SGELIG Training
Maintaining Information Using SGELIG on the Web
Changing a Subscriber's Eligibility Information
Terminating a Subscriber's Coverage
Changing a Subscriber’s Termination Date
Reinstating a Subscriber
Terminating a Dependent's Coverage
Changing a Dependent's Biographical Information
Creating a Communication Log Entry
Changing a Subscriber's Eligibility Information
The Change function provides the ability to make online changes or corrections to a
subscriber's record in SGELIG.
Online changes may be necessary if a subscriber's eligibility information in *SGELIG is incorrect, which may cause a vendor to show the subscriber as ineligible or incorrectly covered. By correcting the record using SGELIG online and sending an emergency update (1ER) to the vendor, the subscriber or a member of his/her family can seek immediate medical attention.
NOTE: All changes made to SGELIG online must also be made to the components local system before the next eligibility dataset is sent to EGI or the online corrections could be negated.
Terminating a Subscriber's Coverage
The Terminate function offers the ability to terminate all coverages in SGELIG for an active subscriber (and any dependents) for up to three months prior to the end of the previous month (if the current month is March, records can be terminated back to the end of November - or three months prior to the end of February).
Changing a Subscriber’s Termination Date
If a subscriber is terminated, but any of the coverage termination dates are incorrect, the Change Termination Date function will allow a change in termination date(s) for up to three months prior to the end of the previous month (if the current month is March, records can be terminated back to the end of November - or three months prior to the end of February).
If a subscriber is terminated in SGELIG, but in fact, is an eligible Subscriber, use the Reinstate function to reactivate an existing coverage record.
Often there are multiple records for any one Subscriber. Before reinstating a Subscriber, it is often helpful to first use the list command 1LS on the mainframe, or the List Records command in SGELIG on the Web to determine which record you wish to reinstate.
Terminating a Dependent's Coverage
This function provides the ability to terminate only a dependent's coverages in *SGELIG for up to three months prior to the end of the previous month (if the current month is March, records can be terminated back to the end of November - or three months prior to the end of February).
Changing a Dependent's Biographical Information
With this function, limited information about a dependent can be modified. This includes name, birthdate, and gender.
Viewing Communication Log Entries
When eligibility records are changed, termed, reinstated, etc. using the SGELIG online
application, information is stored with the record identifying the time and date of the modification,
as well as the logon ID of the person (or EGI-IS program) who initiated the change.
However, if an entry is made in the Communication Log for a subscriber at the same time, more details about the modifications can be noted, providing a useful historical record of updates to a particular subscriber's eligibility information.