Act on Tasks – PEV - Unverified Information

 

Use this user guide to act on an unverified information task specifically created in the Post Eligibility Verification (PEV) process.  Workers can only act on tasks assigned to them.

 

 

From the Home Page access the Admin Dashboard screen. Click the Tasks tab and then, the View My Tasks button.

 

Admin Users can navigate from the Admin View to the Individual Account Dashboard to the View Information from External Sources screen by selecting View Information from External Sources from the Admin Functions drop-down list.

 

 

 

During the  PEV process, self-attested information by customers is verified on an automatic and continuous basis after the initial eligibility determination. Data to be re-verfied  includes: Incarceration, Death Data, and Unemployment Benefit income that is re-verified monthly and wage data that is re-verified four times per year in February, May , August and November.

 

 

 

Process Steps

 

To verify eligibility determination information:

 

1.     Click on the Tasks tab in the Admin User dashboard.

 

·         The Tasks tab is displayed.

 

2.     Click the View My Tasks button to only display tasks assigned to you.

 

Tasks that are assigned to you are displayed when you click on the View My Tasks tab. To assign unverified information task to yourself, refer to the Assign Tasks user guide.

 

3.     To locate the unverified information task, browse the Tasks list or use the search procedure by entering the task’s search criteria:

 

a.     Enter the first name of the holder of the account with unverified information in the First Name textbox.

 

b.    Enter the middle name of the holder of the account with unverified information in the Middle Name textbox.

 

c.     Enter last name of the holder of the account with unverified information in the Last Name textbox.

 

d.    Enter the account holder’s zip code in the Zip Code textbox.

 

e.     Enter the account ID of the account associated with the unverified information in the Account ID textbox.

 

f.     Select PEV - Unverified Information (QHP) or PEV - Unverified Information (Medicaid) from the Type drop-down menu.

 

g.    Check the box(es) to select the Eligibility Results of the account. Options are:

 

                                          i.    Medicaid

 

                                         ii.    QHP/APTC/CSR

 

                                        iii.    Mixed Household

 

                                        iv.    Not Determined

 

MC910220951[1]

 

A PEV - Unverified Information (QHP) task is created when all members of the account are QHP eligible. A PEV - Unverified Information (Medicaid) task is created when all members of the account are Medicaid eligible. Both task types are created for the account when the account includes both Medicaid and QHP eligible members.

 

h.     Select the unverified information status from the Status drop-down menu. Options are: New, Review In Progress, Documentation Requested, Closed Verified, Closed Period Expired and Closed Re-verified.

 

i.      Select the unverified information priority from the Priority drop-down menu. Options are:

 

                                          i.    High

 

                                         ii.    Medium

 

                                        iii.    Low

 

j.      Enter the name of the worker who last acted on the unverified information in the Worker Name textbox.

 

k.     Enter the ID of the worker who last acted on the unverified information in the Worker ID textbox.

 

l.      Select Yes or No for Document Submitted.

 

4.     Click the Search button.

 

·         Unverified Information tasks that match the search criteria are displayed for review. A worker can only act on unverified information tasks that have been assigned to him/her.

 

5.     Click the Unverified Information link under the Type column for the data to be verified.

 

·         The Manually Override Verification Results screen is displayed.

 

·         The Manually Override Verification Results screen displays a list with the name of the account holder, the data element to be verified, the self-attested information the applicant entered (if any), the explanation the applicant provided (if any), the explanation status, and the uploaded documents related to this verification.

 

The Manually Override Verification Results screen can be accessed from the Tasks tab using the procedure above or by searching for an account and selecting Override Verification from the Admin Functions drop-down menu

 

 

6.     Select the radio button adjacent to the data element to be verified.

 

7.     Enter a reason for the verification in the Verification Reason textbox.

 

8.     Select Verified as the new status of the verification from the drop-down menu. Options are Verified and Not Verified.

 

9.     To upload supporting documentation for the verification, click the Browse button.

 

·         A browse window is displayed to select the documents from local files.

 

10.  Select the Document Category from the drop-down menu.

 

11.  Click the Upload button.

 

12.  Click the Verify button.

 

·         The Verification Results screen re-displays and the element is now marked as verified.

 

·         Eligibility rules run every time a verification item in an unverified information task is updated.  If the eligibility determination changes as a result of the update, the new status is immediately reflected in the eligibility results column on the task detail screen. 

 

When this happens a link, New Eligibility Results, is displayed in the Quick Links box on the individual’s dashboard.  This link directly navigates to the Eligibility Determination Results screen.

 

RI UHIP automatically closes an existing PEV task for an account and changes the status to Closed Re-verified, if an individual reports a change and re-submits an application.

 

 

 

 

Results of the Procedure

 

Unverified data is verified. 

 

Documents are uploaded to the account to support the verification.

 

Eligibility is re-determined.

 

 

 

 

 

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