Home

EPICS - NC DHHS Online Publications

1. REFERRALS July 1 2004 C Referral Detail 2 Field Descriptions Field Description Required System Optional Generated REFERRAL ID 10 digit number X generated by the system upon creation of a referral EIS FSIS Case head payee s X ADDRESS address currently residing in EIS FSIS ALIAS NAMES One or more alternate X names for the case head payee EPICS ADDRESS Case head payee s X TYPE address Used when the EIS FSIS address is incorrect Note For EPICS this address is stored in CNDS ALIAS SOCIAL One or more X SECURITY alternative social NUMBERS security numbers for the case head payee PHONE NUMBERS Case head payee s X TYPE phone number s including area code PHONE NUMBERS Case head payee s X EXT phone extension ALLEGATIONS Up to 79 characters X Description of the alleged fraud D Referral Detail 2 Function Keys Key Description F1 To access EPICS on line help F3 To exit and return to Main Menu F4 To display a list F6 To add a referral save F9 To update referral information F12 To cancel and return to the previous screen 10 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 REFERRALS September 13 2004 E To Create a New Referral 1 From the MAIN MENU key the number 2 in the Enter Option field and press Enter The REFERRAL MENU displays FRO3 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 06 18 2004 FRDO030
2. displays FR29 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 02 23 2004 FRD0290 CLAIM DETAIL 15 27 08 REFERRAL ID REFERRAL TYPE _ REFERRAL STATUS _ NAME INDIVIDUAL ID SSN DOB SEX COUNTY ___ PROGRAM CASE ID COUNTY CASE REFERRAL DATE INVESTIGATOR ID CURRENT BALANCE 0 00 SERVICE CODE _ CLAIM TYPE AGENCY ERROR TYPE _ CIVIL JUDGEMENT DATE CRIMINAL JUDGEMENT DATE OP OI PERIODS FROM TO MED PROFILE IND _ MED PROFILE IND _ MED PROFILE IND _ MED PROFILE IND _ OVERPAYMENT AMOUNT SUBSTANTIATION METHOD _ COMPROMISE AMOUNT DELETE REASON ESTABLISHMENT DATE U P CREATION DATE F1 HELP F2 CLEAR F3 EXIT F4 LIST F5 DEBTOR F9 UPDATE F10 DELETE F11 REACTIVATE F12 CANCEL NOTE If you do not know the code or value for a field you can use the F4 function key which displays a list of codes or values for selection This field attribute is only available for those fields that contain a plus sign to the right of the field For additional information about claim codes see Appendix B 8 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CLAIMS JULY 1 2004 In the REFERRAL ID field key the referral ID number for the case head payee and press Enter The referral information displays d For Medicaid only in the SERVICE CODE field key the service code You may use the equal key and F4 key to
3. ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 A COLLECTIONS Payments Field Descriptions March 1 2005 FIELD DESCRIPTION REQUIRED SYSTEM GENERATED OPTIONAL Referral ID 10 digit number generated by the system upon creation of a referral X Debtor Individual ID Unique ID associated with the debtor supplied by CNDS NAME Last name first name and middle initial of the debtor SSN Debtor s social security number DOB SEX Debtor s date of birth Debtor s sex COUNTY 3 digit number between the values of 000 100 representing the issuing county in which the overpayment took place PROGRAM Up to 4 character code that identifies the benefits program to which the referral applies CASE ID Program Case ID associated with referral COUNTY CASE County case number associated with the referral ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS COLLECTIONS Change 1 2005 March 1 2005 FIELD DESCRIPTION REQUIRED SYSTEM GENERATED OPTIONAL TYPE OF CLAIM Up to 4 character code that identifies the type of claim X OP OI BALANCE Up to 9 character the current balance of the claim OVERPAYMENT PERIOD Start and ending date of the overpayment METHOD OF COLLECTION OVERCOLLECTIO N AMOUNT Up to 15 characters identifies the means
4. FIELD DESCRIPTION COUNTY NAME Name of the county the report applies to NAME The full name of the debtor Last Name First Name SSN The social security number of the debtor INDIVIDUAL ID The 10 character ID number of the debtor REF ID 10 digit ID generated by the system upon creation of a referral PROGRAM CASE ID Up to 9 characters Identifies the Program Case ID associated with the claim ERROR MESSAGE The reason provided by TOP that the debtor is rejected for tax intercept ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 2 APPENDIX F REPORTS March 1 2005 FRD221 3 60 DAY NOTICE REPORT REPORT PURPOSE This report is used to show all Food Stamp claim debtors that were sent the 60 day notice Five extra days are given for mailing purposes ACTION REQUIRED No action is required unless the debtor requests an appeal The counties can use this report to calculate when the 65 day appeal period will end for the claim debtor If the debtor requests an appeal during the notice period the county should enter an R in the Federal Tax Appeal Indicator on the Debtor Detail Screen For review purposes only REPORT SCHEDULE Runs on the first of the month REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is only available in XPTR RETENTION PERIOD Three Years FRD221 3 FIELD DESCRIPTIONS
