1-005.01 Duties at Initial Application or Redetermination

469 NAC 1-005.01

At the time of initial application and redetermination, the worker shall -

1. Allow anyone who requests assistance to complete an application;

2. Give an explanation of the program requirements;

3. Collect and review the information entered on the application form;

4. Explain the eligibility and payment factors and how changes will affect eligibility and payment;

5. Explain the eligibility and payment factors that require verification;

6. Obtain the client's written consent for the needed verifications;

7. Explore income that may be currently or potentially available such as RSDI, SSI, Veteran's Assistance benefits (VA), etc.;

8. Give information about the social and other financial services available through the agency, such as social services and Early and Periodic Screening, Diagnosis, and Treatment (EPSDT);

9. Inform the client about his/her rights and responsibilities (see 469 NAC 1-006 and 1-007);

10. Inform the client that s/he must show his/her medical card to all providers and must inform the worker of any health insurance plan, any individual, or any group that may be liable for the client's medical expenses;

11. Explain the assignment of third party medical payments and the requirement to cooperate in obtaining third party medical payments and refund any payments received directly;

12. Inform the client of the requirement to participate in the Nebraska Health Connection, if applicable (see 469 NAC 4-009 ff.)

13. Complete necessary reports and information forms;

14. Act with reasonable promptness on the client's application for assistance;

15. Provide adequate notice to the client of -

a. Approval for a grant and the amount;

b. Approval for medical assistance;

c. Rejection of the application and the reason; or

d. Confirmation of the client's voluntary withdrawal; and

16. Explain the appeal process (see 465 NAC 2-001.02 ff.).

{7/25/95}