Preventing 1503 MEDS Errors

About the Program

Category: Personnel Management, Employment and Training (Best in Category)

Year: 2012

The State of California has identified specific Critical Medi-Cal (a.k.a. Medicaid) Eligibility Determination System (MEDS) Error Alerts which are subject to audit and if not addressed within the specified timeframe, could result in potential financial penalties for San Diego County. MEDS stores vital and confidential client information such as Medi-Cal eligibility and demographics. Each month the Medi-Cal eligibility system documents whether a client is eligible for Medi-Cal, if the person receives full-scope Medi-Cal benefits, if the person is enrolled in a Medi-Cal Managed Care Plan, or if the person must meet a share-of-cost prior to receiving MediCal covered services. The 1503 Error Alert can create other critical alerts, resulting in the erroneous disruption of Medi-Cal coverage for San Diego County residents. The 1503 (MEDS) Error Alerts are generated when demographic information entered on a client in CalWIN, the County’s eligibility determination system, does not match or is inconsistent with (the same client) information entered into the MEDS system. Health and Human Services Agency (HHSA) created a self paced on demand e-Learning training course that launched on December 2010 to staff that have direct impact to MEDS. The electronic training course was designed to help eligibility staff prevent the 1503 MEDS error by highlighting the importance of clearing individuals through MEDS and the County’s eligibility determination system (CalWIN). The online training course focuses on MEDS screens and offers different situations and scenarios that staff may encounter. The course provides solutions, tips, and easy access to a desk aid developed for staff. This online training course has been loaded into the Learning Management System (LMS) and is easily accessible and on-demand to all eligibility staff. The goal for developing the training was to decrease 1503 MEDS errors and avoid the erroneous disruption of Medi-Cal coverage. Over the last year, the result and impact this training has had is an overall 27.6% decrease in the number of 1503 MEDS errors.