5. ORIGINATING COUNTY 3 digit code between the values of 000 and 100 Represents the issuing county in which the suspected overpayment took place OWNER Used to show which county currently owns the referral Defaults to originating county number unless the referral has been transferred PROGRAM Up to 4 characters Code that identifies the benefits program to which the suspected overpayment applies ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS July 1 2004 Change 1 2004 REFERRALS Field Description Required System Generated Optional CASE ID Up to 9 characters Identifies the Program Case ID associated with the suspected overpayment X COUNTY CASE 7 character county case number Note You must key slashes REFERRAL DATE 10 character date MM DD YYYY the referral is received REFERRING PERSON Up to 45 characters Name of the person reporting the referral Note anonymous and unknown are accepted REFERRING PERSON PHONE 10 character including area code phone number of the Referring Person Note Hyphens not accepted REFERRAL SOURCE 2 character code representing the source of the violation NATURE OF REFERRAL 1 character code representing the nature of the violation ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 REFERR
6. COUNTY DETAIL July 1 2004 E County Detail Function Keys Key Description F1 To access EPICS on line help F2 To clear the screen F3 To exist and return to the Main Menu F4 To display a list F9 To update the County Detail screen F12 To cancel or return to the previous screen F To display County Detail information 1 From the Main Menu key the number 1 in the Enter Option field and press Enter The ADMINISTRATION MENU displays 2 From the ADMINISTRATION MENU key the number 4 in the ENTER OPTION field and press Enter The COUNTY DETAIL screen displays FR17 NC DHHS ENTERPRISE PROGRAM INTERGITY CONTROL SYSTEM 02 23 2004 FRD0170 COUNTY DETAIL 15 11 28 COUNTY __ TEAM NUMBER COUNTY NAME COUNTY ADDRESS NC COUNTY TELEPHONE ___ COUNTY EXT COUNTY FAX NUMBER ___ COMMENTS F1 HELP F2 CLEAR F3 EXIT F4 LIST FQ9 UPDATE F12 CANCEL 3 In the COUNTY field key the county code of the county you wish to display and press Enter The remaining fields automatically populate NOTE If you do not know the code or value for a field you can use the F4 function key which displays a list of codes or values for selection This field attribute is only available for those fields that contain a plus sign to the right of the field 3 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays ENTERPRISE PROGRAM INTEGRITY CONTROL SYST
7. 1 From the Name Search screen complete a Name Search using one of the four ways outlined on the Name Search Screen Press Enter From the Name List screen enter an S under SEL by the individual for which the change is needed and press the F11 function key From the Maintain Client screen change the address and or phone number Press the F9 function key When the update is successful the following message is displayed Address Updated and Phone Created Successfully Press the F12 function key twice to return to the Maintenance Menu Press the F3 function key to return to the Main Menu i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CASE MAINTENANCE September 13 2004 Vil UTILIZING F4 If you do not know the code or value for a field use the F4 function key to display a list of codes or values for the selection This field attribute is not available for only those fields that contain a plus sign to the right of the field To enter field details using F4 1 In the field that contains a plus sign to the right of the field key equal sign and press the F4 function key The specific code list screen displays 2 To select a code or value tab to the appropriate code value in the S column and key s 3 Press Enter The previous screen displays with the field populated with the selected code or value 4 Continue entering or updating the screen details i ENTERPRISE P
8. Case head payee s date of birth Sex Case head payee s sex The selection field for viewing the details for a specified referral Referral ID 10 digit number generated by the system upon creation of a referral 49 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CLAIMS JULY 1 2004 Field Description Required System Optional Generated ST The current status x of the referral Date Date the referral x was received Prog Benefit program X that the individual is currently receiving benefits OP Amount Actual amount of X overpayment against the claim Op Period Actual beginning xX from date of the overpayment Op Period To Actual ending date X of the overpayment Balance Current balance of xX the claim CAT Code indicating the X claim type B EPICS History By Case Head Function Keys Function Key Description F1 To access EPICS on line help F3 To exit and return to the Main Menu F4 To display a list F7 To display the previous screen Page Down F8 To display the next screen Page Up F12 To cancel or return to the previous screen C View List Of Referrals For A Case Head By Individual ID 1 From the MAIN MENU key the number 3 in the ENTER OPTION field and press Enter The CLAIMS MENU displays 2 From the CLAIMS MENU key the number 1 in the ENTER OPTION field and press Enter The EP
9. DESCRIPTION COUNTY NAME Name of the county INVESTIGATOR ID 5 character ID of the investigator assigned to the claim NAME The full name of the claim debtor listed on the report Last Name First Name Middle Initial PROGRAM Identifies the Program associated with the referral SSN The social security number of the claim debtor INDIVIDUAL 10 character number of the claim debtor REFERRAL 10 digit ID generated by the system upon creation of a referral of the claim debtor PROGRAM CASE ID UP to 9 characters Identifies the Program Case ID associated with the claim CLAIM CAT Code that specifies the type of claim FED TAX INT Code that indicates the stage of the Federal Tax intercept of a claim debtor FED TAX APPEAL The federal tax appeal indicator code for a claim debtor CLAIM EST DATE The date the claim is established CLAIM BALANCE The current claim balance owed 5 FRD406 3 CLAIMS EXEMPT FROM TOP PRE OFFSET ADDRESS REQUEST REPORT PURPOSE This report shows all Food Stamp claim debtors exempt from the TOP Pre Offset Address request with Federal Tax Indicators of H L X S or with Federal Tax Appeal Indicators of R or Y ACTION REQUIRED No action is required unless the exempt status has changed If the status changes reset the Federal Tax Indicator flag on the Debtor Detail Screen Example the Federal Tax Indicator flag is set to X because of bank
10. ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS SEPTEMBER 13 2004 Change 2 2004 CLAIMS A Repayment Approach Field Descriptions Field Description Required System Generated Optional Referral ID 10 digit number generated by the system upon creation of a referral X Referral Type 1 character code that identifies the type of referral Referral Status Current status the referral is in Debtor Name Full name of the debtor first name last name and middle initial Ind ID Unique 10 character number of the debtor provided by CNDS SSN Debtor s social security number DOB Debtor s date of birth Sex Debtor s sex County 3 digit number with the value from 000 100 representing the issuing county in which the overpayment took place Program Code that identifies the benefits program to which the referral applies Case ID Program Case ID associated with referral 43 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CLAIMS JULY 1 2004 Field Description Required System Optional Generated County Case County case Xx number associated with the referral Referral Date Date the referral X was received Investigator ID ID of the X investigator assigned to the referral Overpayment 10 character date xX Begin Date MM DD YYYY of the start dat
11. G Debtor can request an appeal by entering the code R or waive the appeal by entering the code W This value is entered in the TOP Intercept Appeal Ind field on the Debtor Detail screen H If the debtor waives the right to appeal or does not respond to the 60 Day Notice the debtor s TOP Intercept Indicator field is set to a C indicating the claim is eligible for certification providing the other eligibility requirements still apply This is done by a batch job If the debtor request an appeal certification processing is held until a decision has been made It is very important that the county changes the code R once the appeal is ruled in favor of the county or the debtor and enters the correct code of Y or N If the appeal is ruled in favor of the county the debtor s Federal Tax Intercept Indicator field is set to a C indicating the claim is eligible for certification This is done by a batch job J Once the claim has been certified it remains on TOP files and can only be changed to an I or P value An I value inactivates the claim on TOP files only the claim is still active in EPICS unless closed or terminated If necessary the claim can be reactivated from this value 33 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CLAIMS SEPTEMBER 13 2004 K A P value permanently closes the offset request due to paid up balance or closed on TOP s files If this value is entered the claim can N
12. If the debtor requests an appeal the county must set a flag to R Y or N indicating the request Once the county sets this flag the payment process is on hold until a decision has been made It is very important that the county remove this flag once the appeal is denied or ruled in favor of the debtor NOTE If the debtor should not have been intercepted and is due a full refund and a hearing is not warrant the county can enter a code of D or Y to issue the refund including interest and collection fees This lets the system know to automatically issue arefund For more specific details please see procedures in the collections section If the debtor does not waive the right to appeal or request an appeal payment is processed 35 days after the 30 Day Notice date 37 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CLAIMS SEPTEMBER 13 2004 Vill MAINTAIN CLIENT For a debtor that is not associated with a benefit case EPICS provides a feature MAINTAIN CLIENT that allows you to define a debtor to a claim who is not defined in CNDS Likewise you have the capability to maintain the demographic information for the debtor in EPICS The client demographic information is transferred and stored in CNDS You may access Maintain Client via Debtor Detail screen or Name List screen Once updated in the legacy systems EPICS is not permitted to update their demographics Such updates wo
13. OVERPAYMT AMT LESS THAN COLLECTIONS PAYMT CORRECTIONS MAY BE NECESSARY a If the correct Overpayment Amount has been over collected reverse out the total amount of all payments that were collected in error by completing a payment correction NOTE EPICS DOES NOT ALLOW PAYMENT CORRECTIONS FOR AFDC CLAIMS OUTSIDE THE CURRENT MONTH b Payments collected via NC Debt Setoff DOR and the Treasury Offset Program TOP cannot be reversed nor refunded by county staff 1 If an AFDC Work First claim has been over collected through DOR contact Family Support and Child Welfare Services staff at 919 733 4622 before taking further 12 103 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CLAIMS JULY 1 2004 2 If a Food Stamp claim has been over collected through either DOR or TOP contact the Food Assistance and Energy Programs Branch staff at 919 733 7831 before taking further action 3 If a Medicaid claim has been over collected via DOR contact Brenda Porter or Shara Britt at 919 733 3590 Once the over collected payments have been reversed out enter the correct OVERPAYMENT AMOUNT Re key the payments that were reversed and refund any over collections Any resulting over collection is reflected on the FRD104 Refund Report EXAMPLE On 10 01 2003 a claim was showing an overpayment amout of 400 00 and a current balance of 200 00 A cash payment of 200 00 had been posted in EPICS on
