAS, a search should also be made in MAXIS if a PMI is not found in MMIS. If a person does not have a PMI in MMIS or MAXIS, one will need to be created it in MAXIS. Please see, MAXIS: Creating and changing PMI in MAXIS for instructions.

Recipient summary is the first screen you come to in the user’s case file. It is a summary of some of the other screens. You can view:

• PROGRAM: The three public programs in which the person most recently enrolled
• CASE NBR: The person’s case number
  • The first digit of the case number usually tells what the case is for:
    • County MA will start with 0
    • MNsure cases start with J, 1, 2, etc.
    • SLL PAS, AC and ECS cases all start with S
• ELIG BEG: This is the date the person was enrolled into the program.
• ELIG END: This is the end date of the person’s enrollment. If the end date is listed as 99/99/99, it means the person is currently enrolled into that program with no planned end date.
• CFR: County of Financial Responsibility
• SPENDDOWN: Most recent spenddown information
• WAIVER: Current waiver information
• PPHP: Managed care plan participation
• LA: Living arrangements, e.g., community, skilled nursing facility, etc.
• MCARE: Medicare Part A and Part B begin and end dates

The RSUM screen will display enrollments in Medical Assistance (MA), Alternative Care (AC), Essential Community Supports (ECS) and Institutions for Mental Disease (IMD). If there is a long history of programs, navigate to the RELG screen of MMIS and use F7 and F8 to scroll between the program eligibility screens. PAS staff will be looking for current enrollment in AC or ECS in which case a referral must be made to a lead agency.

This screen lists the individual’s spenddown information, including months of spenddown, spenddown type (waiver obligation, monthly, etc.) and amount. Please note, this screen does not state if the person has met a spenddown amount. If there is more than one screen of information, use F7 and F8 to scroll between them.

This screen contains more detailed information about an individual’s spenddown, including a designated provider, the amount used and the amount remaining. This screen will show if a person has met their spenddown amount in any given month. Use F7 and F8 to scroll through each month the person had, or will have, a spenddown.

This screen lists the setting in which the person resides, e.g., community, institution or group home, and the dates lived in that setting.

It does not show the specific address. If there is a National Provider Identifier (NPI) listed for an out-of-home location, you can place the cursor on the NPI and press F4. This screen will provide you with the out-of-home setting provider name and contact information, such as the skilled nursing facility name and telephone number. Press F6 to return to the person’s file.

If the person resides in a nursing facility, but that information is not reflected in MMIS, this means the nursing facility has not forwarded the DHS 1503 form or the county has not entered the form, which allows the county to update the living arrangement. Claiming dates outside of this span will affect payment for someone on Medical Assistance and residing in the nursing facility.

This screen will provide you with detailed information about current and past public program enrollment. You can see the specific program the individual was enrolled in, the eligibility type, as well as when eligibility began and ended. If the end date is listed as 99/99/99, it means the person is currently enrolled into that program. Use F7 and F8 to scroll between screens if there is a long history of public programs.

Within each program entry are three fields: CFR (County of Financial Responsibility), STATUS and REASON. Each field is filled with a code letter or number. You can place the cursor on any of these field codes and press F12 to see what each code means. Here is an example of F12 for reason.

This screen will provide you with any waiver information available for the individual, including waiver type and begin date. A waiver will always have an end date entered, however, it may be up to a year in the future. The letter in the WAIVER TYPE column is a code for a specific waiver.

SLL PAS staff should be looking for current Elderly Waiver (EW), Community Access for Disability Inclusion (CADI), Community Alternative Care (CAC), Brain Injury (BI) or Developmental Disability (DD). If any of these waivers are current, a referral must be sent to a lead agency.

This screen contains information about the person’s Medicare status, including Medicare number, as well as begin and end dates for Medicare Part A and Part B. Not all information listed on this page is official information. To determine if the information was verified by CMS, you may place your curser over the letter next to the end date and press F12.

Note: Part D information only sometimes displays in MMIS and may be wrong; therefore, Part D information must be found in Medicare.gov or SHIP.

This screen lists any managed care programs the person is currently or was previously enrolled in. To determine the type of managed care plan, look in the PRODUCT DESCRIPTION TYPE column. This column lists Senior Health, Special Needs, MinnesotaCare, etc.

Note: Medicare Advantage plans without Medical Assistance do not display in MMIS.

PAS staff need to look for current enrollments in; Minnesota Senior Health Options (MSHO), Minnesota Senior Care Plus (MSC+) or Integrated or Non Integrated Special Needs Basic Care (SNBC).

