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 />
All documentation supporting the disqualification must be kept permanently, retain when<br />
claim file is destroyed according to purging policy.<br />
Refer to FS Policy Manual, Section 3315 and Pg 44 <strong>of</strong> this handbook for additional<br />
information.<br />
Correcting inaccurate DRS data:<br />
• If a disqualification was entered for a wrong individual or wrong identifying information<br />
was entered:<br />
• Enter update code D (delete) to remove the disqualification and<br />
re-enter or<br />
• Enter update code C (change) to update the existing type and / or counter<br />
• If the instructions from OPIC state to impose a counter that already exists:<br />
a) Change (C) the existing counter to #0<br />
b) Add the new disqualification with the correct counter #<br />
DRS System Alerts:<br />
Msg 1620 - “Client must be Open to Add an Active Disqualification Penalty” will be generated<br />
on DRS when:<br />
• Disqualified individual is coded as a non-member (NM) or ineligible member (ND) is in<br />
SUCCESS.<br />
• Disqualified individual is not coded on STAT because the application was denied by<br />
SUCCESS without an initiated interview.<br />
To correct SUCCESS coding so that DRS can be updated:<br />
• Inactive case – register an application and enter minimum information to assign a<br />
code RP and deny. Document so as not to reflect an invalid denial.<br />
DO NOT register and deny an application solely to update DEM3.<br />
• Active case – the ineligible AU member is coded “ND” (refer to page 46)<br />
“IPV/DRS 1 DQ Data Out <strong>of</strong> Sync” will be generated when:<br />
• A penalty has been imposed on DEM3 which does not match the DRS master file<br />
information for the SUCCESS customer by SSN.<br />
• Information was recorded on DRS which does not match SUCCESS DEM3.<br />
Discrepancies must be reconciled and information on DRS and DEM3 aligned. The only<br />
time the discrepancy is acceptable is when disqualification type “M” has been entered on<br />
DEM3 (refer to page 45).<br />
Rev December ‘10 47