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MS 0410 [1]

Volume 1 – General Administration MS 0410 – R. 6/1/26 – OMTL – 697 Quality Assurance (QA) Case Review

[ All QA case reviews are completed on Worker Portal in the QA Module. Reviews are completed to assess the accuracy of case processing and to identify error trends and training needs to be addressed on a local, regional, or statewide basis.

A. The purpose of a case review is to ensure that:

1. The case is processed correctly;

2. The decision to approve or deny eligibility is made according to the applicable program policy;

3. All information is obtained, reviewed, and evaluated to substantiate an eligibility decision;

4. Impending changes are identified and processed appropriately;

5. Computer matches are acted upon timely and appropriately;

6. All required forms are scanned to the Electronic Case File (ECF), and all inconsistent information is clarified;

7. All areas of eligibility are documented;

8. All elements affected by an error are identified; and

9. All computations are correct.

B. Reviewer Functions:

1. Reviewers follow guidelines issued by the Service Region Administrator’s (SRA) office, which establishes the required number of cases reviewed monthly.

2. Reviewers use the different levels of reviews available. Each level of review contributes to the assessment of casework and identification of the potential need for coaching, mentoring, training, policy support, practice support, and system changes.

C. Review Process:

At each level of case review, these general procedures are appropriate:

1. Reviewers must read cases and review all elements.

2. When errors are identified, the reviewer cites a specific policy for the error.