State of Wisconsin Department of Health Services

HISTORY

The policy on this page is from a previous version of the handbook. 

9.11 Processing Time frame

9.11.1 Verification Receipt Date

9.11.2 Positive Actions

9.11.3 Delay

9.11.4 Negative Actions

 

9.11.1 Verification Receipt Date

The verification receipt date is the day verification is delivered to the appropriate Income Maintenance agency or the next business day if verification is delivered after the agency's regularly scheduled business hours.

 

Income Maintenance agencies must stamp the receipt date on each piece of verification received.

9.11.2 Positive Actions

Begin or continue benefits when:

 

1. The member provides requested verification within the specified time limits and is otherwise eligible.
    

2. Requested verification is mandatory, but the member does not have the power to produce the verification and he or she is otherwise eligible. In this situation, the agency must also make an effort to obtain the verification (9.8).
    

9.11.3 Delay

Notify the member when the agency is not able to process the applicationA request for BadgerCare Plus coverage. The request must be on the Department's application or registration form and must contain name, address, and a valid signature. The applicant must submit a signed and completed application form to complete the application process. within 30 days when:

 

1. Verification is needed, and   
    

2. The member/applicantA request for BadgerCare Plus coverage. The request must be on the Department's or Federally-facilitated Marketplace’s application, registration form or account transfer (from Federally-facilitated Marketplace) and must contain name, address, and a valid signature. The applicant must submit a signed and completed application form to complete the application process. has the power to produce the verification, and
    

3. The minimum time period allowed for producing the verification has not passed, and
    

4.  Additional time is needed to produce the verification.
    

CARESThis system supports the Income Maintenance operations for DHS and DCF. CARES is used to determine eligibility, issue benefits, track premium payments, and manage support for BadgerCare Plus, EBD Medicaid, W-2, Child Care, and Work Programs. provides a verification checklist, to notify the member of the reason for the delay, the specific verification required, and the date the verification is due.

 

9.11.4 Negative Actions

Deny or reduce benefits when all of the following are true:

 

1. The member has the power to produce the verification.
    

2. The time allowed to produce the verification has passed.
    

3. The member has been given adequate notice of the verification required.
    

4. You need the requested verification to determine current eligibility.  Do not deny current eligibility because a member does not verify some past circumstance not affecting current eligibility.
    

 

 

 

 

 

 

 

 

This page last updated in Release Number: 07-01

Release Date: 10/29/07

Effective Date: 02/01/08

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The information concerning the BadgerCare Plus program provided in this handbook release is published in accordance with: Titles XI, XIX and XXI of the Social Security Act; Parts 430 through 481 of Title 42 of the Code of Federal Regulations; Chapter 49 of the Wisconsin Statutes; and Chapters HA 3, DHS 2 and 101 through 109 of the Wisconsin Administrative Code.

Publication Number: P-10171