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 />
SUCCESS REPORTS AS MANAGEMENT TOOLS<br />
Monthly reports generated and auto printed by county and worker load# to be used by<br />
the county for monthly management <strong>of</strong> claims:<br />
DMD 6471I – Claims Management Monthly Report (claims alpha list)<br />
Primary report used by the claims manager. This report is the alphabetic list <strong>of</strong> all claims<br />
currently active in the county and is sorted by program. The county must have a claim file for<br />
each claim listed on the report.<br />
This report is used to:<br />
• Identify claims assigned to the county.<br />
• Identify newly approved claims.<br />
• Locate claims eligible for termination.<br />
• Identify over-collected claims.<br />
• Locate claims that are active and in RP status or closed and in OP status so that<br />
status can be corrected.<br />
• Locate missing claim files.<br />
• Locate claim files that need to be transferred to other counties.<br />
• Identify claims with 0 balance (closed)<br />
Over-collected claims are reported at the end <strong>of</strong> each program’s alphabetic list. A complete<br />
comparison <strong>of</strong> the claim files to the Claims Management Monthly Report should be<br />
completed at least once annually to identify missing claim files.<br />
Any “S” type claim that is not suspended should be changed to an adjudicated code, if<br />
appropriate, to increase retention dollars. The claims manager should discuss these “S” type<br />
claims with the OPIC agent. Some examples <strong>of</strong> “S” type claims are very old AFDC debts,<br />
customers not previously locatable or oversights by OPIC agents in updating codes.<br />
DMD 6473I – Monthly Consolidated Claims Activity Register<br />
This report lists claim payments received each month by program type. The report is used<br />
by claim managers to locate claims paid in full and by fiscal staff in monthly reconciliation <strong>of</strong><br />
Grant In Aid.<br />
DMD 6481I – EW Unprocessed OP/UP List<br />
DMD 6482I – Supervisor Unprocessed OP/UP List<br />
DMD 6483I – Office/County Unprocessed OP/UP List<br />
These reports list all unprocessed overpayments and underpayments currently assigned to<br />
the county, and should be utilized monthly to assure that all benefit errors are being<br />
dispositioned within the appropriate SOP. Disposition remains the responsibility <strong>of</strong> the<br />
assigned county regardless <strong>of</strong> the origin on the error.<br />
Rev December ‘10 49