Measuring Improper Authorizations for Payment in the Child Care Program:
Improper Authorization for Payment Data Collection Instructions [Approved August 31, 2007]

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OMB Control No. 0970-0323
Expiration date: 08/31/2010

INSTRUCTIONS FOR COMPLETING THE DATA ENTRY FORM

State reviewers record the findings from each Record Review Worksheet onto a Data Entry Form. A Data Entry Form must be completed for each case review.

The Data Entry Form summarizes the composite results of the record review documented on the Record Review Worksheet. Below is a list of the information included on the Data Entry Form, instructions as necessary and where the information can be located on the Record Review Worksheet. Note that the term "authorization" means subsidy amounts authorized during eligibility determination/redetermination. (See Glossary.)

1. State – Insert the State name from the first line of the Record Review Worksheet;
2. County – Insert the County name from the first line of the Record Review Worksheet;
3. Child ID – Insert the Child ID from the first line of the Record Review Worksheet;
4. Sample Month/Year – Insert the sample month/year from the first line/top of the Record Review Worksheet;
5. Date of record review – Insert the Record Review Date from the first line of the Record Review Worksheet;
6. One or more errors during sample review month – Insert the number of errors code according to the following key: “0” = no errors, “1” = one or more errors. This information is located on the Record Review Worksheet in Column 4;
7. Total amount of improper authorization for payment (Underauthorization and Overauthorization) during sample review month – Insert the total dollar amount of the improper authorization for payment located on the Record Review Worksheet in Element 430, Column 4;
8. Type of improper authorization for payment – Insert the type of improper authorization for payment code according to the following key: “U” = Underauthorization, “O” = Overauthorization. Enter "NA" if there is no authorization error. This information is located on the Record Review Worksheet in Column 4. (For cases with multiple authorization errors, enter the type of improper authorization for payment for the larger dollar amount of error.);
9. Reason for error due to insufficient or missing documentation – Insert “Y” = Yes if the reason for error was due to insufficient or missing documentation; "N" = No if the error was not due to insufficient or missing documentation; and "NA" if there is no error. This information is located on Record Review Worksheet, Column 4;
10. Total Authorization Amount during sample review month – Insert the total dollar amount included on Record Review Worksheet in Element 420, Column 2.