Mission Statement
The Quality Control Division's mission is to uphold the integrity of Department of Human Services benefit programs by impartially evaluating program benefit determinations. Quality Control is committed to fostering accountability, ensuring transparency, and promoting efficiency in all processes to ensure accuracy of benefit decisions, improve program operations, and reduce errors in determinations.
What We Do
The Federal Government mandates periodic reviews of certain program benefits to confirm that eligibility decisions are correct, ensuring customers receive the proper benefits. These reviews also verify that decisions to deny, terminate, or suspend assistance were appropriate and help identify areas for program improvement.
Each month, the Quality Control Division randomly selects cases from various programs for review, ensuring a representative sample of participants. If you are currently receiving or have previously received Supplemental Nutrition Assistance Program (SNAP) benefits, Medical Assistance, or West Virginia Children's Health Insurance Program (CHIP) benefits, your case may be randomly selected for review.
The Quality Control Reviewer will assess all information collected to determine if the Department of Human Services' agency issued the correct benefit amount of coverage. Any issues found with the eligibility decision during the Quality Control review will be reported to the relevant Department of Human Services' agency.
This thorough process ensures the accuracy of benefit decisions, improves program operations, enhances customer service, and reduces errors.
Benefit of Recipients' Involvement
If your benefits are selected for review, a Quality Control Reviewer will contact you to explain the process. You may be contacted by letter or phone, and the review might involve a phone or in-person interview, or a request for specific documentation related to your case. If the program requires your cooperation, you will be informed of the necessary steps.
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