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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 101 – Coverage Groups and Processing Applications and Reviews Page |326 Effective Month: December 2016 MAKING AN ELIGIBILITY DECISION (Continued) • Documentation - All cases must be thoroughly documented. Documentation is the written record of all information pertaining to the eligibility decision. Case documentation includes the completed application form, the specialist’s verbal and written contacts with the applicant, information requested and received from electronic data sources, the applicant or third party sources, such as governmental or nongovernmental agencies, businesses and individuals, and notification of the eligibility decision. When an applicant claims no income or resources, the specialist must fully document the facts provided to substantiate these claims. “Applicant states none” is not sufficient documentation. The record must also show why the statement of the applicant or beneficiary is reasonable and acceptable. NOTE: For MAGI applicants who attest on the application form that one or more household members receive income that does not count (such as SSI, TANF, VA benefits, Workers’ Compensation, Child Support), consider this as documentation of income available to support the family. In other words, the household is not a $0 income household but rather a household sustained by income that does not count. If the application form has no mention of receipt of non-countable income and there is no declared income or resources, the record must contain a reasonable explanation of how the household is meeting basic needs. When action is taken to deny the application because the applicant has not provided the information necessary to determine eligibility within the specified timeframe, documentation in the record must show an appropriate request(s) was issued to the applicant. • Evaluation –Information provided by the applicant or obtained through electronic data sources or third party sources must be assessed prior to making an eligibility decision. When information is not logical, consistent or reasonable, it must be resolved prior to determining eligibility.