NOTE: Please refer to your agency's AVS procedures documentation.
Staff must receive authorization in order to run an AVS search. Tickles will be generated approximately 90 days prior to the end of the renewal month for clients who do not have an AVS authorization in place.
Staff should review the case record to determine whether authorization was granted on an application or review form previously received, or authorization was granted and documented in the ACES narrative.
If authorization was granted, update the AVS authorization field to "AVS Authorized."
If authorization is not provided, request AVS authorization from the client.
If there has been a break in medical coverage for more than 30 days, a new authorization is required.
AVS will provide banking information for the month the AVS search is submitted.
Approximately 60 days prior to the end of the renewal month, if an AVS authorization is in place for the client and financially responsible people (if applicable), an AVS request will be sent overnight via batch process. Fifteen days after submission AVS results will populate in the AVS portal.
For Medicaid programs that do not have a 60 month look back period, the AVS will provide 4 months of financial institution account balance data from the application date.
For Medicaid programs that have a 60 month look back period, the AVS will review accounts balances and transfers for the 60 month period from the application date.
An AVS request is sent after both the client and financially responsible person (if applicable) have a status of "AVS authorized." At that point, all financial institutions on the ACES resource page that have been added through the financial institution search, will be sent to the AVS vendor to directly search for records at that those financial institutions. An AVS2 tickle will be set for 16 days following submission.
Financial staff must contact the applicant or recipient and give them the opportunity to provide the needed information to resolve a discrepancy and determine ongoing eligibility when AVS returns information that indicates:
- Inconsistent withdrawals during the look back period (for LTSS programs with a transfer look back period); or
- Bank accounts that are over the resource standard; or
- Accounts not listed on the application, or disclosed during the interview (if an adverse action may be necessary); or
- Any other questionable information.
Financial eligibility staff cannot deny or terminate a case based solely on the information received from AVS or LexisNexis. Alternate verification must be requested.
If the client is ineligible due to transfers in the 60 month look back period, determine if there is eligibility for another medical program without a look-back period:
- S-series AH if client is resource eligible
- HWD if the client is disabled and working
- TSOA eligibility
At application or eligibility review, once AVS results are received, document the client's resources in ACES.
Once results are reviewed in the portal and documented in ACES, the AVS case must be closed in the portal using closed/withdrawn.