This measure will show how many 201P applications are processed on a monthly basis by the COB Unit, and whether they are completed or pended due to incomplete information. Starting in June 2019, COB expanded this measure to include the 202LTC applications that they process for VPharm and Medicare Savings Program (MSP).
Vpharm eligibility is determined by members completing either the 1) Vpharm application (201P) or 2) Medicaid application (202MED).
- If only the 201P Vpharm application is received, the Coordination of Benefit (COB) staff process it.
- If both the 201P Vpharm mixed household application and 202MED applications are received, HAEEU staff process them.
This measure looks at 201P Vpharm applications put into the Coordination of Benefit (COB) Unit's working que in OnBase by the Application Data Processing Center (ADPC). The COB Unit has 3 employees with access to OnBase and who have the ability to work these applications. Counts are systematically tracked in OnBase, a reporting tool and calculated monthly.
If an application is found to be incomplete (not worked) due to missing information, a notice is sent to the applicant requesting information and an extra 30 days is given to respond. Members that are given this extra time to follow up with requested information are tracked manually for measure purposes but there are system edits to either complete or close the application.
Data is unavailable for this measure for the month of January 2020 due to a staffing vacancy but will resume in February.
Due to COVID-19 emergency there is a drastic decrease in applications because Vpharm reviews have been bumped.
Last updated: 08/18/2020