To determine which health plan, place your cursor over an entry in the HEALTH PLAN column and press F4 to see the plan name and contact information.

Integrated SNBC enrollment is listed as “INTEGRATED”, and the difference can be seen below.

You can also use F12 for to see the definitions of different codes, for example the reason for disenrollment:

This screen displays information about a recipient’s case manager or care coordinator. The first column specifies whether the case type is county or managed care. The next two columns provide a beginning and end date (99/99/99 if current) of the case manager’s participation. The final column provides the person’s NPI to help you identify the case manager if one is listed. Note: This information is not always up to date and a person may not be on a waiver, but still have a case manager.

To find the caseworker’s name and contact information, place your cursor over the NPI and press F4.

This screen provides the name of, and dates of participation in, other types of insurance, such as retirement coverage.

Note: This page is not always accurate and can cause billing issues if the information is not up to date. 

This screen contains additional data about the person, including Social Security and Medicare numbers, date of death (if applicable), sex, ethnicity, etc.

This screen provides the dates for which an individual is eligible for Social Security Income (SSI) or Retirement, Survivors, and Disability Insurance (RSDI). This screen is blank if the person is not eligible for these benefits.

This screen contains buy-in information for Medicare Part A. Several pieces of information will be useful are:

• PART (A) ACCRETE REQUEST DATE: Date in which the county requested that a buy-in occurs
• ACCRETE DATE: Date the buy-in should begin
• PART (A) DELETE REQUEST DATE: Date in which the county requested the buy-in be deleted
• DELETE DATE: Last date the person eligibility for a buy-in
• BUYIN MONTHLY TRANSACTIONS: List of buy-ins by month

Note: This page is not always accurate.

This screen contains buy-in information for Medicare Part B. Several pieces of information will be useful:

• PART (B) ACCRETE REQUEST DATE: Date in which the county requested that a buy-in occurs
• ACCRETE DATE: Date the buy-in should begin
• PART (B) DELETE REQUEST DATE: Date in which the county requested the buy-in be deleted
• DELETE DATE: Last date of person eligibility for a buy-in
• BUYIN MONTHLY TRANSACTIONS: List of buy-ins by month

Note: This page is not always accurate.

At times you must find or verify a person’s address and phone number. This information may be obtained using the MMIS case number. (This is different than the PMI number.)

The case number is an eight-digit number. To find the case number, locate the person’s file using search information. The case number appears on the RSUM screen. Use this number for the following steps:

• Type X next to the RECIPIENT FILE APPLICATION option, then click Enter on the numeric keypad or Ctrl.

• Enter I for Inquiry in the ACTION CODE field at the top of the screen, then click Tab or use the arrow keys to move the cursor to Case Number. Enter the person’s case number and click Enter on your numeric keypad or Ctrl.

You will arrive at a screen that contains the residential address of the person and phone number, as well as a medical mailing address if another person or organization is designated as the place to receive mail for the individual. You will also see the previous address for the individual here. Due to delays in entering information, at times the information appears incorrect or out of date. Press F6 to return to the menu to search other recipient file screens.

• MSC+ MINNESOTA SENIOR CARE PL
  • Minnesota Senior Care Plus (MSC+) – Medical Assistance managed care. Does not include Medicare or Medicare Part D. People will have Original Medicare and can buy a separate Part D plan.
• MN SENIOR HEALTH OPTIONS – MSHO
  • MN Senior Health Options (MSHO) – A Medicare Advantage Plan that includes Medicare, Medical Assistance, and Medicare Part D.
• INTEGRATED SPECIAL NEEDS BAS
  • Integrated Special Needs Basic Care (SNBC) – A Medicare Advantage Plan available in certain counties for people under age 65 with a disability. Plan includes Medicare, Medical Assistance, and Medicare Part D.
• SPECIAL NEEDS BASICCARE
  • Special Needs Basic Care (SNBC) – Covers Medical Assistance for people under age 65 with a disability. It does not include Medicare or Medicare Part D for people eligible for Medicare. People can enroll in a separate Medicare Part D plan.
• MINNESOTACARE
  • A health plan option available only in MN through MNsure. It does not include or coordinate with Medicare. People who are eligible have lower income, and they are not eligible for Medicare or Medical Assistance.
• PMAP PREPAID MEDICAL ASSISTAN
  • Prepaid Medical Assistance (PMAP) for people under age 65, who are not disabled and have the lowest incomes.