The recipient subsystem stores information about a person’s medical eligibility. Financial workers and MinnesotaCare enrollment representatives enter information into the Recipient File Application. Other systems that share information with MMIS also enter and store data in MMIS.

Workers assign a unique person master index number to every new person added to the MMIS database. A PMI number is a lifetime number with limited exceptions. Use PMI numbers to search MMIS for eligibility information about an individual.

Access the recipient subsystem from the MMIS MAIN MENU
1. Tab to move the cursor in front of the RECIPIENT FILE APPLICATION menu item in the OTHER APPLICATIONS area.
2. Type an X to select the RECIPIENT FILE APPLICATION.
3. Press a transmit key (the numeric enter key or right control key) to advance to the RKEY panel.

Exit the Recipient file after reviewing eligibility information and continue with screening document or service agreement entry:
1. Press function key F6 to return to the RKEY panel.
2. Press the F6 key again to return to the MAIN menu panel.
3. Tab to place cursor in front of file you wish to select.
4. Type an X to select SCREENINGS or PRIOR AUTHORIZATION file.
5. Press a transmit key to advance to selected application and begin entry of a screening document or service agreement.

Workers may navigate to the Recipient file from any screening document or service agreement panel. To navigate to Recipient file from the Prior Authorization Applications file:
1. Press function key F4 or press the F4 key from almost any location in the screening document or service agreement after entering the PMI number.
2. Press a transmit key to advance through the recipient file panels to view information.
3. Press function key F6 only once to exit the recipient file and return to the screening document or service agreement.

RKEY panel displays all recipient and case panels by acronym for reference. Press a transmit key to advance through the Recipient file queue or type the four-letter acronym for the panel you wish to view in the NEXT field at the top left corner of most panels.

RSUM panel displays summary information about a recipient. An asterisk next to a field indicates there is additional history on another panel.

PROGRAM field: MA (Medical Assistance) program code and the date span the recipient is or was eligible for that program. MMIS displays additional program eligibility history on the RELG panel.

SPENDDOWN TYPE field: Spenddown codes and date span. MMIS displays additional spenddown information on the RSPL, RSPD and RSLG panels.

WAIVER TY field: Most recent waiver type, waiver span and last screening date. MMIS displays additional waiver history is on the RWVR panel.

PPHP/MANAGED field: Managed health enrollment information. MMIS displays additional information on RPPH and RFEM panel.

LA field: Recipient’s living arrangement. MMIS displays the two most recent living arrangements with begin and end date here. MMIS displays additional living arrangement history is on the RLVA panel.

MRRP field: Dates and provider identifier when recipient is on the Minnesota Restricted Recipient Program. MMIS displays detailed information on the RPCR and RPRR panels.

MCARE field: Dates for Part A and Part B Medicare. MMIS displays additional Medicare information on RMCR, RSVL and RSVC panel.

RELG panel displays eligibility information such as major program, eligibility date span, status of eligibility on the RELG panel. Codes and dates (valid values) displayed in fields on the RELG panel detail current eligibility status and history.

PRG field: Valid values for major program. Place cursor on code in PRG field and press F12 to view all program codes.

STATUS field: Valid values:

RSN field: Values include 00 (Ongoing) through 99 (Worker closed, no reason entered). Place cursor on code in RSN field and press F12 to see all 99 codes.

ELIG END field: End date of eligibility. MM/DD/YY format indicates last day of eligibility span and 99/99/99 indicates that eligibility status is active.

MMIS displays waiver history on the RWVR panel. MMIS creates a new line when there is a break in the waiver span or a change in waiver type. For each waiver span, MMIS lists waiver type, waiver begin dates, waiver end dates and last screening date.

RPPH panel displays managed health care enrollment information such as the begin date, end date, and contract number. Contact appropriate health plan as necessary to coordinate benefits. Place cursor on the contract number and press F4 to reach the PPH1 panel. MMIS displays the name of the health plan on the PPH1 panel. Press F3 or F6 to return to the RPPH screen. MMIS PPHP/MCP #1 - PPH1

RPOL panel displays necessary insurance information such as policy number, begin date, end date, carrier, etc. as directed by policy.

RPCR panel displays Minnesota Restricted Recipient Program (MRRP) information. Check the PCUR BEGIN DATE and END DATE fields. Only MHCP-enrolled personal care provider organizations or Medicare-certified providers may provide PCA services. Recipient is not eligible for consumer directed support services or PCA Choice when there is a current PCUR span. Enter PCA services as standard PCA on the service agreement.

MMIS displays a list of designated primary providers on the RPCR panel. The PCUR-R panel displays providers for specialty services referred by the primary provider.

RMCR panel displays Medicare information.