14. This line is used to show the total dollar amount Current Balance at the time of the transfer and the number of claims transferred out of the counties for the given quarter for each heading IPV Fraud IHE Non Fraud AE Non Fraud LINE 2All This line is used to show the total dollar TRANSFER IN amount Current Balance at the time of the transfer and the number of claims transferred into the counties for the given quarter for each heading IPV Fraud IHE Non Fraud AE Non Fraud LINE 2B This line is used to show the total dollar COMPROMISE amount of reduction and number of claims reduced by Compromise judgment for the given quarter for each heading IPV Fraud IHE Non Fraud AE Non Fraud Only AJCA coded entries are included AJUC coded entries are NOT included 13 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 FIELD DESCRIPTION LINE 2C 1 This line shows the dollar amount and the AJCI number of claims in which a Current Balance increase occurred LINE 2C 2 This line shows the dollar amount and the AJCD number of claims in which a Current Balance decrease occurred LINE 2C 3 This line shows the dollar amount and the AJUC number of claims in which an Uncompromise occurred LINE 2C 4 This line shows the dollar amount and the AJIT number of claims that have been transferred into the state fro
15. 1 character indicator set to Y when the investigator opens the referral OPEN DATE 10 character date MM DD YYYY the referral was opened by the investigator ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 REFERRALS July 1 2004 Field Description Required System Optional Generated CLOSE REFERRAL 1 character indicator X set to Y when the investigator closes the investigation DATE CLOSED 10 character date X MM DD YYYY the referral was closed by the investigator REASON CLOSED Up to 8 characters X Description for the reason for referral was closed i e paid off OVERRIDE USER RACF ID of the person X ID implementing the STATE OFFICE override PERSONNEL OVERRIDE The county for which X COUNTY the override took place OVERRIDE DATE 10 character X MM DD YYYY date the override took place B Referral Detail 1 Function Keys Key Description F1 To access EPICS on line help F2 To clear the screen F3 To exit and return to the Main Menu F4 To display a list F5 To display the Notepad F6 To add a referral save F9 To update referral information F10 To display the Referral Detail 2 screen F11 To create a new referral with default data from the currently displayed referral F12 To cancel and return to previous screen ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004
16. B Maintain Client Function Keys Key Description F1 To access EPICS on line help F2 To clear the screen F3 To exit and return to the Main Menu F6 To add the maintain client information save F9 To update the maintain client information F12 To cancel or return to the previous screen C Add New Client AS A Debtor 1 From the MAIN MENU key the number 3 in the ENTER OPTION field and press Enter The CLAIMS MENU displays From the CLAIMS MENU key the number 3 in the ENTER OPTION field and press Enter The CLAIM DETAIL screen displays In the REFERRAL ID field key the referral ID and press Enter The claim information displays Press the F5 function key The DEBTOR SUMMARY screen displays Press the F9 function key The DEBTOR DETAIL screen displays In the INDIVIDUAL ID field key and press F4 The NAME SEARCH screen displays NOTE Initially it is required for you to search for the individual via NAME SEARCH Enter the client information and press Enter 39 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CLAIMS SEPTEMBER 13 2004 NOTE The NAME LIST screen displays with a list of names matching the criteria entered If you locate the individual in the NAME LIST select the name and refer to procedures on adding an individual as a debtor 8 Press the F11 function key The MAINTAIN CLIENT screen displays FRO4 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 08 24 2
17. E ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS D MEDICAID REPORTS March 1 2005 REPORT REPORT NAME REPORT DESCRIPTION FREQUENCY NUMBER FRD108M MA LOI DATA SHOWS LETTER OF MONTHLY OVERISSUANCE INFORMATION FOR MEDICAID CLAIMS FRD470 MEDICAID PROFILE IDENTIFIES CLAIMS FOR MONTHLY FOLLOW UP CASE WHICH A MEDICAID LAST MANAGEMENT RECIPIENT PROFILE MUST BE WORKNIGHT REPORT REQUESTED OF EACH MONTH AFDC TANF FOOD STAMP AND MEDICAID REPORTS REPORT REPORT NAME REPORT DESCRIPTION FREQUENCY NUMBER FRD104 COUNTY REFUND LISTS OVERCOLLECTIONS ON DAILY REPORT CLAIMS EXCEPT TOP AND MAILED DOR FRD105 TOP AND DOR LISTS ALL OVERCOLLECTIONS DAILY REFUND REPORT ON CLAIMS FOR TOP AND DOR FRD106 NCDEBTESTRFD LIST ALL ESTIMATED DAILY OVERCOLLECTION ON CLAIMS FOR DOR FRD160 O APPEAL IND LIST CLAIMS THAT HAVE AN A DAILY O IN THE APPEAL FIELD FOR DOR CLAIMS FRD204 UNASSIGNED SHOWS CASES THAT HAVE WEEKLY CASES REPORT NOT BEEN ASSIGNED TO AN INVESTIGATOR FRD206 OVERRIDE LISTS CASES WHERE THE WEEKLY EXCEPTIONS OVERRIDE FEATURE WAS REPORT USED FRD213 CLAIMS SELECTED LISTS CLAIM DEBTORS THAT WEEKLY FOR NC DEBT HAVE BEEN SELECTED FOR SETOFF NC DEBT SETOFF FRD214 DOR DUPLICATE LISTS DEBTORS PRESENTIN WEEKLY SSN EPICS THAT CONTAIN DUPLICATE SSN S MULTIPLE INDIVIDUAL ID NUMERS FRD240 ZERO SSN REPT LIS
