"File Folder Contents Beginner Sub Folder Document Type Scanning PIN SSN Document Description Spec - Download as Excel"
File Folder Contents "Beginner" Sub-Folder / Document Type Scanning PIN/SSN Document Description / Special Instructions Required / Specific Naming Optional Convention Case Information Applications (Non-CAF) R N APP Scan any RFAs or Applications. Includes the HCF16019A and its translations. Previously RFAs used the RFA code. Do not use the RFA Doc code anymore. If it's a mail-in CAF, or the client brought a completed CAF to the office, scan the whole thing, excluding instructions. Include Combined Application forms, blue fold-outs, white mail-ins. . CARES generated ACCESS applications (Apply For Benefits) are automatically stored in the ECF with the APP code. Include RFAs and applications for Medicaid, FoodShare, W-2 and Related Programs Application (DWSW-2471), W-2 and Related Programs Registration (DWSP-14880), Child Care, Emergency Assistance Application (DWSW-2010), Job Access Loan Application (DWSP-2482), refugee application paper work and applications for other programs such as W-2 emergency payments, county issued programs, HCF 10081, HCF 10119, HCF 16060, HCF 16019, HCF 10112, HCF 10138, HCF 10129, HCF 10076, HCF 10100, HCF 10101, HCF 10140, FSET Non-cooperation form letters asking the FoodShare be reinstated, Wisconsin Veterans Home at King - Medicaid Review (HCF 10147). Authorization of Representative forms R N REP W-2 and Related Programs Authorization of Participant Representative form (DWSP-2375), the Authorized Representative section of ACCESS' Apply For Benefits, if completed. CARES Application Forms R N CAF Scan signature page only. Combined Application forms, blue fold-outs, white mail- ins. Change Reporting Form R N CHG HCF 16006 (FoodShare Wisconsin Change Report), HCF 10137 (Medicaid Change Report), HCF 16066 (FoodShare Wisconsin Income Change Report), DWSP-2001 (Change Report), ACCESS Report My Changes Change Reports are stored in the ECF with the CHG code. Child Care Worksheet R N CCWS All CC related worksheets, including manual Child Care payment worksheets, DES- 11559 Child Care Payment Worksheet for edited Licensed Child Care Providers,DES-11560 Child Care Payment Worksheet for Certified and Accredited Certified Child Care Providers, DES-11561 Child Care Payment Worksheet for Attendance Based Payments to Licensed Child Care Providers, DES-11562 Child Care Payment Worksheet for Enrollment Based Payments to Licensed Child Care Providers Complete Case File O N CCF This code can be used on a case cover sheet to indicate that it is a complete case file. This code is intended to be used in Milwaukee County, but can be used in other locations, as appropriate. For more information, please contact us by sending a note to "Contact Us" above. Electronic Benefit Transfer R N EBT EBT related documentation. Fair Hearing Requests and Decisions R N FH DHA-28 and other written requests for a fair hearing. Over-payment/Recoupment R Y OP Overpayments, underpayment and benefit recovery documents used for over payment or under payment calculation., AFDC and/or W-2 Services Repayment Agreement DES-10790 Wisconsin Works (W2), Overpayment Recoupment Notice, Food Stamp Financial Worksheet (HCF 16073) and FoodShare Wisconsin Worksheet (HCF 16033) (DES-10787) Wisconsin Works (W2) Overpayment Worksheet (DES- 10785), BV worksheets, associated letters. Sheriff's reports and manual wage verification used to calculate overpayments. Request for Write Off or Adjustment DWSD-11439. State Letter of 'Acknowledgment of Receipt'. For overpayments related to fraud, refer to FRAUD. Request for Assistance R N RFA This code is obsolete. Code any requests for assistance or applications with the "APP" code. SMRF Form R N SMRF FoodShare Six Month Report Form. HCF 16076 Requesting Verification R N VER Includes all non-CARES generated request for verification documents including checklists, agency letters, Request for Verification form (DWSP-2303), etc. Non Financial Information Declining Aid forms O N DAF Voluntarily Declining Aid (DWSW-2233) EVF-H form R Y EVFH Centrally scanned. If the client turned in the form at your agency, you may scan it and act on the change. Internal or State QC Info O N QC FoodShare TCRs, other Quality Control or Quality Assurance documents. Legal Documents R Y LEGAL Includes guardianship papers, power of attorney, divorce, separation, Marriage certificates. Bankruptcy papers. Notice of Intent to File a Lien, MA-113. Affadavits of Lost, Destroyed, or Stolen Benefits (FIS-12768). For all Child Support legal documents, refer to CS. Proff of Identity R Y ID Any identity or citizenship document or form: Includes birth certificate, baptismal certificate, immigration status docs, drivers license, passport, state id's, county ids. Do not scan birth queries or birth notification letters from the state. P-140. Also, any documents used to meet the MA/BC citizenship and identity verification requirement. Includes the forms: Statement of Identity for Children Under 16 Years of Age (F- 10154), the Spanish version of this form (F-10154S),( Assign these to the primary person) and Statement of Citizenship and/or Identity for Special Populations (F- 10161). See DC for Death Certificates. 