There are three types of claims:
Several factors, including who discovered the potential overpayment, the type of claim and the EU’s circumstances, affect whether or not a claim is established, the time period covered by the claim, and the cause code entered in CARS. The type of claim impacts repayment, the order in which claims are repaid, and whether the claim is reviewed by WIU.
Once you have determined a possible overpayment exists, register the discovery. The discovery will either be rejected or a claim will be established.
If a claim will be established, determine the reason the overpayment occurred. Document the circumstances of the overpayment and establish the claim. Refer to CARS User guide REGISTERING A DISCOVERY CLAIM REFERRAL AND ESTABLISHING A CLAIM.
Refer to the CARS Code Sheet or access the OVCD 0003 screen for possible cause codes. Choose the cause code that most closely describes the reason for the overpayment. Overpayments may occur for different reasons during different times of a certification period. Establish separate claims for each reason an overpayment occurs. If there are two reasons for an overpayment in the same time period, establish one claim and use the reason that best describes the cause.
Record the circumstances of the claim including verification received and used to determine the reason, amount, and timeframe of the claim on the Note Add (OVNA) screen.