CHDP Gateway Internet Step-by-Step User Guide (gateway …

1 CHDP Gateway Internet Step-by-Step User GuideContentsCHDP Gateway Internet TRANSACTION Service Center: Transaction Equipment and A CHDP Gateway Internet Tool Gateway Web Site Transaction the CHDP Program Pre-Enrollment Application (DHCS 4073)..9 Complete the Internet Transaction FieldReview and Edit a the Establishing EligibilityConfirm the Gateway Messages OverviewMessages Approving Denying Approving Infant Messages Reference Gateway Internet Transaction Overview 1 CHDPG atewayInternet TransactionOverviewObjectivesThe purposeof thisChild HealthandDisabilityPrevention(CHDP)Gatew ay Internet Step-by-Step User Guideis to provideinstructionsfor performinga CHDPG atewayInternet tr thisse ctionyouwill learn.

2 Thebenefits of usingtheCHDPG ateway Where to find helpin or derto performa CHDPG atewayInternettransactionIntroductionPre -EnrollmentTheCHDPG atewayallows eligiblechildren and youthto receive upto twomonthsof full-scopeMedi- Calpre-enrollmenteligibility. CHDPpr oviderscan pre-enrolleligible patie nts in to Medi-CalusingtheCHDPG ateway Internet tr processalsoallowsthesameCHDPG atewaytransactionto automatically enrolleligibleinfants under1 yearof agein to Medi-Calwi thoutth eirparent(s)ha vingto completeaMedi-Cal/HealthyFamiliesApplica tion(MC321).Eligibleinfants arethosewhosemothershadMedi- Cal eligibilityat thetimeof deliveryand continueto residein California.

3 Eligiblein fants receivefull-scope, no-costMedi-Caluntil 2013 CHDP Gateway Internet Transaction Overview 2 TobegintheGatewayprocess,theparent,legal guardianoremancipatedminormustcompletean dsignaChild Healthand DisabilityPrevention(CHDP)ProgramPre-Enr ollmentApplication(DHCS4073, ).TheEnglishversionoftheformcan bedownloadedfromtheCHDPD ownloadspageafterloggingontotheTransacti onServicesareaoftheMedi-Calwebsite ( ).VersionsoftheDHCS4073forminotherlangua gescanbedownloadedfromtheMedi-Calwebsite by clickingtheProgramstab,thentheCHDPP roviderManualsandBulletinslink,andthense lectingtheAppendix: sinformationis ,thepatient sinformationis ,a responsemessagedisplays,indicatingthepat ient seligibilityforservices.

4 Providersprinttheresponsemessagetwice:On ecopyis giventotheparent,legalguardianoremancipa tedminorandtheothercopyiskeptinthepatien t ,thepatientusestheprintoutas anImmediateNeed ,legalguardianoremancipatedminormustsign theImmediateNeedEligibility 2013 CHDP Gateway Internet Transaction Overview 3 TelephoneServiceCenter:1-800-541-5555 Ifyouhaveanyquestionsorconcernsregarding aCHDPG atewayInternettransaction,pleasecalltheT elephoneServiceCenter(TSC) , ,tohelpyouwith: Troubleshootingyourcomputertomakesureith asthecorrecttechnicalspecifications Accessingthecorrectsoftwareandbrowser AccessingtheCHDPG atewayInternettransactionInternetTransac tionEquipmentandSoftwareThefollowingequi pmentandsoftwarearerequiredfordownloadin gtheChildHealthandDisabilityPrevention(C HDP)ProgramPre-EnrollmentApplication(DHC S4073, )andforperformingtheCHDPG atewayInternettransaction: Computer:Windows98operatingsystemorhighe r;PentiumIprocessor( )orhigher.