86faf4ab-3ad6-4631-b7bb-485e72671484.xls Page 1 Doc Codes File Folder Contents "Beginner" Sanctions O N SANC Documents related to sanctions (excluding W-2 hour sanctions or strikes). Includes FoodShare, FSET sanctions, approved or denied and sanction cures, drug felony, and all IPV documents, including W-2. For W-2 hourly sanction and strike documents, refer to WSGC. School Information R Y SCHL School related documents used for all programs except Learnfare. For Learnfare, refer to WLCM. Includes school schedules used for Child Care authorizations, Financial Aid Information, Student Financial Aid Report (HCF 16021). Separate Eating forms O N SEF Household information request Social Security Card O Y SSN Not considered proof of identity. Only scan cards where the number has not yet been validated or has a mismatch on CARES. Application for a SSN, HCF 16022 Social Security Number Referral Miscellaneous Nonfinancial R Y MNF Use this document code for any nonfinancial document that doesn’t have a specific code. Examples are the HCF 10186 "Designation of a BadgerCare Plus Essential Person, Funeral and Cemetary Aids Reimbursement Request (HCF 10141). Spousal Allocation Statement O Y SAS Asset Information All Funeral/Burial Related Info R N FB Primarily related to funeral or burial assets. Annuity Contracts R N ANNC Asset Information - Other R N AST Life Estate legal documents, land contracts, trusts, Tax Bill, Assessment, property values, property sales listing, etc. Retirement account information. Home equity loan. Bank Accounts R N BNK Checking, savings, certificates of deposit (CDs). Bank Inquiry Life Insurance Policies R N LIP No need to copy full policy that can be obtained from Insurance Agent. Term, group, or whole (face and cash value). Life Insurance Information request, Life Insurance Inquiry (HCF 10144). Stocks and Bonds Info R N SB Savings Bonds. Vehicle Info R N VI Income Earned Income R Y EI Paychecks, check stubs, paystubs, etc. (treat as a multi-page document if more than one per job), employer statements. EVF-E form R Y EVFE Centrally scanned Self-employment Income R Y SEI Includes SEIRF's, other self employment info, tax forms for the most current tax year, and Self-Employment Income Report (DWSP-2131), room and board documents/ forms, Self Employment Income Worksheet - Corporation (HCF 16034), Self Employment Income Worksheet – Partnership (HCF 16036), Self Employment Income Worksheet – Sole Proprietor Farm and Other Business (HCF 16037), Self Employment Income Worksheet – Subchapter S Corporation (HCF 16035). Unearned Income R N UI Child Support, alimony, Social Sec. Kinship Care. Expenses Child Care Expense R N CCE Child Care receipt Manual Child Care Authorization Sheets Child Support Expense R N CSE All Child Support expense related documents, including documents related to child support payments. Residency and Shelter/Utility Expense R N SUE The most current lease (even if expired), shelter forms , proof of rent, utility bills such as phone or electric, tax payments, mortgage, property taxes, Section 8 papers, CDA papers, homeless agreements, etc. In / Out of Nursing Home form W-2 / FSET Electronic Funds Transfer R Y WEFT Electronic Funds Transfer Authorization (DES- 10791) Fact Finding documents R Y WFF Wisconsin (W-2) Agency Fact finding Review Notice (DES-10782), Request for Wisconsin Works (W-2) Fact Finding Review (DWSW-10783) , Wisconsin Works (W-2) Agency Fact Finding Review (DWSW-10784), W-2 Services Fact Finding Review Voluntary Withdrawal (DWSW-11155) Household Budget Worksheet for W-2 O N WBW Household Budget Worksheet for W-2 (DES-2443) Learnfare Case Management Plan R Y WLCM Learnfare release and other school enrollment and attendance information DES- 10789 Learnfare Case Management Plan Miscellaneous Work Program documents O Y WMSC For all other work program documents in which an appropriate document type does not exist Out of State Inquiry R Y WOSI