Medicaid Benefits
This must be completed prior to taking Negative Action on any case.
What is PTR
Outstanding IEVS matches must be processed before transferring or closing a case.
True or False?
True
Expedite Screening Tool needs completed at every Intake Application and/or Intake Interview?
True or False?
True
Client submits TANF Application and Interview was completed. What is the referral process to OMJ?
Send Sarah and email same day with client's information along with screenshot of EDBC.
Do you need to review if client is ABAWD if the 7405 is being sent to the client?
Yes or No?
Yes
*This is a requirement and we're noticing that this is not happening like it used to.
This is the first step in the Medicaid verification process?
Utilize electronic verification sources:
Federal Data Hub, E-Verify, The Work Number, AVS
While reviewing an Overpayment Referral, it is found that an Agency Error and an IHE occurred in the same month. What type of claim does this become?
Agency Error
Interim Report is received and states "No Changes" however, client states Rent is $550 and was previously $425. RFC was sent requesting updated Rent Receipt or Lease Agreement. No verifications were received.
Is this a valid IR?
Yes. IR is still valid however, client is not eligible for rental deduction.
What is the first four things you should review when you log in each morning in EDMS and what is the order to process the cases?
30 Days/Interviews
Overdue Documents
Changes
Documents Received
What are 5 of the weekly alerts that you are required to be processing currently?
(Not IEVS/New Hires)
Workman's Compensation
SVES-Prisoner
Buy-In
LTC
Age Change
ABAWD
AVS
The Work Number is a LEAD. We can't use it unless we are given permission by client or employer correct?
True or False?
False:
It is a lead, but is used to verify the information that the individual provides. Permission is granted via the application so no additional permission is needed to use the Work Number to verify a report from the individual.
What the standard (measured in percentage) in which each county agency is held to when processing IEVS matches appropriately and timely?
Federal Requirement is 80%
April 2024- Hardin County ranked 78 out of 88 counties coming in at 9.86%
Rent and Utility verification must include:
Name and Address of the client on the verification
Work Registration Screens need completed at EVERY Intake, Renewal and Household Change for Adult Members.
True or False?
True- This is a State requirement. You must review the EDBC budget to make sure EDBC states the same exemption as you have listed on Work Registration.
What is the funnel category for RMS?
(Highest to Lowest)
PRC TANF Benefits- 100%
Chip Child Benefits- 79%
Regular Medicaid/Snap- 50%
Can a client still self-attest to being over income?
Yes. This policy has not changed. Additional information: Add: OAC 5160:1-2-10(B)(8)(a)(i) states: When an individual's declared income exceeds the relevant federal poverty level (FPL) threshold, the individual's declared income will be accepted without further verification.
The county receives incentives for overpayments processed based on the type of overpayment claim that is established. What is the percentage that the agency receives for an IHE claim?
IHE- 20%
IPV- 35%
Agency Error- 0%
Once an ABAWD has reached the 3/36 time-limit, the only ways they can regain SNAP eligibility are by:
Client is ABAWD required and Work Referral Sent. Client then contact IM Case Manager stating they're working 32 hours per week. Case Manager sends Change Report to OMJ and states client is meeting an exemption. Is this a valid Change Report?
Yes or No?
No because you need to be very specific when submitting a Change Report and put the exemption on the Change.
EX: Client is now exempt as client is working 32 hours per week.
Children Services Referral needs to be completed via email to what Children Services employees?
Morgan Gault and Alexa McClure
Client submits Medicaid Renewal with income reported from a different employer than what is listed in Ohio Benefits. Case Manager pings the hub and income does not verify and electronic sources were reviewed and income still not verified. Two notices were mailed however, during the process the client calls and states he's unable to obtain the pay stubs from previous employer, but can provide pay stubs for new employer. Can the agency use client statement to verify old employment? Yes or No?
Yes. The client contacted the Case Manager and states they're unable to obtain the documents therefore we can use their self attestation.
Client reports during a SNAP Renewal that their hours at Walmart have decreased and they are now also working as a substitute teacher. Client states they are paid bimonthly as a substitute teacher. Caseworker requests the last 30 days pay for both jobs. Client submits only one pay for each job. The work number was able to verify more pays for Walmart and they were used as they appear reflective. What steps would you take to enter the one pay turned in from the substitute teaching job?
*Note: when reviewing this paystub, you can clearly see that this was not their first pay as the YTD in much higher than this check amount.
Choose all that apply
A. Enter the paystub you have as one pay and enter $0 for the second pay they would have received that month
B. Attempt collateral contact with the employer
C. Call the client and request the last three months pays to establish an average
D. Enter the paystub that was submitted as twice monthly
3/30: Snap application received and screen as potentially eligible for expedited services.
4/1: Interview was conducted and all verifications are received, except verification of shelter costs.
Is this 3/30 application eligible for expedited services?
What action should the worker take?
Yes
Approve expedited Snap and request shelter expense as postponed verification
When you receive a case for Intake, Renewal and/or Change. What is the first action that needs taken before even reviewing the case?
Read Journal
What is the Hardin County CSS Schedule Monday-Friday?
Monday- 8:00-3:30
Tuesday- 8:00-11:00 ; 10:30-1:00
Wednesday- 8:00-11:00
Thursday- 8:00-11:00; 1:00-3:30
Friday- 8:00-11:00
*Make sure you are signed in at your correct times, we are getting too lenient and this is your responsibility to make sure you are marked "ready"