Article 10 Section 1 Quality Control (QC)

 

Table of Contents

Title

PG Cite

Policy

10.01.01A

Review Sample Timeframe

10.01.01B

Specific Review Areas

10.01.01C

 

10.01.01 Policy

 

10.01.01A
Policy

QC reviews are only conducted as desk reviews. The primary purpose of the review is to evaluate worker accuracy, detect error trends and training needs.

 

CMSPG LTR 13 (03/12)

 

10.01.01B
Review Sample
Timeframe

Cases are selected for review by QC workers from a random sample of the total case population on a monthly basis.

 

CMSPG LTR 13 (03/12)

 

10.01.01C
Specific Review Areas

Specific areas of review include, but not limited to:

         Application processing timeframes;

         Income treatment and budget computation;

         Correct determination of Medi-Cal linkage factors;

         Correct determination of financial and non-financial eligibility factors such as property, residency and alien status, etc.; and

         Acceptable and adequate verification and documentation.