Submitting an Application and Application File Date

Submitting an Application and Application File Date A. An application for Medicaid may be filed in any of the following described submission methods. 1. In person at any regional office, official out-stationed location or other location outside the regional office where eligibility staff are on official duty, such as a nursing facility, hospital or other public facility. The filing date is the date received by the office or other location. 2. By mailing to any regional office. Applications received by mail which arrive after the end of the month, but which are postmarked by the last day of the month, will be considered to have been received by the regional office on the last day of the month in which they are postmarked. 3. By fax received in any regional office. The date of filing is the date received by the Division of Medicaid’s central or regional offices. An original signature is not required. 4. By on-line submission to the Federally Facilitated Marketplace (FFM) which is then transferred to the Division of Medicaid. The filing date is the date received by the FFM. An electronic signature is accepted for applications filed on-line to the FFM. 5. By telephone via a telephonically recorded application process. The date of filing is the date the telephonic signature is recorded. Unless the telephone interview is recorded, the completed application must be sent to the applicant for signature in which case the date of filing is the date the Division of Medicaid receives the signed application form. 6. By on-line submission of the application to DOM. The filing date is the date received by the agency’s central or regional office. An electronic signature is accepted for applications filed on-line with the agency. 7. By on-line submission of the application through the Common Web Portal (CWP). The filing date is the date filed with the CWP. An electronic signature is accepted for applications filed on-line with the CWP. B. Once a signed and dated application has been received by the Division of Medicaid, it cannot be altered by adding, changing or deleting any information. 1. During an interview, an applicant may make changes to the information on an application. 2. If the interview is in-person, the applicant must initial the changes. 3. If the change to information on the application is reported in any other manner, it must be documented in the case record and/or in the case narrative, but not on the application form.