9.8 General Rules

Avoid over-verification (requiring excessive pieces of evidence for any one item or requesting verification that is not needed to determine eligibility). Do not require additional verification once the accuracy of a written or verbal statement has been established.
Do not verify information already verified unless there is reason to believe the information is fraudulent or differs from more recent information. If fraud is suspected, determine if a referral for fraud or for front-end verification should be made (9.10.1).
Do not exclusively require one particular type of verification when various types are adequate and available.
Verification need not be presented in person. Verification may be submitted by mail, fax, e-mail, or through another electronic device or through an authorized representative .
Do not target special groups or persons on the basis of race, religion, national origin or migrant status for special verification requirements.
Do not require the member to sign a release form (either blanket or specialized) when the member provides required verification.
Do not require verification of information that is not used to determine eligibility.

Except for verification of access to employer sponsored health insurance (9.9.6), the member has primary responsibility for providing verification and resolving questionable information. However, the IM worker must use all available data exchanges to verify information rather than requiring the applicantA request for BadgerCare Plus coverage. The request must be on the Department's or Federally-facilitated Marketplace’s application, registration form or account transfer (from Federally-facilitated Marketplace) and must contain name, address, and a valid signature. The applicant must submit a signed and completed application form to complete the application process. to provide it, unless the information from the data source is not reasonably compatible with what the applicant or member has reported (see Chapter 9.12 Reasonable Compatibility).

Assist the member in obtaining verification if he or she requests help or has difficulty in obtaining it.

Use the best information available to process the applicationA request for BadgerCare Plus coverage. The request must be on the Department's application or registration form and must contain name, address, and a valid signature. The applicant must submit a signed and completed application form to complete the application process. or change within the time limit and issue benefits when the following two conditions exist:

The applicant/member does not have the power to produce verification, and
Information is not obtainable timely even with your assistance.

Do not deny eligibility in this situation, but continue in your attempts to obtain verification. When you have received the verification, you may need to adjust or recover benefits based on the new information. Explain this to the applicant/member when requesting verification.

This page last updated in Release Number: 15-01

Release Date: 05/15/2015

Effective Date: 05/15/2015