IM-146 08/03/01 FOOD STAMP CLAIM POLICY REVISION
|FOOD STAMP CLAIM POLICY REVISION
|Effective 08/06/2001, the policy
and procedures for food stamp claims processing are changed. This
memorandum addresses the changes in policy. The procedures for entering
information required for food stamp claims in the data system are addressed
in a separate memorandum.
The following are definitions of terms used throughout this memorandum.
CARS is changed to add screens that allow us to track timely processing of claim referrals and to associate all responsible household members to an established claim. The new screens work with the existing screens. Minor changes made to existing screens are discussed in a separate memorandum.
REGISTERING A CLAIM
All food stamp discovery claim referrals must have the date of discovery entered. The date of discovery is the date county staff become aware of a possible overpayment. The discovery claim referral is registered in CARS the same day it is discovered.
EXAMPLE 1: The caseworker, Joe Shmoe, discovers a possible overpayment for the D'Arcy household on August 6, 2001. Workers in this particular county are responsible for their own claims. Joe registers the discovery claim referral in CARS on August 6, using his/her own user ID (SHMOZ00) and his supervisor's user ID. The date of discovery is August 6, 2001.
EXAMPLE 2: Jane Doe, discovers a possible overpayment for the Biafra household on September 12, 2001. Jane Doe registers the discovery claim referral in CARS on September 12 without verifying eligibility information. Jane enters her own user ID (DOEZAZ) and the user ID of the supervisor of the claims worker/unit. The claims worker/unit is notified of the discovery claim referral on September 13. The date of discovery is September 12, 2001, the day the possible overpayment is discovered. The claims worker who receives the claim referral changes the user ID to his/her own.NOTE: It is up to each office to determine who is responsible for obtaining verification needed to establish the claim. Each office determines the policy for notifying the claims worker/unit that a claim referral has been registered.
Once a discovery claim referral is registered, CARS calculates the due date for the claim. Discovery claim referrals must have a claim established or the referral rejected by the third to last working day of the quarter following the quarter of the date of discovery.
EXAMPLE: The discovery date is August 6, 2001. The discovery claim referral due date is December 27, 2001. The claim must be established or the claim referral must be rejected by December 27, 2001.Each worker receives a weekly report, Weekly Pending Discovery Claim Referral Report (Report Number FCLWK500-01), showing pending discovery claim referrals assigned to him/her. Each management unit receives a report showing all pending discovery claim referrals within that unit. The report displays the discovery claim referral due date and indicates delinquent discovery claim referrals.
REJECTING CLAIM REFERRALS
Claim referrals may be rejected for any of the following reasons:
The demand letters now include overpayment information for each month of overpayment. Included is the amount of benefits the household received each month of the claim period, the amount the household was eligible to receive each month, and the overpayment amount for each month. A screen is developed to capture this information. The layout is similar to the claim worksheet, form IM-86. It is no longer a requirement to complete form IM-86 on food stamp claims. Continue to use FBCA as applicable.
The following individuals are now responsible for repaying a claim established after 08/06/01. Do not add new responsible individuals to claims established prior to 08/06/01.
NOTE: An authorized representative is not responsible to repay an Agency Error claim.Several screens are developed to attach responsible individuals ("claim members") to the claim. The responsible individuals are listed on the demand letters.
Collections will only be made against one household for a single claim when responsible claim members reside in multiple households, in the following order:
Once all the information necessary to establish a claim has been entered in CARS, worker involvement in the claim establishment process is complete. CARS will automatically generate a demand letter to be sent the next working day. The date the letter is generated is considered the date of establishment.
EXAMPLE: Information is entered to establish a claim on 12/28/01. The letter is generated in the overnight batch process prior to midnight. 12/28/01 is the date the claim is considered established. The next business day the letter could be mailed is 12/31/01.If insufficient information is entered in CARS and a demand letter cannot be generated, a Daily Incomplete Pending Claim Registration Report (Report Number FCLDY500-01), is generated. This report is produced daily and sent to the worker and the supervisor.
As soon as a discovery claim referral is registered, it will be assigned a 20-digit Discovery Identifier(ID). This Discovery ID consists of ten digits for the DCN (the DCN is preceded by two zeros in anticipation of the ten-digit DCN to be used for FAMIS), the eight-digit discovery date (YYYYMMDD), and a two-digit sequence number. This will allow staff to enter more than one claim referral per case with the same discovery date.
EXAMPLE: A discovery claim referral registered for DCN 12345678 with a discovery date of August 10, 2001, will have the Discovery ID 00123456782001081001. A second discovery claim referral registered for the same DCN and the same discovery date will have the Discovery ID 0123456782001081002.CLAIM INDICATOR
To allow multiple food stamp claims to be established (the date the demand letter is generated) on the same day for a DCN, CARS will assign the claim indicator letter "I" for the first claim established and a successive letter for subsequent claims (J, K, L, etc.). If only one food stamp claim is established on a given day, the claim indicator letter is "I". The claim indicator assignment is based only on the DCN and the date of claim establishment. It is completely independent of the Discovery ID.
At the point the claim is established, CARS assigns a claim identifier, consisting of the claim indicator, DCN, space, program, space, date of establishment.
EXAMPLE: Two claims for DCN 12345678 are established (demand letters are generated) on September 22, 2001. Both claims are program 12. The first claim established has the claim identifier I12345678 12 092201 and the second claim established has the claim identifier J12345678 12 092201.Some screens are claim-specific screens. OVCC, OVPI, OVMA, OVMD, and OVIM require the correct claim identifier to access the screens. OVMA, OVMD, and OVIM are new screens that are covered in a separate memorandum. If the claim identifier is not known, access the OVCS - CARS SYSTEM - CLAIM SUMMARY SCREEN. OVCS displays information for each claim for a given DCN, including the program, date established, from date, to date, claim balance, and claim status. Access OVCS by typing OVCS, space, I, DCN.
NOTE: The claim indicator is displayed after the program code in the "PGM" column on OVCS. The claim indicator is only displayed on OVCS if it is other than "I". A blank space after the program code indicates that the claim indicator is an "I".
The method of accessing other CARS screens has not changed. They require only an "I" before the DCN. These other screens either display information regarding all claims for a given DCN regardless of the identifier or program, or they allow the user to cycle through the screens to view specific claims.
EXAMPLE: The claims worker determines a member associated to a claim needs to be added. The worker needs to access OVMA. To find the claim identifier, view a list of all the claims for DCN 12345678. Type OVCS I12345678. Locate the claim that is to be changed. After determining the claim identifier, to change claim information on a claim with program 12, claim indicator "J", and date established 09-22-01, overtype the tran ID with OVCA J12345678 12 092201.REPORTS
Four reports are used to monitor claim referrals to ensure the time frames are met. If more than 10% of the claim referrals are delinquent, a backlog exists and a corrective action plan will be required.
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