10A NCAC 23A .0103 QUALITY ASSURANCE
(a) Case actions taken by the county department of social services are subject to review by state and federal quality control procedures. A statistical sample is selected from both active and negative case actions.
(b) The purpose of the QC review is to identify eligibility errors and erroneous payments resulting from:
(2) Recipient liability understated or overstated;
(3) Third-party liability; and
(4) Claims processing errors.
(c) A report of an error discovered in a QC case shall be sent to the appropriate county agency for corrective action.
(d) If the county agency has verification that disputes a QC finding of error, it may submit the verification to the Recipient Services Section for review. The Recipient Services Section cannot overturn a listed error, but shall determine whether the error shall be coded client-responsible, agency-responsible, or state-responsible. Upon its review, the Recipient Services Section shall notify the county agency of its decision regarding responsibility for the error.
History Note: Authority G.S. 108A-54; 42 C.F.R. 431.800;
Eff. September 1, 1984;
Amended Eff. August 1, 1990;
Transferred from 10A NCAC 21A .0501 Eff. May 1, 2012.