1142.020.00 CLAIMS REFERRAL PROCEDURES AND DETERMINATION OF DATE OF DISCOVERY

IM-#142 December 2, 2005

CARS is divided into two areas, the discovery tracking system and the claim tracking system. A discovery claim referral is tracked from date of discovery through notification to the EU that an overpayment has occurred by generation of a demand letter or rejection of the referral. Once a claim is established, the claim tracking system is used to monitor collection activity.

Register a discovery claim referral in CARS using the Discovery Add (OVAD) screen to begin the discovery tracking process. Enter the date the potential claim is identified as the date of discovery. A discovery identifier is assigned, which includes the 10-digit DCN, the date of the discovery, and a sequence number to track the number of food stamp claims discovered for the DCN on that day. Refer to CARS user guide REGISTERING A DISCOVERY CLAIM REFERRAL AND ESTABLISHING A CLAIM for instructions.

CARS uses the date of discovery to determine that the claim was established in an appropriate time frame. When a claim referral is registered, CARS calculates the due date of the claim. The discovery claim referral must be acted on and the claim established or rejected by the last day of the quarter following the quarter in which the potential claim was discovered. A Weekly Pending Discovery Claim Referral Report (FCLWK500-01) shows three days prior to the end of the quarter as the due date to act on the claim referral for management purposes.

Claim referral procedures vary according to how the potential claim is discovered:

FSD county staff discovers potential overpayment:

Potential overpayment is discovered as a result of quality control review:

The Welfare Investigation Unit (WIU) establishes trafficking of food stamp benefits:

WIU, Food Stamp Program and Policy Unit, or another source discovers a potential overpayment:

1142.025.00 PROCESSING TIME/MONITORING

IM-#142 December 2, 2005

When a discovery claim referral is registered, CARS calculates the due date for the referral. The referral must be acted upon and the claim established or rejected as invalid referral by the last day of the quarter following the quarter in which the potential claim was discovered.

For management purposes the due date for processing a discovery claim referral is shown as 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 31, 2001 to be counted as processed timely. Three work days are allowed from the due date to the end of the month to ensure the claim referral is processed timely.

A Daily Incomplete Pending Claim Registration Report (FCLDY500-01) is generated if incomplete information is entered into CARS and a demand letter cannot be generated. The report is used to identify and track claims that have been initiated, but not completed, and is distributed to the worker.

A Weekly Pending Discovery Claim Referral Report (FCLWK500-01) is generated weekly showing the claim referrals assigned to a specific worker that have not been completed. The report displays each discovery claim referral due date and indicates delinquent discovery claim referrals. The report is used as a management tool to track pending discovery claim referrals and is distributed to the worker.

A Monthly Discovery Claim Status/Activity Report (FCLME501) is generated showing all discovery claim referrals registered, moved, rejected and established during the month. The report includes a summary of the number of claims processed during the month and the number pending at the end of the month. This report is used as a case management tool to monitor timeliness of discovery claim referral processing and is distributed to the supervisory unit.

A Quarterly Discovery Claim Status/Activity Report (FCLQT501) is generated showing a summary of all claims processed during the quarter. This report shows currency of claims established and is used as a management tool to monitor timeliness of discovery referral processing.