B How to Process an ALTCS Application for a Deceased Customer

Program	Manual Section
ALTCS	MA1302B

Procedure

Follow these steps to process an application received for a deceased ALTCS customer:

Step	Action
1	Check the customer’s date of death and enter it into HEAplus. Was the date of death before the earliest application month, including prior quarter? If YES, STOP. Deny the application for “Applicant deceased”. If NO, continue to Step 2.
2	Schedule the financial interview. NOTE When the customer submitted the application and had no representative, send the appointment letter to the customer’s last known mailing address and enter “To the Estate of [customers name]” in the “In Care Of” field of the mailing address screen in HEAplus.
3	Did someone respond to the interview request? If NO, STOP. Deny the application for appointment missed. If YES, continue to step 4.
4	Inform the representative about the Estate Recovery program to make sure the representative wants to proceed with the application. Does the representative want to proceed with the application? If NO, STOP. Deny the application for Voluntary Withdrawal. If YES, continue to step 5.
5	Complete the interview.
6	Request the PAS. Enter a case note that the request is for a posthumous PAS.
7	Do you have all the proof needed to determine financial eligibility? If YES, determine financial eligibility through the month of death. When the customer is not eligible, deny the application. When the customer is financially eligible, wait for the PAS to be completed to disposition the case. If NO, continue to Step 8.
8	Send an RFI for the missing proof. Was all the proof provided? If YES, determine financial eligibility through the month of death. When the customer is not eligible, deny the application. When the customer is financially eligible, wait for the PAS to be completed to disposition the case. If NO, STOP. Deny the case for the appropriate denial reason.
9	When the PAS is completed, disposition the case. Is the customer medically eligible? If NO, STOP. Deny the application for failed PAS. If YES, approve the application and disposition all months through the month of death. NOTE When approving an application for a deceased customer with a Special Treatment Trust, add a comment on the Notification of a Special Treatment Trust to DBF (DE-137) form that the customer was deceased at the time of approval.