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Eliminating The Mystery Behind Quality Control

Eliminating The Mystery Behind Quality Control. October 2008 MFWCAA Conference. Why Do We Need Quality Control?. Payment accuracy Timeliness Negatives To ensure program access and integrity. Federal Fiscal Year (FFY).

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Eliminating The Mystery Behind Quality Control

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  1. Eliminating The Mystery Behind Quality Control October 2008 MFWCAA Conference

  2. Why Do We Need Quality Control? • Payment accuracy • Timeliness • Negatives • To ensure program access and integrity

  3. Federal Fiscal Year (FFY) • The Federal Fiscal Year starts October 1st and runs through September 30th.

  4. Who is QC? • There are 9 QC reviewers. • One person completes second party reviews of all correct cases. • One person completes second party reviews of all error cases. • This person also handles all challenges, differences, and case assignments.

  5. MN QC Review Process • Universe sample of all active MN cases with a food benefit – MFIP, FS, UH, and even GRH • Random sample of cases • 93 – 95 cases a month

  6. Case Assignment • QC receives the sample on the 1st working day or the 2nd of the month – whichever is later.

  7. QC performs an independent review of cases.

  8. Do they ever talk to each other?

  9. Findings are compiled and issued via “snail” mail for most counties. How Do I Find Out About The Status of My Case?

  10. Findings • What is the error? • Client or agency? • How did QC discover the error?

  11. Challenge Process • Counties are allowed 10 days to challenge QC findings

  12. Federal Reporting • QC has 4 months to complete a case. • 90% deadline • 100% deadline

  13. Is State QC The Final Authority? • Federal re-review of completed cases • Federal re-review of incomplete cases

  14. Negatives • QC has two months to complete a review of negative actions. • Most reviews completed using only MAXIS. • Sample size is 70 – 80 cases a month

  15. Timeliness • Includes the review of application processing and expedited

  16. Tips from QC • When in doubt, DOCUMENT, DOCUMENT, DOCUMENT! • Send in policy questions!

  17. We Continue to NeedYOU!!!!!!!!!

  18. Questions? • Tracy K. O’Brien, PAC, PAID • Tracy.k.obrien@state.mn.us • 651/431-3993

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