Administrative Procedures – Table of Contents

0107.020.00 Case Reviews for MO HealthNet for the Aged, Blind, and Disabled Programs

IM-144, September 17, 2019

Eligibility Supervisors must complete targeted case reviews monthly. Managers must also complete periodic re-reviews and complete a full case review. Case reviews are intended to identify trends to be used for training needs and policy clarifications.

A total of twenty-four targeted reviews must be completed per supervisor (agency wide, state wide). This may be achieved by each supervisor completing a total of 24, or an average of 24 between multiple supervisors.

EXAMPLE: Park County has 2 supervisors. There must be a total of 48 reviews completed each month.  2 supervisors x 24 reviews per supervisor = 48 reviews.

In January, Supervisor Aaron completed 12 reviews. Supervisor Stephanie completed 36 reviews. 12+36 = 48 reviews.

In February, Supervisor Aaron completed 27 reviews. Supervisor Stephanie completed 21 reviews.

27+21 = 48 reviews.

The goal was met for January and February, even though the supervisors each completed a different number of reviews each month.

 

EXAMPLE: Park County has 2 supervisors, Lee County has 4 supervisors, Potter County has 6 supervisors.

2+4+6= 12 supervisors

12 supervisors x 24 reviews per supervisor = 288 reviews each month.

In March, Park County supervisors completed 52 reviews, Lee County completed 98 reviews, and Potter County completed 138 reviews.

52+98+138 = 288 reviews

The goal for March reviews was met, regardless how many reviews each individual supervisor completed. The total average was 24 reviews per supervisor.

The targets of each month are determined by the needs of the MO HealthNet programs such as a focus on reviewing income, address, shelter expenses, or medical expenses. The targets may vary from office to office depending on the focus of the office.

EXAMPLE: Lee County completes Vendor Applications. In February, the manager saw a number of errors regarding life insurance values while he was doing manager reviews. He determined that the supervisors should focus on making sure that resources are being verified correctly during the March supervisor readings.

EXAMPLE: Potter County completes MHABD Annual Reviews. In February, the manager noticed several errors regarding start dates and end dates for earned income while he was doing manager reviews. He determined that the supervisors should focus on income monthly budgets during March supervisor readings.