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2040.005.05 Claims Referrals

Upon discovery of a claim, make a claim referral. Claim referral procedures vary according to how the potential claim is discovered.

Local FSD staff discovers potential overpayment:

  • The eligibility specialist completes the claim referral (CR-1) form and submits to the Program Integrity Unit (PIU) point of contact. When submitting the referral, submit all supporting documentation available.

When the Welfare Investigation Unit (WIU), Early Childhood Prevention Services Section (ECPSS), Quality Control or another source discovers a potential overpayment, agency staff notifies the Program Integrity Unit (PIU) of the possible overpayment by submitting a claim referral.

PIU will establish a claim when an overpayment is determined.