Recently Asked Questions
 

1. A list of identified problems.

2. Answers to policy and processing questions.

3. Question and Answers for Identified Problems..

Questions and Answers for Identified Problems

1. Question: I encountered a case with a shelter error for FS, but not for MA. I was not able to code the case as correct for MA but not FS.

Answer:  Fixed May 6, 2006.

2. Question: I encountered a case where the rent/utility questions display for family MA cases.

Answer:  Fixed May 6, 2006.  

3. Question: I selected a case to review from the "Select Case” sample list.  When I went back to the "Select Case” sample list I noticed that the case still appeared on the "Select Case” sample list.  After I select a Case, it should be removed from the "Select Case” sample list, right?
    

Answer:   Fixed May 6, 2006.

4. Question: I noticed that once information is entered on the expense screen, it would not allow us to make changes.
    

Answer: Fixed May 6, 2006.
 

5. Question: I reviewed a Family MA case that displayed numerous "insurance premium" fields on the expense page.  Why are these expenses being displayed in a Family MA case?

Answer:  Fixed May 6, 2006.

6. Question:  A case I pulled for review was in closed status for the month in review.  Why was this case included in the sample?

Answer:   Fixed May 6, 2006.

7. Question: I did a review where the baby should have been on MN, but was on MHSC.  The MN option was not a listed category in the drop-down menu to select.  We need all the MA status options to correct the case?

Answer:  Fixed May 6, 2006.

8. Question:  If you want to stop in the middle of a review, there is no place to "save" the information, and leave the system to go back to it later?

Answer:   Fixed May 6, 2006.
 

Policy and Processing Questions
 

1. Question:  If an error is discovered in a second party review must the error be corrected and corrective action completed by the end of the following month in order for the 2nd party review to be considered "complete"?
    

Answer:  Please refer to Administrators Memo 06-02 , Item 10 on page 3.  

"A case that is found in error is considered complete when the case is corrected.  Although it is expected as a normal course of business that a claim will be established when warranted, this action does not need to be completed within the time period mentioned above."  Completion of the corrective action process does have to meet the same timeframe but will be part of the agency monitoring process.

2. Question: In some cases, we have noticed the benefit month is different than the pull month. This is somewhat confusing to our reviewers.  Is there a way to bold the benefit month or make the benefit months consistent?
    

Answer:  The month under review can be different than the pull month.  This depends on whether the case was confirmed as an intake, a review or an on-going case in the month prior to the pull.  In fact, it is possible that the sample pull month, the month under review, and the confirmation month will be three different months.  

• 1. The sample pull month indicates the month when an agency's case sample is physically extracted from CARES and loaded into IMQA.  It is also the month used when referring to an agency's monthly 2nd Party Review requirements.  Although the sample month may reflect the same case detail information as the benefit month under review, it is not necessarily so.
      

  2. The "Benefit month in review” is the month the reviewer must examine the case details in a second party review. The benefit month is displayed in the "Benefit month in review" field on the Case Detail Screen.   The 2nd party reviewer must examine the case details for the "Benefit month under review", not the sample month and not the confirmation month.  
      

  3. The Confirmation date displays the month the benefit being reviewed was confirmed.  The confirmation month is provided to assist the reviewer but, again, should not be confused with the month under review.

3. Question: When is the sample month available?  

Answer: The new month's sample is available the Monday after the first Saturday of the month.  For example, the May sample will be available May 8th.  

4. Question: I don't understand how cases are selected for the IMQA sample pull.  Some cases have an application or review in the last month, others are ongoing cases.

Answer:  This sample pull is explained in Agency Requirements and Sample Criteria  in the IMQA manual.

5. Question: I found a case where shelter cost did not display in the IMQA tool, although costs are in CARES and were in the budget.  (At the time of confirmation these expenses were not verified, and it was an expedited issuance, does that have something to do with it?)

Answer:  Only expenses verified at confirmation will be brought over to the tool.  However, when reviewing this case, expedited FS does  allow the unverified shelter expenses as a deduction.  Therefore this case would not be coded as in error.

6. Question: Is the agency Second Party Review requirement still two reviews pulled per worker per month?

Answer:  The Agency Requirements for Second Party Review is described in Administrators Memo 06-02.  As described in this memo, "Because the programming work to allow for the manual select case option will not be available until April or later, the required number of reviews is reduced temporarily from .9% to .5% of the agency's caseload until this functionality is implemented." Refer to the IMQA manual for the Agency Requirements and Sample Criteria.  The .9% or .5% case sample pulled is by county and not by worker or supervisor unit.  So, some workers may have more pulled and others may not have any pulled if their cases don't meet the sample pull criteria.

7. Question: Priority is not listed as an option under Application Type field on the Application Page.  Is an expedited application the same as priority?  

Answer: Priority Service and Expedited Issuance are two different things.  Priority Service is the determination that the individual must be seen or contacted within 2 days to complete their application interview.  Eligibility for Priority Service is determined by the limited information gathered on the registration form while eligibility for Expedited Issuance is determined after gathering all the information during the application interview. That was the reasoning behind the choice to use 'Expedited' as the application type instead of 'Priority'.

8. Question: Is the IMQA tool only available when CARES is up?

Answer:  IMQA is not dependent on CARES availability since the sample pulls are done at a certain time of the month.  However, if you are reviewing a case, it is likely you will need to be able to query CARES.