18. FIELD DESCRIPTION OFFSET CYCLE NO The TOP cycle number in century year week format associated with the proposed certification COUNTY NAME The name of the county the report applies to NAME The full name of the debtor and the address of the debtor Last Name Middle Initial MULTI COUNTY Indicates the debtor has claims in other counties and has been sent 60 day notices there also PROGRAM Identifies the Program associated with the referral always FS SSN 9 digit social security number for the debtor INDIVIDUAL 10 character number of the claim debtor REFERRAL 10 digit ID generated by the system upon creation of a referral CASE ID Program Case ID Number associated with the debtor CLAIM BALANCE The current balance due on the claim DATE SENT The date the 60 day notice is mailed to the claim debtor ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 3 APPENDIX F REPORTS March 1 2005 FRD222 2 CLAIMS CERTIFIED FOR TOP OFFSET REPORT PURPOSE This report lists claim debtors for all programs that have been selected for TOP Offset ACTION REQUIRED No action required unless the select status has changed If the status changes reset the TOP Offset Indicator flag on the Debtor Detail Screen REPORT SCHEDULE Run on a weekly basis REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is available in XPTR RETENTION PERIOD T
19. RETENTION PERIOD Three Years i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS FRD433 FIELD DESCRIPTIONS March 1 2005 FIELD DESCRIPTION COUNTY CODE Three character code identifying the county COUNTY NAME The name of the county the report applies to SSN 9 digit social security number for the debtor NAME The full name of the debtor Last Name First Name Middle Initial PROGRAM Identifies the Program associated with the referral CLAIM OVERPAYMENT The overpayment amount due on the claim at the the county AMOUNT time of establishment PRGM CASE ID Up to 9 characters Identifies the Program Case ID associated with the claim REFERRAL ID 10 digit ID generated by EPICS upon creation of a referral DATE SENT The date the letter is sent to the claim debtor or to FINAL HEARING The date the appeal process expires 19 FRD 441 COLLECTIONS REPORT REPORT PURPOSE This report is used to show all payments received on referrals for the county The report identifies total dollars received by program and a grand total for all programs ACTION REQUIRED Review this report for accuracy Contact appropriate State staff if there are discrepancies REPORT SCHEDULE Runs on a monthly basis around the 5 calendar day of each month REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIB
20. AE Non Fraud during the given quarter Dollar Amount Formula Line 7e Total Cash Collected Line 8 Coupons Line 9 Recoupments Line 10 Offsets 18 Change 1 2005 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS APPENDIX F REPORTS March 1 2005 FIELD DESCRIPTION LINE 12 TERMINATED CLAIMS This line is used to show all claims terminated during the given quarter for each heading IPV Fraud IHE Non Fraud AE Non Fraud This line shows the number of claims and dollar amounts The dollar amount reflects the current balance at the time the claim was terminated These entries are identified by an AJTE code LINE 13 NON CASH ADJUSTMENTS This line is used to reflect amendments or corrections which need to be made because of changed or incorrect entries related to food stamps EBT recoupment or offset collections from a previous quarterly report for each heading IPV Fraud IHE Non Fraud AE Non Fraud This includes reversals of a previous quarter S EB EX R LR or O payments LINE 14 CASH ADJUSTMENTS This line is used to reflect amendments or corrections which need to be made because of changed or incorrect entries related to cash check or money orders collections from a previous quarterly report for each heading IPV Fraud IHE Non Fraud AE Non Fraud This includes reversals of previous quarter C FSC CT N or T payments LINE 15 TRANSFERS BETWEEN A B
21. ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS 2500 APPENDIX F REPORTS Change 1 2005 March 1 2005 APPENDIX F REPORTS 100 REPORT SERIES CREATED DAILY 200 REPORT SERIES CREATED WEEKLY March 1 2005 400 REPORT SERIES CREATED MONTHLY EXCEPT 428Q 428Y AND FRD 431 500 REPORT SERIES CREATED QUARTERLY FRD 431 IS CREATED BI WEEKLY A FOOD STAMPS REPORTS REPORT REPORT NAME REPORT DESCRIPTION FREQUENCY NUMBER FRD108 FS LOI DATA SHOWS LETTER OF DAILY OVERISSUANCE 90 days INFORMATION FOR FOOD STAMP CLAIMS FRD221 1 TOP PRE OFFSET SHOWS FOOD STAMP CLAIMS WEEKLY ADDRESS THAT WERE NOT PROCESS 90 versions UNPROCESSABLE ABLE BY TOP FRD221 3 60 DAY NOTICE LISTS THE CLAIM DEBTORS WEEKLY REPORT THAT WERE SENT THE 60 DAY 120 versions NOTICE FRD222 2 CLAIMS CERTIFIED LISTS CLAIMS CERTIFIED FOR WEEKLY FOR TOP OFFSET TOP OFFSET 156 versions FRD406 2 CLAIMS SELECTED LISTS THE CLAIM DEBTORS MONTHLY FOR TOP PRE THAT WERE SELECTED FOR 15 versions OFFSET ADDRESS TOP PRE OFFSET ADDRESS REQUEST REQUEST FRD406 3 CLAIMS EXEMPT LISTS THE CLAIM DEBTORS MONTHLY FROM TOP PRE THAT WERE EXEMPT FROM 15 versions OFFSET ADDRESS TOP PRE OFFSET REQUEST REQUEST FRD410 CLAIMS TRACKING SHOWS OVERCOLLECTED MONTHLY MAILED AND EXCEPTIONS FOOD STAMP CLAIMS 36 versions REPORT FRD416 CONSOLIDATED LISTS ALL FOOD STAMP MONTHLY REPORT OF CLAIM COLLECTIONS
22. ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 There is a two part State Roll Up page that displays the number for all counties and the total dollar amount for all counties ACTION REQUIRED For review purposes check the entries on this report against other records kept in the office Look for cases transferred in that are still on the unassigned cases report and assign Confirm that deletion requests pending have been processed REPORT SCHEDULE This report is scheduled to run on the first of the month of the quarter for the previous quarter REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is mailed and is available in NCXPTR RETENTION PERIOD Three Years FRD509 FIELD DESCRIPTIONS FIELD DESCRIPTION COUNTY NAME The name of the county the report applies to COUNTY CODE Three character code identifying the county CLIENT NAME The full name of the case head payee Last Name First Name Middle Initial INVESTIGATOR ID 5 character ID that corresponds to the investigator assigned to the claim PROGRAM CASE ID Up to 9 characters Identifies the Program Case ID associated with the referral REFERRAL ID 10 digit ID generated by the system upon creation of a referral BALANCE The balance at the time report is created CATEGORY Code that specifies the type of overpayment claim DATE OF DISCOVERY
23. This report is viewable at the owner county level REPORT DISTRIBUTION This report available in XPTR RETENTION PERIOD Three Years FRD105 FIELD DESCRIPTIONS FIELD DESCRIPTION COUNTY NAME The name of the county the report applies to DEBTOR NAME The full name of the debtor the overcollection occurred on Last First Middle Initial PROGRAM Identifies the Program associated with the referral CASE ID Up to 9 characters Identifies the Program Case ID associated with the overcollection INDIVIDUAL ID OF DEBTOR 10 character number of the debtor SSN 9 digit social security number for the debtor DATE OF COLLECTION The date the payment was actually entered in EPICS METHOD OF The method by which the payment was received COLLECTION AMOUNT OF The amount owed back to the debtor OVERCOLLECTION 3 FRD 106 NC DEBT EST RFD REPORT PURPOSE This report shows all estimated overcollections on claims for DOR The actual DOR refunds will be made by the State Controller s Office ACTION REQUIRED Review for accuracy If the overcollected amount should not be refunded the appropriate State Office should be contacted immediately This may happen if a cash payment was posted incorrectly in the county a ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 REPORT SCHEDULE The report is scheduled to run on a daily basis REPORT SECURITY LEVE
24. To save and update the screen press the F9 function key To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays TOP PAYMENT ONLINE POSTING CORRECTION REFUND REVERSAL STATE LEVEL ACCESS ONLY There are times that State Staff must post TOP payments issue refunds as tax intercept flag was not set or a TOP reversal cannot automatically be completed by EPICS A Post Payment By Referral 1 2 5 6 From the MAIN MENU select option 4 COLLECTIONS MENU From the COLLECTIONS MENU select option 1 PAYMENTS ADJUSTMENTS REVERSALS On the PAYMENTS screen key the referral ID number and press ENTER Enter METHOD OF COLLECTION of T CYCLE NUM and PAYMENT AMOUNT Amount minus the collection fee Enter any COMMENT however this is an optional field Press F6 ADD The TOP payment is posted B Post Payment By Individual ID Number 1 2 From the MAIN MENU select option 4 COLLECTIONS MENU From the COLLECTIONS MENU select option 1 PAYMENTS ADJUSTMENTS REVERSALS On the PAYMENTS screen key the individual ID number and press ENTER i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 COLLECTIONS March 1 2005 4 Enter METHOD OF COLLECTION of T CYCLE NUM and PAYMENT AMOUNT Amount minus the collection fee 5 Enter any COMMENT however this is an optional field 6 Press F6 ADD The TOP payment is posted C TOP Payment Correction R
25. _ LANGUAGE TYPE PHYS _ COUNTY CODE ___ PHONE NUMBER EXT TYPE HOME_ F1 HELP F2 CLEAR F3 EXIT F6 ADD F9 UPDATE F12 CANCEL From the Maintain Client screen enter the Name SSN if no ssn enter zeroes Sex Race you may enter up to 5 codes Ethnicity Language Address and County Code Phone Number is optional Press the F6 key 24 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CLAIMS SEPTEMBER 13 2004 The Maintain Client screen is redisplayed with the individual ID number assigned and the message CCIPN65D Person and Address Created Successfully Press the F12 key The Name List screen is redisplayed with the individual Enter the S by the individual under the Sel column and press ENTER The Debtor Detail screen is displayed with the individual ID selected along with the debtor s demographic information Press the F6 key to add the debtor To add the individual as a debtor press the F6 function key To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays or To add another debtor press the F12 function key The DEBTOR SUMMARY screen displays Press the F9 function key The DEBTOR DETAIL screen displays Repeat steps 5 6 D Changes To A Debtor There are few fields that can be updated on the Debtor Detail Screen The debtor information is brought forward and is protected Depending on the program determines what fi
