CLAIMS HANDBOOK - Department of Human Services

BENEFIT RECOVERY (CLAIMS) HANDBOOK
Payments moved from one sequence to another for the same AU:
Example:
Claim sequence 001 is over-collected by $20 due to grant reduction and
sequence 002 has a balance of $50.
Access RMEN-J, use bottom left and right portions of the screen:
a) Enter overcollected claim sequence (001)
b) Enter “C” (type)
c) Enter amount to be corrected ($20)
d) Enter original type of payment causing the over-collection (G) see
MMEN-C to determine source of payment
e) Enter same AU #
f) Enter claim sequence with balance (002)
g) Enter claim type of sequence with balance
h) Enter amount from step (c)
NOTE: The correction code (C) can only be used for the same AU #. DO NOT use for
multiple AU numbers. Transfer claims to one AU # prior to correcting the balances.
Correcting the claim balance when the error IS NOT caused by posting:
Use of these codes will not affect GIA or correct posting errors. If multiple claims exist,
suspend all claims except the one with the erroneous balance.
At the top of the RMEN-J screen, use the source code:
(+) to increase the claim balance (cannot exceed original balance)
(-) to decrease the claim balance
Example # 1:
Claim transferred from another state and established with incorrect balance of
$100. Claim balance should be $75.
Access RMEN-J, top portion of the screen:
a) Enter today’s date
b) Enter (-) as payment source
c) Enter $25 as amount to be decreased
Example # 2:
A claim is established for $400 (Jan. $200 and Feb. $200). Due to timely
notice, only the $200 claim for February is valid.
Access RMEN-J, top portion of the screen:
a) Enter today’s date
b) Enter (-) as payment source
c) Enter $200 as amount to be decreased
There should be a clear audit trail in the claim file for every action.
A copy of the customer’s receipt and proof of SUCCESS posting must be maintained in the
claim file.
Rev December ‘10 34