Programs Reviewed as a Desk Audit
- Childcare
- Medicaid
- TANF
- NEON
What is a Desk Audit?
A QC reviewer compares the application, national and state databases, and documents on file to determine accurate case processing according to state policy and procedures.
Why was my case chosen for a Quality Control review?
A computer program generates a random sample of households who received assistance in the assigned month to review that case for program accuracy for the assigned review month.
Do I have to participate in the Quality Control desk audit review?
No! Unlike requirements of a case pulled for a SNAP, desk audits do not have to participate in an interview with QC. However, there are times the QC reviewer may need to reach out to you to obtain or clarify information.
Child Care
Cases are randomly selected each month from Active child care cases for which a child care payment has been made for services received in the review month; these cases are reviewed for accuracy. During the child care review the QC reviewer is evaluating accuracy of the case file. They utilize documentation provided which may include child care application, attendance records, and payment records.
Federal Partners:
Medicaid
Each month cases are randomly selected, and the QC reviewer evaluates the documentation in the case file, along with state and federal databases, to ensure the correct Medicaid eligibility was approved during the month selected for the review. The QC reviewer will also identify the paid medical claims for the case and verify that all elements affecting the eligibility and payment status during the review month are correct.
Centers for Medicare and Medicaid Services
Medical Assistance Manual
Presumptive Eligibility
Temporary Assistance for Needy Families (TANF)
Each month QC reviews are randomly assigned TANF cases that are then reviewed for accuracy to ensure the eligible families were issued timely and accurate benefits. TANF QC reviewers use the case notes and verifications in the case file to determine if all the proper documentation was acquired and the correct benefits were provided.
Administration for Children and Families
TANF State Plan
Eligibility and Payment Manual
New Employees of Nevada (NEON)
Cases are randomly selected each month and assigned to a NEON QC reviewer. The cases are reviewed for accurate NEON activity participation and that a Personal Responsibility Plan (PRP) was developed for required members. NEON QC reviewers are looking to verify that the customer and the agency were both participating in helping the customer obtain their assigned NEON goals.
Administration for Children and Families
Eligibility and Payment Manual