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General verification
Purpose: This chapter describes what verification is required and when.
Worker Responsibilities
- Before requesting verification:
- Look in the case record (HPF document center, Barcode ECR, WebAx, case notes) and third party sources to verify the information.
- Only request verification needed to verify the eligibility factor.
- Do not request verification to be in a particular type or form. For instance, do not ask for a bank statement to verify resources. Instead, request “proof of resources, such as a bank statement for the month of March 2017.”
- Use alternative methods, such as telephone calls, as the primary method to verify the client’s circumstances. Request paper verification only when there are no other methods readily available.
- When verification is needed:
- Verification may be needed when the information received is questionable. Consider the information questionable when it:
- Contradicts or conflicts with other statements made by the client;
- Is received from a third-party source that contradicts or conflicts with other statements made by the client; or
- Calls into question the accuracy of the information provided by the client.
- Ask for documents the client can easily get. If it will take the client more than three business days to get the verification, such as immigration documents, offer to help get it. Do not deny or terminate AH if the client is responding to verification requests by reporting they need more time.
- If the client has a disability or needs equal access services, offer to help get the information.
- If the verification will cost money (such as out-of-state birth, death, or marriage certificates, medical information, copies of bank statements, etc.), explore alternate verifications before offering to purchase the items.
- Verification may be needed when the information received is questionable. Consider the information questionable when it:
- Processing verification received:
- Accept reasonable explanations. Use the prudent person concept and document this.
- When a client provides partial verification, send another request letter asking for more information and allow more time. The exception is when the provided verification confirms the client is not eligible. For example: a worker requests proof of income and citizenship, but only receives the income verification. The income verification shows the client is over income. It is not necessary to repend for the citizenship verification. AH can be terminated for over income.
- Use the following criteria to evaluate verification and verbal/written statements used for verification:
- Does it verify the eligibility factor? (For example, a child's birth certificate verifies age and citizenship, but not residency.)
- Is the document/statement the most reliable available evidence?
- Was the document/statement prepared near the time the event took place?
- Is the document/statement signed and dated?
- Has the time period the document/statement covers expired?
- Does the document appear to be altered?
- After evaluating a document on the above criteria, determine if you have enough information to establish eligibility. If not, document the reason and request further verification.
Certain eligibility factors do not change and do not require another check in the future, including:
- US citizenship (unless extremely rare circumstances);
- Family relationships by birth, marriage, and divorce; and
- Social Security Numbers (unless in the rare circumstance the client has more than one).
Documentation:
- When requiring additional verification, document why additional verification is needed.
- What to document for each case:
- What verification you requested;
- Why you requested verification/additional verification;
- What verification you received;
- When you received the verification;
- What action you took, if any, to help the client get the verification;
- Whether the client has a disability that would make it hard or impossible to get the verification, and/or whether the client is a victim of domestic violence and failed to get the verification due to the domestic violence;
- Whether the client has been designated as Equal Access (EA) and if so, whether you followed the EA Plan.
- What decision or action you took.
- In the letter to the client, explain what information was requested and that it was not received or explain it was received but did not verify eligibility.
Verification of citizenship/identity for Classic AH/non-MAGI and some MAGI-based cases can be found in ACES:
Citizen valid value | identity valid value |
---|---|
T1, T2, EW or FV | V, E or F |
Clients who match with the SSA interface for citizenship/identity will automatically be updated by ACES with "FV" valid value for citizenship and "F" valid value for identity.
If it is determined the interface is in error and the federally verified codes need to be changed, call or email:
Kevin Cornell 360 725-1423 kevin.cornell@hca.wa.gov
Chris Stehr 360-725-1304 chris.stehr@hca.wa.gov
For MAGI-based AH through HPF, citizenship and lawful presence is found in ACES Online on the Client >> Demographic screen.
Example of a client’s citizenship attestation that was verified through the federal hub:
Example of a client’s lawful presence attestation that was verified through the federal hub:
Survivors of domestic violence/ACP Participants
If a client is a victim of domestic violence:
- Have the client write a statement that explains what proof or way of getting proof would put the client and/or children at risk of harm, if any.
- Help the client get proof that will not put them at risk.
- For a victim of domestic violence who is also an immigrant, consider a referral to an immigration attorney or to the Northwest Immigrant Rights Project.
Example: A woman and her two children apply for coverage. They are living at the local domestic violence shelter and the father of the children lives in the family home. Do not call the family home to verify any information. Do not require the victim to return to the home to get any verification.
When a client presents an ACP authorization card:
- Enter the ACP address into HPF or ACES. Only call the ACP at 360-753-2972 to verify that the client is currently certified in the program if return mail is received.
- If the client is currently certified in the ACP:
- In HPF, enter PO Box 257. This triggers a popup to enter the post mail box (PMB). Enter the PMB and Olympia, WA 98507.
- In ACES, enter the ACP mailing address and participant code number as shown on the card in place of the client's physical address on the ACES ADDR screen.
- Mail all letters to the substitute address.
- Do not ask the client to provide their actual address. Do not record the client's physical address in any case notes or retain copies of any documents that list the client's physical address.
- If information is found or entered that could be used to locate an ACP client, notify your supervisor to redact information from ACES and/or HPF.
- When verifying residency, household composition, or shelter costs, do not ask the client to provide documents that state their physical address. Accept any document that lists the ACP address and reasonably verifies the eligibility factor.
- If the client provides a document that lists the physical address, work with a supervisor to contact ACES, Barcode and/or HPF to remove any reference to the address.