Here are two case examples that illustrate how to document verification resolutions.
Example 1 – Verification development where the
CS
determines not to use the agency data displayed on the Verification screen
Lucy White filed for the Medicare Part D Extra Help on January 25, 2009. When the
Wilkes-Barre Direct Operations Center (WBDOC) technicians scanned the SSA-1020-OCR
(Application for Extra Help with Medicare Prescription Drug Plan Costs), no exception
issues were created. However, MAPS selected the application for verification because
the other agency data shows other pension income of $138.00, stocks and bonds of $5,877.00,
and gross distribution of $2,500.00. After telephoning the applicant, the CS resolves
and documents the verification issues as follows:
Item
|
Application Information
|
Agency Data
|
Verification Resolution
|
Documentation in Report of Contact (DWRC) Screen
|
Other Pension
|
$0.00
|
$138.00 (IRS data for tax year 2007)
NOTE: The IRS data was $1,656.00 and MAPS divided it by 12 and posted the monthly amount
of $138.00
|
$0.00
|
Contacted applicant Lucy White to ask about the other pension amount of $138 not reported
on the application. Applicant explained $138 was received per month and that the pension
payment ended in March 2008. Because this is pension income, the CS must request proof that the payments have stopped and document evidence
per HI 03035.012
|
Stocks and Bonds
|
$0.00
|
$5,877.00 (IRS data for tax year 2007)
|
$0.00
|
Lucy White reported selling stocks in 11/2008 to buy a car. Lucy has not purchased
any more stocks since then.
|
Gross Distribution
|
$0.00
|
$2,500.00
(IRS data)
|
$0.00
|
Contacted applicant Lucy White to ask if the IRS data was for retirement account,
a pension or an annuity. Applicant explained receiving a withdrawal from the 401(k)
plan. We count Retirement accounts and withdrawals from retirement accounts as resources.
The CS must request the balance of the 401(k) account and follow the verification
and documentation instructions in HI 03035.007A.3.
|
Example 2 - Verification development where the
CS
determines to use a “New Amount” on the Verification screen
Gloria Lee filed for the Medicare Part D Extra Help on March 16, 2009. MAPS selected
the application for verification because the agency data shows the
IRS-1099
information with interest income that indicates a bank account balance of $14,750.00.
Gloria did not report the bank account information on the application. The CS documented
the telephone discussion they had with Gloria later that month as follows:
Item
|
Application Information
|
Agency Data
|
Verification Resolution
|
Documentation in Report of Contact (DWRC) Screen
|
Bank Account
|
$0.00
|
$14,750.00 (IRS data for tax year 2007)
|
$5,300.00
|
Contacted applicant Gloria Lee to ask about the bank account information of $14,750
listed in Agency Data not reported on the application. The applicant forgot to report
the bank account information on the application and provided the current account balance.
|