26. keyed the system does not send the debtor back through the A or B stage b The NC DEBT SETOFF field TOP INTERCEPT IND field and the FS APPEAL IND field are all unprotected For further instructions see the DOR process section the TOP process section and food stamp appeal section E To Delete a Debtor STATE LEVEL ACCESS ONLY If a debtor is added to a claim in error or is invalid you can soft delete the debtor However a soft deletion delete does not actually remove the debtor from the claim only disassociates the debtor s with the claim in order to retain integrity of the database and to provide an audit history Likewise if you need to delete a claim you must soft delete the debtor s first If the specified debtor has already made payments on the claim you should adjust correct the payments and make certain the funds are returned to the debtor as necessary The adjustment correction must also be processed through the accounting systems Upon completion of the adjustment correction you can proceed with soft deleting the debtor in EPICS County level personnel should contact the DSS DMA office for deletion of a debtor 1 From the MAIN MENU key the number 3 in the ENTER OPTION field and press Enter The CLAIMS MENU displays 2 From the CLAIMS MENU key the number 3 in the ENTER OPTION field and press Enter The CLAIM DETAIL screen displays 3 In the REFERRAL ID field key the referral ID and press Enter The cla
27. 1 2004 REFERRALS July 1 2004 b From the REFERRAL MENU key the number 1 in the Enter Option field The REFERRAL LIST screen displays FR23 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 06 29 2004 FRD0230 REFERRAL LIST 11 44 33 INVESTIGATOR ID COUNTY More REFERRAL S REFERRAL TYPE STAT DATE PROGRAM LAST NAME FIRST INDIVID ID F1 HELP F3 EXIT F4 LIST F6 DETAIL F7 PREV F8 NEXT F12 CANCEL C In the INVESTIGATOR ID field key the number 99999 d Press Enter The referral list displays all unassigned referrals for the county NOTE Unassigned referrals maintain a status of UN unassigned e To view referral details key a s in the S column next to the referral and press Enter The REFERRAL DETAIL 1 screen displays f To view REFERRAL DETAIL 2 screen press the F10 function key The REFERRAL DETAIL 2 screen displays g To return to the previous screen press the F12 function key The REFERRAL DETAIL 1 screen displays h To return to the REFERRAL LIST screen press the F12 function key The REFERRAL LIST screen displays or To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays To assign a referral via the Referral List Supervisor only a From the MAIN MENU key the number 2 in the Enter Option field and press Enter The REFERRAL MENU displays b From the REFERRAL MENU key the number 1 in the Enter Option field and press Enter The R
28. 2 2004 CASE MAINTENANCE September 13 2004 B County Transfer Function Keys FUNCTION Description F1 To access EPICS on line help F3 To exit and return to the Main Menu F4 To display a list F7 To display the next screen page down F8 To display the next screen page up F11 To transfer cases F12 To cancel and return to the previous screen C Transfer A Case Referral To Another County 1 From the Main Menu key the number 6 in the Enter Option field and press Enter The MAINTENANCE MENU displays FRO9 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 06 29 2004 FRDOO90 MAINTENANCE MENU 11 32 38 1 COUNTY TRANSFER 2 CASE REASSIGNMENT 3 CASELOAD REASSIGNMENT 4 NAME SEARCH NAME LIST ENTER OPTION _ F1 HELP F3 EXIT 2 From the MAINTENANCE MENU key the number 1 in the Enter Option field and press Enter The COUNTY TRANSFER screen displays ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CASE MAINTENANCE September 13 2004 FR49 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 06 29 2004 FRD0490 COUNTY TRANSFER 11 34 29 INDIVIDUAL ID _ COUNTY More NAME SSN DOB SEX EFFECTIVE TRANSFER S S REFERRAL ST PROG INVEST ASSIGNED COUNTY EFF DATE TRANSFER TO COUNTY __ EFFECTIVE DATE OF TRANSFER F1 HELP F3 EXIT F4 LIST F5 DETAIL F7 PREV F8 NEXT F11 TRANSFER F12 CANCEL ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 3 CASE MAINTENANC
29. 36 versions PAYMENTS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 REPORT REPORT NAME REPORT DESCRIPTION FREQUENCY NUMBER FRD452 CLAIMS EXEMPT LISTS CLAIM DEBTORS THAT MONTHLY FROM TOP ARE EXEMPT FROM TOP FRD505 QUARTERLY SHOWS THE STATUS OF ALL QUARTERLY STATUS OF CLAIMS FOOD STAMP CLAIMS B FOOD STAMP AND TANF REPORTS REPORT REPORT NAME REPORT DESCRIPTION FREQUENCY NUMBER FRD419 MONTHLY LISTING LISTS ALL IPV MONTHLY OF DISQUALIFIED DISQUALIFICATIONS RECIPIENT RECORDS FRD422 INVESTIGATOR S LISTS IPV MONTHLY MAINTENANCE DISQUALIFICATIONS THAT REPORT END IN THE UPCOMING MONTH MAILED DISQUALIFICATIONS ENDING C AFDC AND TANF REPORTS REPORT REPORT NAME REPORT DESCRIPTION FREQUENCY NUMBER FRD108W_ WF LOI DATA SHOWS LETTER OF MONTHLY OVERISSUANCE INFORMATION FOR WORK FIRST CLAIMS FRD401 EIS RECOUPMENT LISTS CLAIMS WITH MONTHLY ERROR REPORT RECOUPMENTS THAT DO MAILED MATCH CLAIMS IN EPICS FRD401 2 ACTIVE WF CASES _ IDENTIFIES WORK FIRST MONTHLY ACTIVE CLAIMS NO CASES THAT CONTAIN NO LAST EIS RECOUPMENT RECOUPMENT DATA AND WORKNIGHT REPORT THERE IS A RECOUPABLE OF EACH CLAIM IN EPICS MONTH FRD418 AFDC TANF CROP LISTS COUNTY RESPONSIBLE MONTHLY REPORT OVERPAYMENTS CLAIMS FRD506 4972 QUARTERLY SHOWS AFDC AND TANF QUARTERLY REPORT OF CLAIMS OVERPAYMENTS IN AFDC TANF
