Consumers often need to upload documents to resolve Data Matching Issues (DMIs) and SEP Verification Issues (SVIs). Getting follow-up documents uploaded on time ensures your client keeps their subsidy and/or coverage.

You can upload and track follow-up documents for your client from your HealthSherpa for Agents dashboard.

In this article we will cover:

A Data Matching Issue (DMI) means that the information entered on a consumer's subsidy application doesn't match what is on file with the government (or may not be available within their records) and therefore needs to be verified.

A DMI occurs in the following 3 situations:

When a DMI is not resolved your client may lose their subsidy or eligibility for health coverage. Clients have 90-95 days to resolve a DMI based on the date their application was submitted (not the effective date). Consumers typically need to upload documents to resolve DMIs.

Special Enrollment Periods (SEPs) are certain timeframes outside of the annual Open Enrollment Period (OEP) when a consumer can can enroll in ACA coverage or change ACA plans.

An SEP Verification Issue (SVI) occurs when a Consumer is eligible for an SEP due to a Qualifying Life Event (QLE), such as losing coverage, and is asked to verify they have experienced the QLE.

When an SVI is not resolved your client may lose their SEP eligibility. Clients have 30 days to resolve an SVI based on the date they select a plan (not the effective date). Consumers typically need to upload documents to resolve SVIs. Additionally, consumers cannot make a binder payment or use their new or updated coverage until all SVIs have been satisfied.

DMIs & SVIs can happen on HealthCare.gov, HealthSherpa, and anywhere else you may complete Marketplace enrollments.

There are several statuses you might see for each follow-up:

You can get an initial view of document statuses by looking at your Clients List. You may also use the Documents filter to see all clients with a particular Document status.

You may also choose to leverage the Documents Due tab. Located on the Clients page, the Documents Due tab features a list of clients with DMIs and SVIs. Learn more about the documents due tab here.

You may also head to the consumer's Clients details page. Here, you can view all of the consumer's unique follow-ups and their statuses from the Follow-ups section.

From your Clients page, select a consumers name to view their Clients details page. Here, you may access a full list of the consumer's follow-up items, who they're required for, and the deadline to complete each required follow-up item. Select the 'Verify' button to proceed with document upload. Note: the 'Verify' button may update to say 'View' once documentation has been submitted.

The documents required will vary depending on the type of DMI or SVI that needs to be satisfied, and in some cases it may be necessary to submit multiple documents to resolve a single DMI or SVI.

Each verify page contains a list of acceptable documents you may choose from to satisfy the specific follow-up item in question. Select documents from your device to upload or choose documents already saved on HealthSherpa then submit.

You may repeat this process as many times as needed (e.g. multiple documents need to be uploaded, documents need to be resubmitted, revised/additional documentation is required).

You will see a success indicator when files have been successfully submitted to CMS for review.

Submitted documents can be accessed at any time from multiple locations. Learn more about viewing document history here.

Clients can view and upload their own follow-up documents independently using their own HealthSherpa Consumer Dashboard. Consumers also receive reminder emails from HealthSherpa prompting them easily upload follow-up documents.

For documents with a status of "Action needed" or "Insufficient documentation," Agents can also manually prompt clients to submit follow-up documents. To manually prompt a client to upload documents, you will send a unique upload link to the consumer. The unique upload link can be sent to a client from your Clients dashboard, from the documents due tab, or from the Client's Details page.

Submitted documents can be accessed at any time from multiple locations. Learn more about viewing document history here.

Whether you share the unique upload link with your consumer directly from HealthSherpa or choose to copy the link to share it another way, the consumer will receive a follow-up document reminder email.

The email will list any follow-ups tasks currently in "Action needed" or "Insufficient documentation" status. Learn more about the consumer's experience when using the follow-up documents reminder email here.

The email signature that displays will match the information associated with your HealthSherpa account. To customize the email signature that displays, follow the instructions here.

Consumers often need to upload documents to resolve Data Matching Issues (DMIs) and SEP Verification Issues (SVIs). Getting documents uploaded on time ensures your client keeps their subsidy and/or coverage.

The list of acceptable documents to select from varies based on the type follow-up item you are resolving:

As a reminder, each verify page within HealthSherpa contains the embedded list of acceptable documents you may choose from to satisfy the specific follow-up item selected.

You are also able to request documents from Clients and Leads before DMIs and SVIs are generated.

To manually prompt a client to upload documents early, you will send a unique intake link to the consumer. The unique intake link can be sent to a client from your Clients dashboard or the Leads dashboard.

To send a unique intake link to a consumer, find the consumers name within your dashboard then select the associated dropdown menu within the Actions column.

Note: An Intake link will only be available for a Lead if a date of birth has been saved to the Lead.

You can send the unique intake link via email directly from HealthSherpa or choose to copy the link to share it another way.

Selecting 'Email intake link' will launch a pop-up displaying a preview of the email. From the preview email pop-up, you may make customizations and manually type the client's email address to have the email sent directly from HealthSherpa.

You can also choose to select the 'Copy the link' tab to share it another way.

Uploaded documents can be accessed at any time from multiple locations. Learn more about viewing document history here.

Whether you share the unique intake link with your consumer directly from HealthSherpa or choose to copy the link to share it another way, the consumer will receive an email requesting documents.

The email signature that displays will match the information associated with your HealthSherpa account. To customize the email signature that displays, follow the instructions here.

When consumers select the 'Upload Documents Securely' button, they will be prompted to verify their identity then taken to a page where they may securely upload their files.

Consumers may upload as many files as they'd like. Once finished, they will select the 'Submit documents securely' button to finalize their submission.

Consumers will receive a success indicator once files have been securely submitted so they know when they may exit the page.

HealthSherpa provides agents with a digital 'Documents uploaded' notification once a consumer has uploaded or submitted documents. You will receive an email from no_reply@healthsherpa.com notifying you each time a consumer has successfully uploaded or submitted documentation:

To disable these notifications, go to the Agent Settings menu found within your gear icon. From the emails tab, you will find a section where you may turn document upload emails off.

Documents uploaded or submitted by consumers and agents can be accessed at any time, from multiple locations.

You may view follow-up upload history from the verify page associated with each respective follow-up.

You may also view uploaded documents from the Documents tab within a consumer's Client's details page.

You will be able to select the send email option, but you will see an error message similar to the one here letting you know the email could not be sent:

You can choose to copy the link to share it another way, or go to the Client's details page manually type the client's email address from the 'Preview email' pathway.

When you've successfully sent or copied the upload link, you will receive success alerts similar to these:

Yes. Consumers can upload documents using a computer or a mobile device.

To verify their identity, the primary applicant/contact will need to enter their date of birth.

If you are having any technical issues using HealthSherpa, please contact our Agent Support team at (888) 684-1373, at agent_support@healthsherpa.com, or via chat from within your account.