9. Question: If benefits were correct, do we record all errors? For instance, if the wrong assets were used for an EBD MA case, but the correct assets are under the asset limit, was the case in error?
    

Answer: These cases are not defined as errors for MA, the case should be called correct. The reviewer should note the discrepancies and instruct the ESS to correct the case. Even though discrepancies are identified on a case, they may or may not lead to an eligibility error.  If the eligibility and cost share are correct despite identified discrepancies, the case should be considered correct.  To be sure the case remains correct, any discrepancies found should be corrected.
 

Note: If the discrepancy resulted in a premium/cost share/etc. difference, the case is in error.

10. Question: Do we need to scan TCR’s (targeted case reviews) any more since there is a history in IMQA?  

Answer:  Agencies should no longer be using TCR's.

11. Question: Is a SMRF considered a mail-in review?  Some of the cases selected were not from reviews or applications, but had a SMRF processed.  

Answer:  A processed SMRF does not meet the criteria as a mail in review for the review sample pull.  This sample pull is explained in Agency Requirements and Sample Criteria of the IMQA manual as well as Operations Memos 06-05 and Administrators Memo 06-02.  If there are not enough intake and review cases for the sample pull, we will select ongoing cases for your sample cases.  The SMRF has nothing to do with the case sample pulled.

12. Question: Is there a printable version of this tool?

Answer:  The web-based IMQA review tool simplifies and expedites the second party review process.  Using printed versions of this tool is discouraged, because it does not have the efficiency and tracking advantages available with the web based tool.

You can screen print by clicking anywhere on the page you want to print before you hit the print button, and it will screen print that particular page.  

13. Question: Is there a printable version of the IMQA Second Party Review Manual?

Answer:  A PDF version of the IMQA Second Party Review Manual will not be offered.  PDF versions of handbooks offer none of the functionality of the web-based versions and are time consuming to produce.
 

To print any web page, including a policy page found in any Eligibility Management handbook, follow these instructions.

• 1. Right click on the page.  If the page is divided up into sections or frames, make sure you right click on the area you want printed.  For a policy page, right click on the policy itself, and not on the Toolbar or Navigation Pane.

  2. Click on "Print."

  3. A dialog box will come up with your default printer selected.  You can change the printer here if you want.

  4. Choose "OK."

The web page will be printed to the selected printer.  However, it may not be formatted exactly as it appears on the web page.  There may be a page break in the middle of the text.

Enhancements/Suggestions

1. Question: Would there be a way to code the review for follow-up/turnaround feedback at the local level?  Would there be a way to have some sort of an indicator that we need additional information from the worker?  We feel this would help with our goal of not only finding the percentage of cases in error, but to also take corrective action.  Currently cases in complete status are not truly complete.

Answer:  We are looking into adding a third case status such as "pending" in the next phase.   You are right, "complete" status should really mean the whole 2nd party review process and corrective actions required have been completed.

2. Question: We would like to be able to run reports from IMQA that consist of errors by type, errors by worker, dates, and a report of cases with error by agency.

Answer: We will add your suggestions for the report phase.

3. Question: Would there be a way to add a summary screen where findings could be reviewed by the worker?  The information that we would like included would be the date of the review, case name and number, reviewer name, review month, comment section for the reviewer’s findings, a response due date and then a comment section for the worker to be able to respond.

Answer:  A Summary Screen was added May 6, 2006.

4. Question: On the FS Findings page what should we enter for a correct amount when we know that an error occurred but we are unable to determine what the correct amount should have been.  In the "old" system, we could show an error with $0 dollar amount and then update once the information was obtained that was needed to determine the correct benefit.  

Answer:  We will add this as a suggestion to enhance in the next phase.

5. Question: Our agency reviewed a Healthy Start case where only the children were eligible, the MA findings page listed the parents in an MHSC category.  Why would the parents show in this category of assistance?  

Answer:  The Medicaid Eligibility Findings Page was updated May 6, 2006 to provide "fiscal member"as a drop down option.

6. Question: I did a review on a FS case entered on 2/28/06.   That date (2/28/06) is the confirmation date listed on the IMQA case detail screen.  I found that the MA was closed and should have been opened but I couldn't document that in the IMQA system because I couldn't access the MA findings screen.  I don't know, but suspect, I couldn't access that screen because MA wasn't open during the benefit month in review.  I spoke to the worker who will run eligibility with dates to get it open for March but it seems like a flaw in the system not to be able to document that type of thing as an error.

Answer:  There is no MA Findings Page because this is a FS only review case.  There should be a way to record this finding.  This is being suggested for enhancement in the next phase.

9. Question: When reports are run and statistics compiled, will the primary worker or the person who confirmed the case be used?  My previous assumption was that it would be the person who confirmed the case and that is how I have selected cases from the pull for review, but want to be sure that I understand clearly.

Answer: Report development is a future initiative. We are still taking suggestions for the best way to compile these reports.

10. Question: On some of the screens, I can't find a way to move on to another screen when the current one is not completely filled out. I also can't seem to find a "home" key to bring you to the beginning page of the IMQA tool. Is there one?

Answer: Home Key added May 6, 2006.

11. Question: Will there be a "county" report button like there is a PAC and QA report button?

Answer: This is being considered as a future enhancement.