104 - appendix - sc dhhs

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1、SOUTHCAROLINADEPARTMENTOFHEALTHANDHUMANSERVICESMEDICAIDPOLICYANDPROCEDURESMANUALCHAPTER104–AppendixPage64AppendixAAcronyms3AppendixBBasicApplicationProcess9AppendixCCaseRecordFormat10AppendixDCertificateofCreditableCoverage(COCC)12AppendixEWelvistaofSC(formerlyknownasCommuniCare)13Appen

2、dixFCommunityHealthCentersofSC14AppendixGCost-of-LivingAdjustments(COLA)21AppendixHCourthouse/PropertySearches24AppendixIDefinitions30AppendixJEarlyPeriodicScreening,DiagnosisandTreatment(EPSDT)Program49AppendixKRaceCodeValues50AppendixLIRSForm1095-BDocumentationofHealthCoverage51Append

3、ixMForms53AppendixNFreeMedicalClinicsofSC54AppendixOHealthInsurancePremiumPayment(HIPP)Program58AppendixPIncomeEligibilityandVerificationSystem(IEVS)59AppendixQTelelanguage,Inc61AppendixRLifeInsuranceVerification62AppendixSLifelineAssistanceProgram63AppendixTReservedforFutureUse64Append

4、ixUMedicaidPolicyRequestsThroughGroupLink65AppendixVNationalVoterRegistrationAct(NVRA)66AppendixWNewEyesfortheNeedyProgram67AppendixXHealthyConnections(Medicaid)InsuranceCard70AppendixYPrescriptionAssistancePrograms71AppendixZProgramOperationsManualSystem(POMS)onInternet73AppendixAAToll

5、-FreeNumbersatSCDHHS74AppendixBBVerificationofCarValues76AppendixCCWomen,InfantsandChildren(WIC)atDSS78VersionMonth:February2016SOUTHCAROLINADEPARTMENTOFHEALTHANDHUMANSERVICESMEDICAIDPOLICYANDPROCEDURESMANUALCHAPTER104–AppendixPage64AppendixDDTheWorkNumber80AppendixEEWebAddressIndex82Ap

6、pendixFFFederalQualifiedHealthCenters83AppendixGGChildren’sRehabilitativeServices85AppendixHHAboutReverseMortgages86AppendixIIVerifyDirect89AppendixJJMedicallyIndigentAssistanceProgram(MIAP)CountyDesignees90VersionMonth:February2016SOUTHCAROLINADEPARTMENTOFHEALTHANDHUMANSERVICESMEDICAID

7、POLICYANDPROCEDURESMANUALCHAPTER104–AppendixPage64AppendixAAcronyms(Rev.10/01/13)AcronymDefinitionABDAged,BlindandDisabledABD-NHAged,BlindandDisabled–NursingHomeACDAnticipatedClosureDateACEAssistanceforCoachingExcellenceAIDSAcquiredImmuneDeficiencySyndromeALJAdministrativeLawJu