CLAIMS HANDBOOK - Department of Human Services
CLAIMS HANDBOOK - Department of Human Services
CLAIMS HANDBOOK - Department of Human Services
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BENEFIT RECOVERY (<strong>CLAIMS</strong>) <strong>HANDBOOK</strong><br />
TABLE OF CONTENTS<br />
Overview <strong>of</strong> Benefit Recovery 5<br />
Glossary 6-7<br />
Claims Establishment and Approval<br />
Claim Files 8<br />
Documentation 9<br />
The SUCCESS Submenus 10<br />
Claim Type and Reason Codes 11<br />
Identifying and Dispositioning an Underpayment 12<br />
Identifying and Dispositioning an Overpayment 12 - 13<br />
Approval and Schedule <strong>of</strong> New Claims 13<br />
Recovery Schedule Codes 14<br />
Determining Standard <strong>of</strong> Promptness and Statute <strong>of</strong> Limitations 14 - 15<br />
Compromise / Write Off 15<br />
Claim Status Codes 16<br />
SUCCESS System Notices 17 - 18<br />
The Office <strong>of</strong> Program Integrity and Compliance (OPIC) 18 - 19<br />
Processing Non Fraud Claims Screened Out By OPIC 20<br />
Rev December ‘10 3
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