- TO:
- ALL FAMILY SUPPORT DIVISION OFFICES
- FROM:
- ALYSON CAMPBELL, DIRECTOR
- SUBJECT:
- UPDATES TO THE REPORT OF MO HEALTHNET QA/QC REVIEW (IM-210MHN) FORM
- FORMS MANUAL REVISION #6
DISCUSSION:
The purpose of this memorandum is to introduce the updated IM-210MHN form. The updated form will be used by field offices and the Quality Assurance / Quality Control Unit (QA/QC) as a tracking tool to ensure appropriate updates/actions are taken timely on error cases as well as on cases that have deficiencies.
The updated IM-210MHN identifies discoveries made by QA/QC as defined below.
- Correct: The overall eligibility determination was correct and no issues or problems were identified during the review of this case.
- Error: The decision about overall program eligibility was incorrect.
- Deficiency: The overall eligibility determination was correct but an issue or problem was identified during the review of the case.
- NSTR – Not Subject To Review
QA/QC will distribute the IM-210MHN to the Eligibility Specialist, Eligibility Specialist Supervisor, and Office/County Manager, as well as the Regional Administrator. The IM-210MHN is divided into Sections A through C. Section A and B (QA/QC Findings and MO HealthNet Level of Coverage) are required to be completed by the QA/QC Unit. QA/QC will submit the IM-210MHN to the office for review and response. Section C #1 - #7, and required signatures will be completed by the local office for errors and deficiencies.
If the local office disagrees with an error case review or the deficiencies reported on the IM-210MHN, the county has the opportunity to challenge the QA/QC finding in Section C. If the county disagrees with the case review, the Eligibility Specialist Supervisor or Office/County Manager must contact the Quality Assurance Manager immediately to discuss. If the Eligibility Specialist Supervisor and QA Manager cannot resolve the issue, the determination is forwarded to the QA/QC Unit Manager who will make the final decision.
It is the local office’s responsibility to establish procedures to ensure the IM-210MHN is completed, the case is updated and/or corrected, and the completed IM-210MHN is returned to the QA/QC Unit.
It is vital that a response is received by QA/QC no later than by close of business on the third working day after receipt of the IM-210MHN.
NECESSARY ACTION:
- Review this memorandum with appropriate staff.
- Utilize the updated IM-210MHN.
AC/gb