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Updated Uniform Application, Clinic Client Application, and Manual
We've uploaded a new version of the Uniform Application (Version 2) and Clinic Client Application (Version 12), effective July 1, to the CICP Provider Information webpage. The manual has been updated to remove all references to the patient needing to supply a Social Security Number.
The changes to the application include the following:
- Removed the requirement for CICP applicants to provide a Social Security number or sign a No SSN affidavit per the passing of the Medical Services Board rule change. As a clarification, this change makes no policy changes to Hospital Discounted Care.
- Adjusted so all the Unemployment pages print out
- Added Application Assistance Mapping Tool to the screening page
For hospitals: if a patient has already started an application on or before June 30, 2024, the application should be completed using Version 1.6. If the patient was screened on or before June 30, 2024 but does not start an application until July 1 or later, Version 2 should be used to complete their application. Any screenings or applications started July 1, 2024 or later should be completed using Version 2.
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