Information about benefits received in other states - Out of State Inquiry (W-2) form (DES-4021) Vendor Payment Request R Y WVPR DES-3147 Vendor Payment Request. W-2 Attendance Tracking R Y WAT The log of training activities and job search preparation activities W-2 Barrier Screening Tool Documents R Y WBST All Barrier Screening Tool (BST) documents including the BST Agreement form (DWSW-13578). Do not scan a paper copy of the tool unless the tool is not entered into the BST system. W-2 Job Search Log R Y WJSL Include all job search log documents and any documentation used to verify contact with employers, e.g., copies of business cards, employer letters, etc.. For all other attendance tracking, including facilitated job search activities, refer to WAT. W-2 Participation Agreement R Y WPA DWSW-10755 Wisconsin Works (W2) Participation Agreement W-2 Placement-Related Forms R Y WPF All W-2 placement related forms, including (e.g., Trial Job Employer Agreement (DES-10759), W-2 Worksite Training Site Agreement (DES-10792), W-2 Case Management Services Agreement (DWSP-13269), worksite evaluations and participant's progress reports. For worksite attendance or any other attendance documents, refer to WAT. W-2 Supportive Services Plan R Y WSSP Supportive Services Plan (DWSW-12956-E) 86faf4ab-3ad6-4631-b7bb-485e72671484.xls Page 2 Doc Codes File Folder Contents "Beginner" W-2/FSET Employability Plan R Y WEP This includes the signature page of the CARES printed EP, any paper EPs not contained in CARES, Wisconsin Works (W-2) Employability Plan (DES-10788) and any other supporting documentation used to supplement the information contained in the EP. Miscellaneous / County Specific Child Care Miscellaneous R N CCMSC Any other Child Care related document not otherwise specified. Other County Documents O N OCNTY Includes county generated documents or forms that do not fit into another category. Does not include documents generated by the customer or State forms. All SeniorCare forms. Uncategorized Correspondence O N UCOR Includes Letters to other Agencies. Envelopes from mail that has been returned to the agency. Notes from the customer, including notices with changes. EOS forms send to other state to check for open benefits. Call Center E-mail correspondence, emails from customers reporting changes, etc. Correspondence Application Notice for Pregnant Women N/A N APNPW These documents are not scanned. They are converted to PDFs by CARES and stored with this document code. Application Notice for Children N/A N APNCH These documents are not scanned. They are converted to PDFs by CARES and stored with this document code. Application Summary for Pregnant Women N/A N APSPW These documents are not scanned. They are converted to PDFs by CARES and stored with this document code. Application Summary for Children N/A N APSCH These documents are not scanned. They are converted to PDFs by CARES and stored with this document code. Correspondence N/A N CORR These documents are not scanned. They are converted to PDFs by CARES and stored with this document code. CORR is used for all other miscellaneous CARES generated notices and letters. For manual notices an agency sends, see NOD. Notice of Decision R N NOD Non-CARES generated Notices of decsion including the Medicaid Recipient Asset Allocation Notice (HCF 10098), Community Spouse Asset Share Notice (HCF 10096), Medicaid Recipient Asset Allocation Notice (HCF 10097), Medicaid Recipient Income Allocation Notice (HCF 10098), Funeral and Cemetery Aids Program Reimbursement Notice (HCF 10143). Disability Determination Bureau (DDB) (Restricted) DDB Related Information R Y DDB DDB Packet (the red folder contents). You must scan the contents of any red folder you have in your agency. Use the DDB code for the contents of the red folder and any miscellaneous DDB document that is not specifically covered by the new codes. Use DDB for manual DDB decision letters. Red folders were made obsolete after the automation of DDB processing in October 2007. New, more specific document codes were added in October 2007 for other types of DDB documents. See ADDD, MADA, ADDMD, DDDOC, and DDWSH for details. MADA Application R Y MADA Medicaid - Disability Application HCF 10112 Authorization to Disclose Information for R Y ADDD Authorization to Disclose Information to Disability Determination Bureau (DDB) HCF DDB 14014 Additional Disability Determination Medical R Y ADDMD Documents for DDB Disability Determination Documents from R Y DDDOC This doc code is used by the DDB and is not to be used by IM workers. DDB Disability Determination Worksheet