B Using Reasonable Compatibility for Income

Program	Manual Section
All Programs	MA605

Procedures

HEAplus is programmed to apply reasonable compatibility rules for income, and in most cases will set the verification factors correctly. However, duplicated income records or a customer disagreeing with an income amount may cause an application to pend unnecessarily.

Use the table below to see if reasonable compatibility may be used for an application that pended for proof of income:

Step	Action
1	Review the results of the hub search in the “Confirm Income Sources” battery and all income entered in other batteries. When income from the same source is listed and counted more than once, keep the most current income record from the source and remove any others.
2	Did the customer report or attest to getting total counted income above the income limit after all allowable deductions? If YES, STOP. The information is reasonably compatible. Enter the income reported by the customer. Enter case notes that reasonable compatibility was used for proof of income. Deny the customer for income exceeds the limit. If NO, continue to Step 3.
3	Did the customer report no income and the hub shows no results? If YES, STOP. The information is reasonably compatible. Enter case notes that reasonable compatibility was used for proof of income. Make sure that the Expenses Exceed Income screen is completed. If NO, continue to Step 4.
4	Did the hub return a zero amount for an income source that the customer reports ended? If YES, STOP. The information is reasonably compatible. Enter case notes that reasonable compatibility was used for proof of income. If NO, continue to step 5.
5	Did the customer report income below the limit and the hubs returned a record for each source reported? If YES, continue to Step 6. If NO, STOP. The information is not reasonably compatible. Request proof of income from each source that did not return a hub result or where the customer disagreed with the amount returned.
6	Did the customer agree with each income amount returned by the hubs? If YES, STOP. Verify the income factors and continue processing the case. The information is reasonably compatible. Enter case notes that reasonable compatibility was used for proof of income. If NO, continue to Step 7.
7	Ask the clarifying questions in HEAplus for each income amount with which the customer disagrees. If the customer has already answered the questions, review the answers.
8	Did the customer state that the income received is higher or lower than what the hub returned? If higher, STOP. Verify the income factor and continue to process the case. If lower, continue to Step 9.
9	Review each income pending proof. Do any of the following apply? Terminated income from employment AND customer started getting retirement income from that source. Terminated income from employment AND customer started getting UI. Customer states UI benefit is exhausted AND amount received in income period is $0.00. Customer states not working for employer AND started getting long-term disability or Worker’s Compensation after the date last worked. If YES, verify the income factor. Enter case notes that the income was reasonably compatible. Continue to Step 10 if any income factors are still pending, otherwise STOP and continue processing the case. If NO, continue to Step 10.
10	Review each remaining income pending proof. Would the customer still qualify for AHCCCS with no change in premium or SOC if the higher amount were used? If YES, verify the income factor. Enter case notes that the income was reasonably compatible. Continue to Step 11 if any income factors are still pending, otherwise STOP and continue processing the case. If NO, continue to Step 11.
11	The information provided by the customer is not reasonably compatible with the information found by the hubs. If an RFI has not already been sent, send an RFI requesting proof for any remaining incomes with pending verification factors.