SAMPLE POLICY WORK

through documented IQ tests, historical data from former service centers, etc.).

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Internal Cross-Verification:

– If any discrepancies are noted, the Eligibility Specialist requests additional documentation or clarification and updates the applicant’s file accordingly. – Only after a thorough review and internal confirmation are the applicant’s documents marked as “Eligibility Confirmed” in the electronic record system.

Roles and Responsibilities:

• Eligibility Specialists are responsible for reviewing and confirming eligibility with rigorous attention to regulatory details. • Intake Staff provide the preliminary documentation, ensuring that the applicant’s initial information is accurately recorded. • Compliance and Regulatory Affairs Teams conduct periodic audits of eligibility records to ensure adherence to TN.0357.R05.00 and TennCare guidelines.

Step 2: Documentation Collection and Verification

Documentation Requirements:

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Standard Enrollment Form: All applicants must complete a standardized enrollment form that gathers key demographic information, consent signatures, and preliminary clinical data.

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Supporting Documentation: Required documents include: •

Completed eligibility determination reports (e.g., psychological evaluations, medical records, discharge summaries from previous developmental centers). • Legal documents verifying identity, guardianship (if applicable), and any additional forms required for state licensing purposes. • Any supplementary documents specific to the applicant’s historical service records (e.g., records from Arlington or Clover Bottom Developmental Centers, discharge summaries from the Harold Jordan Center, or transfer documentation from the Statewide Waiver).

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Verification Process:

– All documents must be reviewed by the Enrollment Specialist using a standardized documentation checklist. – Each document is scanned into the secure electronic record system and tagged with the date of submission and the reviewing officer’s initials. – In cases where the document is not clear or appears outdated, follow-up actions are initiated, including scheduling re-assessments or directly contacting the issuing authority.