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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 101 – Coverage Groups and Processing Applications and Reviews Page |325 Effective Month: December 2016 101.08 PROCESSING APPLICATIONS Specialists must determine eligibility based on information contained on the application form as well as information secured during the application process. Appropriate DOM forms, along with other legal or official documents which support the eligibility decision must be filed in the case record. As part of the eligibility process, information provided by the applicant, secured through electronic data bases and obtained from other sources must be verified, documented, and evaluated by the specialist prior to making the eligibility decision. If information provided by or on behalf of an applicant on the application form is consistent with information obtained through electronic data sources, eligibility must be determined based on such information. An applicant must not be required to provide additional verification or documentation unless needed information cannot be obtained electronically or the information obtained electronically is not consistent with information declared on the application or otherwise secured during the application process. 101.08.01 MAKING AN ELIGIBILITY DECISION Eligibility decisions are made using the following: • Verification - Verification is the substantiation, confirmation or authentication of an assertion, a claim or previously submitted information. Verification is obtained through the use of electronic data sources or by information provided by the applicant. The specialist will accept reasonable documentary verification provided by the applicant and will be primarily concerned with how adequately the verification proves the statements on the application form. Only information material to the applicant’s eligibility is subject to verification, through electronic means or otherwise. Verification provided by an applicant or beneficiary must never be discarded, destroyed, ignored or altered.