1 Presumptive Eligibility by Hospitals

Centers for Medicare & Medicaid Services
CMS eXpedited Life Cycle (XLC)

Medicaid and CHIP Program (MACPro)
S21-Presumptive Eligibility by Hospitals PRA
document
Version 1.0
08/21/2017

Document Number: 231-QSSI-MACPro-PRA-S21-D
Contract Number: HHSM-500-2007-00024I: HHSM-500-T0014

CMS XLC

Table of Contents

Table of Contents
1. S21-Presumptive Eligibility by Hospitals – Screenshots ...................................................... 1
1.1

Presumptive Eligibility by Hospitals ................................................................. 1

List of Figures
Figure 1: Presumptive Eligibility by Hospitals – 1 ............................................................ 1
Figure 2: Presumptive Eligibility by Hospitals – 2 ............................................................ 2
Figure 3: Presumptive Eligibility by Hospitals – 3 ............................................................ 2
Figure 4: Presumptive Eligibility by Hospitals – 4 ............................................................ 3
Figure 5: Presumptive Eligibility by Hospitals – 5 ............................................................ 3
Figure 6: Presumptive Eligibility by Hospitals – 6 ............................................................ 4
Figure 7: Presumptive Eligibility by Hospitals – 7 ............................................................ 4

S21-Presumptive Eligibility by Hospitals PRA document Version 1.0

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S21-Presumptive Eligibility by Hospitals – Screenshots

1. S21-Presumptive Eligibility by Hospitals – Screenshots
1.1

Presumptive Eligibility by Hospitals

Figure 1: Presumptive Eligibility by Hospitals – 1

S21-Presumptive Eligibility by Hospitals PRA document Version 1.0

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S21-Presumptive Eligibility by Hospitals – Screenshots

Figure 2: Presumptive Eligibility by Hospitals – 2

Figure 3: Presumptive Eligibility by Hospitals – 3

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S21-Presumptive Eligibility by Hospitals – Screenshots

Figure 4: Presumptive Eligibility by Hospitals – 4

Figure 5: Presumptive Eligibility by Hospitals – 5

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S21-Presumptive Eligibility by Hospitals – Screenshots

Figure 6: Presumptive Eligibility by Hospitals – 6

Figure 7: Presumptive Eligibility by Hospitals – 7

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