E Giving Customers Request for Information (RFI) Due Date Extensions

 

Program

Manual Section

ALTCS Only

MA701

MA705I

All Programs

MA1301B

MA1501B

 

Procedure

Use the table below to determine if you should give an RFI due date extension or if a new RFI should be sent.

When…

Then…

The proof needed was requested on a past RFI for the current application

A verbal RFI extension may be given. The verbal extension should:

  • Be reasonable (usually at least five days);

  • Not make the case untimely; and

  • Be clearly documented in case notes

IMPORTANT:

Manually change the RFI due date in HEAplus so that the system does not automatically deny the customer for not providing proof.

The proof needed has never been requested on an RFI

An RFI must be sent, giving the customer 15 days to return the proof.

 

Examples

1) Giving a verbal RFI due date extension

The customer applied online and an RFI was sent on June 1. The due date on the RFI was automatically June 16. The RFI asked for proof of income that could not be verified by the hubs. On June 16, the customer called and asked for a due date extension. The customer said his boss is out of town and he does not have any other access to the proof.

Since the proof was already requested on an RFI for the current application, a new RFI is not needed. It is acceptable to give a verbal five day due date extension. Document the new due date in case notes. Manually change the Health-e-Arizona Plus (HEAplus) due date to prevent an automatic denial.

NOTE     ALTCS staff cannot manually update the RFI due date in HEAplus. A case note is sufficient.

 

2) A new RFI is needed

The customer applied online and an RFI was sent on January 1. The due date on the RFI was automatically January 16. The RFI asked for proof of income that was reported by the hubs that the customer said he no longer gets.

On January 10, the customer called to say that he forgot to report a new income source when he submitted the application. The new income is not verified by the hubs.

In this case, proof of the new income has never been requested on an RFI. Add the new income to HEAplus. Send another RFI to the customer for proof of the new income and proof of terminated income from the original RFI. HEAplus will automatically give another 15 days for the customer to give us proof.

 

3) When proof provided is incomplete and the customer may be given an extension or denied.

The customer submitted an ALTCS application and an RFI was sent on April 1. The due date on the RFI was automatically April 16. The RFI asked for proof of bank account statements for the Ridgecrest Credit Union checking account ending in 2223 that was not verified by the Asset Verification Service (AVS).

The customer provided the account statements requested before the RFI due date. The bank statements show transfers to another account ending in 5576 that was not previously reported. You call the customer and they explain that it is a savings account that has since been closed.

The RFI asked for proof of who owns the accounts when there are transfers to other accounts. In this case, the customer did not provide the requested proof. The customer may be given a verbal extension to provide the proof OR the customer could be denied for not providing proof of resources. This is handled on a case-by-case basis and should be clearly documented in case notes.

 

4) When proof provided is incomplete but a new RFI is not needed.

The customer submitted an ALTCS application and an RFI was sent on November 15. The due date on the RFI was automatically November 30. The RFI asked for proof of bank account statements for the Credit Union checking account ending in 5678 that was not verified by the Asset Verification Service (AVS).

The customer provides a bank statement with an explanation and proof of all transactions except one, a check to GHA AZ for $650. We now need to investigate the purpose of the check and compensation received. We call the customer and she explains it is her homeowner’s association payment to Greenborough Home Association of AZ, which is billed every six months, and she no longer has the bill. This is a reasonable explanation and could easily be supported through a Google search.

The customer’s statement can be accepted in this case. A new RFI or an RFI extension would not be needed.