CLAIMS HANDBOOK - Department of Human Services

BENEFIT RECOVERY (CLAIMS) HANDBOOK
ISSUING REINSTATED BENEFITS / BENEFITS FROM EXPEDITED
CHANGES
The SUCCESS system “sees” benefits issued when a case is reinstated as an underpayment,
but these benefits cannot be offset as a claim payment and must be issued to the customer.
Benefits due to the customer due to an expedited change must also not be offset. Existing
claims must be placed in suspended status prior to reinstatement / issuance to prevent
erroneous offset.
Before reinstating a case or issuing expedited underpayment, screen for existing claims on the
STAT screen.
If the claim indicator field in the upper right hand corner is coded “Y”:
1. Access RMEN using the F20 function key. The case # will be pre-populated.
2. Select Option E and ENTER
3. Change the claim status to SU by typing over RP or OP (field will be green). ENTER to
return to the RMEN Sub menu
4. Return to the STAT screen using the F3 function key and complete reinstatement
5. Allow overnight processing to issue underpayment
6. Access RMEN E and change the claim status code to RP (SUCCESS will update to OP
if appropriate, verify and update manually if necessary)
Suspension must be lifted after the overnight cycle to assure that future payments via grant
reduction are recouped appropriately.
CORRECTING THE CASE/CLAIM WHEN BENEFITS HAVE BEEN
OFFSET IN ERROR
To restore benefits:
1. Access RMEN E. Suspend claim(s) – Step 3 above
2. Access RMEN C. Issue underpayment for correct amount and month. Underpayment
will be agency error
3. Allow overnight processing to issue underpayment
4. Return claim(s) to RP status – Step 6 above
To correct claim balance:
1. Identify posting of underpayment (MMEN C)
2. Access RMEN J – bottom left
3. Key claim sequence showing offset (001, 002, etc.)
4. Key type B (backout)
5. Key amount of incorrectly posted underpayment
6. Key U (Underpayment offset) for original source
7. ENTER to confirm backout
***Increasing the claim balance using the (+) code will not correct the state collection
report. The balance must be corrected by removing the incorrect payment from the claim
***
Rev December ‘10 64