5 Minimum32 MBRAM ModemSpeed:Minimum28 KBPS Printer Browser: Internet Explorer version and higher, Mozilla Firefox version and higher, Google Chrome, Safari version and higher,or Opera 11 AdobeFlash Player version 6 or higher (CHDP) ProgramPre-EnrollmentApplication(DHCS407 3, ) a CHDP Gateway Internet Transaction 4 Performing aCHDPG atewayInternet TransactionObjectivesIn thissectionyouwilllearn: Howto access theCHDP Gate way fromthe Medi-Calwebsite How to downloadaChildHealthandDisabilityPrevent ion (CHDP)ProgramPre-EnrollmentApplication(D HCS4073, ) How to complete theCHDPG atewayInternet transactionfields How to confirmeligibilityfor Medi-CalorCHDP servicesFebruary 2013 Performing a CHDP Gateway Internet Transaction 5 WebToolBoxBeforebeginninga GatewayInternettransaction,youshouldknow howtoaccesstheWebToolBoxfortheappropriat esoftware ,clicktheWebToolBox separatescreenwillopenanddisplayallofthe toolsyouneedtoaccesstheChildHealthandDis abilityPrevention(CHDP)

6 Program Pre-EnrollmentApplication(DHCS4073, )orto linkApril2013 Performing a CHDP Gateway Internet Transaction 6 CHDPG atewayHelpHelpmessagesareavailableforcer tainfieldsoftheGatewayInternettransactio n(onlythefieldslistedintheApplicationHel pscreenbelow).Forassistancewithanyofthes efields, linkFebruary 2008 Performing a CHDP Gateway Internet Transaction ,followthesteps theaddress bar of your browser, then press ENTERto open theMedi-Cal home the Transactions tab to open theLogin 2008 Performing a CHDP Gateway Internet Transaction 83 Enter your Medi-Cal provider number orNationalProvider Identifier (NPI) in the UserIDfield and your seven-digit Provider IdentificationNumber(PIN) in thePasswordfield and click Submit.

7 You are now logged logging on, the Transaction Services screen opens, displaying one ormore tabs whichcontainall ofthe transactions available to you. Click each tabto locatespecific you are logged on, youwill betimed out if you are idle on any screen forlonger than 20 minutes (approximately). Any information you have entered will not be you are timedout, you must log on againand repeat the previous the Prgms (Programs) tab or selectPrograms from the menu in the left programs will displaythatare available to the CHDP Gateway Pre-Enrollmentlink. (This link only displays for authorizedCHDP providers.)April 2008 Performing a CHDP Gateway Internet Transaction 9 DownloadtheCHDPP rogramPre-EnrollmentApplication(DHCS4073 )Tobegina CHDPG atewaytransactionontheInternet,theparent ,legalguardianoremancipatedminormustcomp letetheChild HealthandDisabilityPrevention(CHDP)Progr amPre-EnrollmentApplication(DHCS4073, )

8 WhentheyvisitaCHDP , CHDPD ownloadsfrom the menu in the left column of any Gateway Internettransaction CHDP GatewayPre-Enrollment Application form DownloadPage will 2013 Performing a CHDP Gateway Internet Transaction 102 Click CHDP Pre-enrollment will launchin the browser window anddisplay the print the pre-enrollment application, click the Printicon on the toolbar of AcrobatReader (do not click the browser s Printicon).If you accessthe form often, you may wish to savethe formto your computer for faster retrieval and printing. To do so, click theSave icon on the toolbar of Acrobat Reader and save the form to your you are finished, clickBackon theForms Download pageor click theBackbuttonof the 2008 Performing a CHDP Gateway Internet Transaction transactionconsistsoftheVerificationandA pplicationscreens, (*).

9 SCREEN:1 Select Yes if the patient is younger than 19 yearsofage. If you select No you will receive a messagethat the patient is overage for program you select No , verify the patient s age before the number of people in the patient s family. If the patient has no family, enter 1 forthe the gross monthly oryearly income of the patient s whole dollars only. You may enterboth income amounts, butonly one is Yes if the patient wants toapply for continuing coverage through theMedi-Calprogram. Select No ifthe patient does not wishto apply. If the patient indicated Yes , he/she will receive aMedi-Cal/Healthy FamiliesApplication(MC 321) form within 10 business you click Next, the message Verifying eligibility, please appears.

10 If the patient iseligiblefor the CHDPG ateway, you will advance to the Applicationscreen. If the patient is not eligible, youwill receive amessage that the patient sincome is too high for program 2013 Performing a CHDP Gateway Internet Transaction 12 APPLICATIONSCREEN(TOPTHIRD SHOWN):1 Select Yes if the patient hasa Benefits IdentificationCard (BIC), whether activeor inactive, or No if thepatient doesnot have a field is optional. If thepatient hasa BIC, enter theID number from the frontof the the patient s last name, first name and middle initial. If thepatient goesby a single nameonly, enterit in the LastNamefield and enter the word None in the Male or Female.