Reasonable Opportunity

Reasonable Opportunity

  1. Attempt to verify CIT/ID through Tier 1 - Federal Data Hub/EATSS, if verified no further action. If not verified move to step 2

  2. Tier 2 – The Kansas Immunization Register (KSWebIZ) database. This can be used to verify identity for only children. The Department of Revenue (Driver’s License) database may be used to verify identity of an individual with a Valid Kansas license. If able to verify no further action required, if not verified move to step 3

  3. Tier 3 – Research the case file for imaged documents to determine if Hard Copy has already been received. If there is a hard copy no further action required, if not move to stop 4

  4. Contact the applicant requesting needed CIT/ID information. This will not delay or deny the application. If it is determined that the application is otherwise eligible (just waiting on CIT/ID confirmation) the application will be processed and approved using the Reasonable Opportunity (RO) period.

    1. Reasonable Opportunity has a period of (3) calendar months commencing from the date the case is authorized. If the applicant fails to provide the verification by the end of the Reasonable Opportunity period, coverage ends allowing timely notice.

    2. If the verification is provided within a month after being denied, eligibility can be reinstated without a new application/request from the applicant.

NOTE: The Reasonable Opportunity period may be extended in situations where the individual is making a bona fide effort to obtain the verification but circumstances outside his/her control are delaying the effort. A decision to extend the period must be thoroughly documented and supported in the case file.

 For full RO overview please see KFMAM 2045.07

 

Setting Up Reasonable Opportunity in KEES

  1. On the Citizenship/Identity List pge select Edit for the consumer who needs you were unable to verify in Tiers 1 through 3 above.

  2. In U.S. Citizenship Verification section select the following:

    1. Document Type on File – Reasonable Opportunity – Medical

    2. Medical Citizenship Verified – Verified

    3. Non-Medical Identity Verified – Only for Non-Med workers

  3. In Identity Verification section select the following:

    1. Document Type on File – Reasonable Opportunity – Medical

    2. Medical Citizenship Verified – Verified

    3. Non-Medical Identity Verified – Only for Non-Med workers

  4. Select Save