from R Y DDWSH This doc code is used by the DDB and is not to be used by IM workers. DDB Restricted Documents Child Support R N CS All Child Support (non-expense related documents) including initial or subsequent paternity orders, court orders regarding support payments, referrals to child support, including Good Cause Claim (DWSP-2019), Good Cause Notice (DWSP-2018), Notice of Assignment- Child Support, Family Support, Maintenance and Medical Support (DWSP-2477), Any legal documents regarding Child Support should use the CS code and not LEGAL. For specific CS expenses, use CSE. CIP/COP Info R Y CIP COP Assessment, CIP/COP Approval Letters, Waiver Requests. Family Care (pilot program) documents, Interagency Notification of Termination of Medicaid Waiver Eligibility For a Community Waiver Participant (F-10142), Unprocessed Family Care, Pace, or Partnership Disenrollment Request (F-00009) Child Welfare R Y CW Any child welfare related documents including the HCF 10184 Badgercare Plus Youth Exiting out of Home Care and 10185 BadgerCare Plus Child Welfare Parent/ Caretaker Relative Communication. Death Certificates R Y DC Documentation Referral to Other Agency R Y WDR This is used for referrals to outside agencies such as the DVR and CAP programs, assessment referral forms, etc. This includes work program referrals, supportive services referrals, etc. For referrals within an agency, refer to OCNTY. Estate Recovery Prog. Disclosure forms R N ERPD Fraud Related Information R N FRAUD All documents supporting fraud claims, minus copies that can be obtained from CARES, Fraud and Front End referral forms. Supporting documents for overpayments related to fraud. For all other overpayments, refer to OP. For IPV related documents, refer to SANC. 86faf4ab-3ad6-4631-b7bb-485e72671484.xls Page 3 Doc Codes File Folder Contents "Beginner" MA Manual Eligibility Forms R N MAEF MA Remaining Deductible Form (HCF 10109), MA Cert Form (3070) in order of initial date of certification, and spousal impoverishment allocation forms. Authorization for Retroactive CTS Emergency MA paperwork. Wisconsin Well Woman Medicaid Determination, Good Faith Medicaid/BadgerCare Plus Certification (HCF 10111). Medical Assessments R Y MAS Drug test results and all documents formerly coded as MDE (Physician's Evaluation): Mental health or other incapacitation docs, special needs documents (child care), pregnancy verification. Drug Test Results, Temporary Stay for Nursing Home, Medicaid Purchase Plan (MAPP) - Work Requirement Exemption (HCF- 10127). See DC for Death Certificates. Medical Exam and Capacity Form (W-2) R Y WME W-2 Medical Exam and Capacity Form (DES-2012). For all other physician's evaluations or medical assessments, refer to MAS. Medical Expenses/Deductible Documents O N ME Cover sheet and all verifications of medical costs, other health insurance, pharmacy and doctor bills. Copies of checks for BadgerCare premiums and payment coupons, Medicaid Purchase Plan (MAPP) Member / Premium Information (HCF-10122). Non-Medical Assessments R Y WVAS All non-medical assessment documentation, including vocational assessments, career/employment readiness assessments, education assessments, AODA assessments, domestic violence assessments, self-declared needs assessments, family profiles, etc. Release of information forms R Y ROI Any release of information form, including Authorization for Disclosure of Confidential Information (DWDS-10779) form, School Enrollment and Attendance Information Release (DES-11297). Documents that used to be coded as CONF should now use the ROI code. Sanction and Good Cause documentation R Y WSGC For all W-2 nonparticipation or noncooperation related documents, including hourly nonparticipation, nonparticipation strikes and good cause documents. For IPV related docs, refer to SANC. SSI/SSDI Referral/Advocacy documents R Y SSIA TPL / Accident Report O N TPL W-2 Attendance Tracking R Y WAT Include individual timesheets, group sign-in sheets, computer printouts or other documentation verifying attendance at a W-2 activity, including education and training attendance documentation and facilitated job search activity tracking. For independent job search logs, refer to WJSL. For other documents related to school, refer to SCHL. W-2 Agency Extension Record R Y WEX DWSW-11661-E W-2 Agency Time Limit Extension Record. W-2 Service Provider Correspondence R Y WSPC Documents to service providers outside of the W-2 agency that are confidential. For non-confidential documents to service providers, refer to UCOR. 86faf4ab-3ad6-4631-b7bb-485e72671484.xls Page 4 Doc Codes