Wisconsin Department of Health and Family Services Income Maintenance Quality Assurance Second Party Review Manual |
Policy Note: Coding household relationships incorrectly can affect the outcome of the case and can cause the incorrect test group, incorrect assistance group, or incorrect individual participation status for Healthcare. Check the relationships against what appears in the application on file and against any other information in the file that reveals household relationships.
Policy References
FSH 3.3.1 Food Unit. BC+ Group Chapter 2
Names:
Name of individual(s) included in the fiscal group and/or the eligibility determination.
Programs:
The program(s) this individual is included in for fiscal and/or eligibility determination.
Correct HH Member?:
Determine if indiviudals were correctly included in the FS and or Healthcare eligibility determination under review. Select the correct response from the drop down box provided:
Yes = Individual correctly included in the eligibility determination for the program(s) displays.
No = Individual incorrectly included in the eligibility determination for the program(s) displays. A discrepancy in number (5) must be selected.
Yes FS/No MA = Individual correctly included in the eligibility determination for FS, and incorrectly included for Healthcare. A discrepancy in number (5) must be selected.
Yes MA/No FS = Individual correctly included in the eligibility determination for Healthcare, and incorrectly included for FS. A discrepancy in number (5) must be selected.
When an individual is incorrectly included or excluded in the program(s) field (4), the reviewer must select a discrepancy reason from the drop down box for what caused it to be incorrect.
Indicate if the household composition was determined correctly according to Healthcare policy and/or FoodShare policy. Select Yes or No from the drop down box.
Yes = Reviewer has determined that all household members have been included correctly.
No = Reviewer found some or all of the household members were not included or excluded correctly in the household. A discrepancy must be selected in field (5).
When the household composition in field (4) is incorrect, the reviewer must select a discrepancy from the drop down box for what caused it to be incorrect.
This page last updated in Release Number: 08-03
Release Date: 04/03/08
Effective Date: 02/01/08