State of Wisconsin |
HISTORY |
The policy on this page is from a previous version of the handbook.
Verification is part of determining eligibility. To verify means to establish the accuracy of verbal or written statements made about a group’s circumstances.
If the member is applying for other programs of assistance or if you are looking for sources of verification, see the specific verification chapters for those programs in their respective handbooks.
Documentation is a method by which you accomplish verification. Case comments in CWW provide documentation, including worker notes regarding collateral contacts, viewing documents, home visits, etc. Include enough data to describe the nature and source of information if follow up is needed.
The verification receipt date is the day verification is delivered to the appropriate IM agency or the next business day if verification is delivered after the agency's regularly scheduled business hours. IM agencies must stamp the receipt date on each piece of verification provided.
The applicant or 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 applicant to provide it, unless the information from the data source is not reasonably compatible with what the applicant or member has reported (see Section 20.3.8.1 Reasonable Compatibility for Income for Health Care and Section 20.3.5.2 Reasonable Compatibility for Assets).
IM agencies must assist the applicant or member in obtaining verification if they request help or have difficulty in obtaining it.
The best information available should be used to process the application or change within the time limit when both of the following conditions exist:
Applicants meeting the health care program eligibility criteria based on this best available information are eligible for benefits. Even after the application or change is processed using best available information, the IM agency is required to continue in their attempts to obtain verification. When the verification is received, benefits may need to be adjusted or recovered based on the new information. The agency must explain this to the applicant or member when requesting verification.
This page last updated in Release Number: 22-01
Release Date: 04/04/2022
Effective Date: 04/04/2022
The information concerning the Medicaid program provided in this handbook release is published in accordance with: Titles XI and XIX of the Social Security Act; Parts 430 through 481 of Title 42 of the Code of Federal Regulations; Chapters 46 and 49 of the Wisconsin Statutes; and Chapters HA 3, DHS 2, 10 and 101 through 109 of the Wisconsin Administrative Code.
Notice: The content within this manual is the sole responsibility of the State of Wisconsin's Department of Health Services (DHS). This site will link to sites outside of DHS where appropriate. DHS is in no way responsible for the content of sites outside of DHS.
Publication Number: P-10030