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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 October 2008 MFWCAA Conference
Why Do We Need Quality Control? • Payment accuracy • Timeliness • Negatives • To ensure program access and integrity
Federal Fiscal Year (FFY) • The Federal Fiscal Year starts October 1st and runs through September 30th.
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.
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
Case Assignment • QC receives the sample on the 1st working day or the 2nd of the month – whichever is later.
Findings are compiled and issued via “snail” mail for most counties. How Do I Find Out About The Status of My Case?
Findings • What is the error? • Client or agency? • How did QC discover the error?
Challenge Process • Counties are allowed 10 days to challenge QC findings
Federal Reporting • QC has 4 months to complete a case. • 90% deadline • 100% deadline
Is State QC The Final Authority? • Federal re-review of completed cases • Federal re-review of incomplete cases
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
Timeliness • Includes the review of application processing and expedited
Tips from QC • When in doubt, DOCUMENT, DOCUMENT, DOCUMENT! • Send in policy questions!
Questions? • Tracy K. O’Brien, PAC, PAID • Tracy.k.obrien@state.mn.us • 651/431-3993