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Wisconsin Department of Health and Family Services Income Maintenance Quality Assurance Second Party Review Manual Release 08-02 April 3, 2008 |
Policy References:
BadgerCare Plus: BC+ 16.1 Income , BC+ 16.4 Earned Income
EDB- MEH:15.1 Income Introduction , 15.5 Earned Income
FoodShare: FSH 8.3.4.4 Enter Income in CARES
Note
If utilizing data exchange (DX) resources when determining whether the FS and Healthcare income information is correct (see #14 & #18 field explanations below) keep the following points in mind.
Remember to divide the wage query DX amount by three since the amount provided is for a quarter, not a month.
Remember to consider start and end dates of employment, temporary overtime, and other temporary situations that may effect income for a short time. If a discrepancy is found between the CARES amount and the wage query DX amount, select "no” in the"Correct” field and select the option"DX amount discrepancy” from the discrepancy drop down box.
The reviewer will have the opportunity to decide on the Discrepancies page whether this constituted an error large enough to be the primary error on the case.
Policy Reference: EBD-MEH 20.1 Verification Introduction, BC+ 9.1 Verification
Field Descriptions
Pay Frequency:
How often the individual is paid as reported in CARES. This includes but is not limited to:
Weekly
Bi-weekly
Monthly
Correct Pay frequency:
If the Pay Frequency (3) is not correct, enter the correct pay frequency in this field. Choose an option from the drop down box. This field will only display if the FS Correct? (14) or Healthcare Correct? (18) fields are answered NO.
Regular
Tips
Commission
Bonus
Total per PP:
The total income per pay period (PP) as reported in CARES. This is the amount that is entered into CARES by the IM worker prior to any conversion calculation (for FS) or manual override.
Correct Type of Pay:
If the Type of Pay (5) is not correct, enter the correct pay type in this field. Choose an option from the drop down box. This field will only display if the FS Correct? (14) or Healthcare Correct? (18) fields are answered NO.
Correct Hourly Rate of Pay:
If the hourly rate of pay (6) is not correct, enter the correct pay rate in this field. Enter a currency value here. This field will only display if the FS Correct? (14) or Healthcare Correct? (18) fields are answered NO.
Correct Hours per Pay Period:
If the hours per pay period (7) are not correct, enter the correct number of hours in this field. Enter a numerical value here. This field will only display if the FS Correct (14) or Healthcare Correct (18) is answered NO.
Correct Total Per Pay Period:
If the earned income details are corrected in (9), (10) or (11) this field will automatically calculate the correct total income per pay period based on reviewer’s entries. This field will only display if the FS Correct? (14) or Healthcare Correct? (18) fields are answered NO.
FS Budget or Override:
The average prospective budgeting amount (which is the 4.3 conversion amount) or the override amount from CARES. The prospective budgeting amount (ie. the converted amount) is the default value that is auto populated here. If the worker did a manual override on the case, the amount auto populated will be the override amount. OVR will display in this field if an override amount was used in CARES.
FS Correct?:
Determine if the earned income information from CARES in fields (1, 2, 3, 5, 6, 7, 8, and13) is correct for FS income budgeting. Select Yes or No.
Yes = All auto populated information is correct.
No = Some or all auto populated information is incorrect. If no is selected, blank fields will display below the auto populated fields so reviewer can make corrections where needed.
Discrepancy:
If any of the CARES earned income information is incorrect, select a discrepancy reason from the drop down box provided.
Correct FS Budget:
If changes have been made to the income details and there is a new budget amount, reviewer needs to enter the new amount here.
Healthcare Budget or Override:
This is the average prospective budget amount or the override amount from CARES. The prospective budget amount is the default value that is auto populated here. If the worker did a manual override on the case, the amount auto populated will be the override amount. OVR will display in this field if an override amount was used in CARES.
HealthcareCorrect?:
Determine if the earned income information from CARES in fields (1, 2, 3, 5, 6, 7, 8, 17) is correct for MA income budgeting. Select Yes or No.
Yes = All auto populated information is correct.
No = Some or all auto populated information is incorrect. If No is selected, blank fields will display below the auto populated fields so the reviewer can make corrections where needed.
Discrepancy:
If any of the CARES earned income information is incorrect, select a discrepancy reason from the drop down box provided.
Correct Healthcare Budget:
If changes have been made to the income details and there is a new budget amount, the reviewer needs to enter the new amount here.
Has all earned income been included?:
Determine if there is income that has not been reported and should have been. Select Yes or No. Use data exchanges or other available collateral information to determine this.
Yes = Reviewer has determined that all earned income for the case has been reported.
No = During course of review, it was determined that the case has earned income that was not originally reported or showing in CARES.
Discrepancy:
This must be completed if the response to #21 is No. If all earned income has not been included, select a discrepancy reason from the drop down box provided. Enter dollar amount of error in the Comments section of the Healthcare Error Identification page and/or the FoodShare Discrepancies and Findings page.
This page last updated in Release Number: 08-02
Release Date: 04/03/08
Effective Date: 02/01/08