117 APPLICATION PROCESSING TIME FRAMES SR 99-26, 06/99 (FAM-A)

Mail a Notice of Decision to the individual as soon as an eligibility has been determined, but no later than 45 calendar days from the application date.

Exception: Mail the Notice of Decision to the individual as soon as possible when the decision cannot be reached due to a failure or delay on the part of the applicant or any other unusual circumstances beyond the control of the Division of Family Assistance. Document the reason for the delay in the case file.

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Presumptive Eligibility Determinations

Certain agencies authorized to use Form 800P, Application for New Hampshire Healthy Kids Medical Insurance or Medical Coverage for Pregnant Women, may also make presumptive eligibility determinations. Presumptive eligibility is a process in which a provider makes a preliminary eligibility decision based on an interview with the applicant and documentation available at the interview.

The agency worker has 5 working days to provide a notice of determination to the individual and the District Office using Form 800P.

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Individuals found presumptively eligible must be opened for benefits within 5 days of receipt of Form 800P by the District Office, unless, upon review, the District Office determines that the presumptive eligibility decision was in error.