30. 8 In the DATE OF DISCOVERY field key the date of discovery This is a required field and must be in MM DD CCYY format a This date cannot be greater than the REFERRAL DATE b This date cannot be greater than the current date C This date can be prior to or the same as the REFERRAL DATE d This date can be changed if the referral status is not CL TE or OT 9 In the REFERRAL PERSON field key the name of the person who provided the referral information 10 In the REFERRAL SOURCE field key OT for Transfor from Out of State 11 In the NATURE OF REFERRAL field key the code that represents the nature of violation 12 If applicable enter date in the optional fields NOTE To determine which fields are optional see Referral Detail 1 Field Descriptions 13 To add save the data on the REFERRAL DETAIL 1 screen and continue entering required data on REFERRAL DETAIL 2 screen press the F6 function key The REFERRAL DETAIL 2 screen displays NOTE EPICS attempts to validate the data ensuring all required fields are populated If not the system informs you of the fields that require details and will not proceed to REFERRAL DETAIL 2 screen until you provide the fields with the appropriate data If either the case head payee or the Program and Case ID is not found in EIS FSIS you are prompted with a message The override function can only be completed by State Staff Program Integrity Staff when applicable For auditing and revi
31. COUNTY NAME The name of the county the report applies to COUNTY CODE Three character code identifying the county SSN 9 digit social security number for the debtor NAME The full name of the debtor the error applies to Last Name First Name Middle Initial CASE ID Up to 9 characters Identifies the Program Case ID associated with the error AMOUNT The dollar amount that was recouped from the debtor s current benefit allotment MESSAGE Short description that describes why the recoupment could not be posted in EPICS TOTAL The sum of all recoupment error amounts for the county 2 FRD 418 AFDC TANF CROP REPORT REPORT PURPOSE This report shows all AFDC TANF County Responsible Overpayment claims ACTION REQUIRED Review for accuracy REPORT SCHEDULE Runs on a monthly basis REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is available in XPTR RETENTION PERIOD Three Years 2 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 FRD418 FIELD DESCRIPTIONS FIELD DESCRIPTION COUNTY Number and name of the county PROGRAM Code that identifies the overpayment program PROGRAM CASE ID Up to 9 characters Identifies the Program Case ID associated with the disqualification COUNTY CASE NO 7 character county case number INVESTIGATOR ID 5 character ID of the investigator as
32. Care Non Title IV E Foster Care Medicaid only Classification M N IAS Title IV E Adoption Subsidy Foster Care Medicaid only Classification C M MAA Medicaid Aid to the Aged Medicaid only Classification B C F G H I M N O P Q R MAB Medicaid Aid to the Blind Medicaid only Classification B C F G H I M N O P Q R MAD Medicaid Aid to the Disabled Medicaid only Classification B C F G H I M N O P Q R MAF Medicaid Aid to Families with Dependent Children Medicaid only Classification C F G H I M N O P R T U V W MIC MIC Medicaid amp NC Health Choice Aid to Infants and Children Medicaid amp NCHC only Classification F G H J K L M N S MPW Medicaid Aid to Pregnant Women Medicaid only Classification F G H I N MQB Qualified Beneficiaries which supplements Medicare payments Medicaid only Classification B E Q MRF Medicaid Refugees Medicaid only Classification M N MSB Medicaid Special Assistance to the Blind Medicaid only Classification C RRF Refugee Assistance Medicaid only SAA Special Assistance Aid to the Aged Medicaid only Classification C Q SAD Special Assistance Aid to the Disabled Medicaid only Classification C Q TANF Temporary Assistance to Needy Families Classification Each Medicaid program code has a classification The classification is added to the program cod
33. Currituck 028 Dare 029 Davidson 030 Davie 031 Duplin 032 Durham 033 Edgecombe 034 Forsyth 035 Franklin 036 Gaston 037 Gates 038 Graham 039 Granville 040 Greene 041 Guilford 042 Halifax ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 APPENDIX E CASE MAINTENANCE CODES July 1 2004 COUNTY CODES Continued CODE COUNTY 043 Harnett 044 Haywood 045 Henderson 046 Hertford 047 Hoke 048 Hyde 049 Iredell 050 Jackson 051 Johnston 052 Jones 053 Lee 054 Lenoir 055 Lincoln 056 Macon 057 Madison 058 Martin 059 McDowell 060 Mecklenburg 061 Mitchell 062 Montgomery 063 Moore 064 Nash 065 New Hanover 066 Northampton 067 Onslow 068 Orange 069 Pamlico 070 Pasquotank 071 Pender 072 Perquimans 073 Person 074 Pitt 075 Polk 076 Randolph 077 Richmond 078 Robeson 079 Rockingham 080 Rowan 081 Rutherford 082 Sampson 083 Scotland 084 Stanly 085 Stokes 086 Surry 087 Swain 088 Transylvania 089 Tyrrell ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 APPENDIX E CASE MAINTENANCE CODES COUNTY CODES Continued July 1 2004 CODE COUNTY 090 Union 091 Vance 092 Wake 093 Warren 094 Washington 095 Watauga 096 Wayne 097 Wilkes 098 Wilson 099 Yadkin 100 Yancey
34. District Court Action H Administrative Disqualfication Hearing S Superior Court Action W Waiver of Administrative Disqualification Hearing C DISQUALIFICATION PERIOD PERIOD DESCRIPTION 1 96 Number of Months 97 10 Years Dual Participation 98 Greater than 96 Months 99 Lifetime Permanent Disqualification D DQ OFFENSE CODE CODE DESCRIPTION A Drug Trafficking Conviction Involving Less Than 500 B Any Trafficking Conviction Including Drugs Involving 500 or More C Firearms Trafficking Conviction Any Amount D Trafficking Administrative Finding E Duplicate Participation F Application Fraud Including Non Report of Changes Z Other Intentional Program Violations ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 APPENDIX E CASE MAINTENANCE CODES July 1 2004 2400 APPENDIX E CASE MAINTENANCE CODES Change 1 2004 July 1 2004 COUNTY CODES CODE COUNTY 001 Alamance 002 Alexander 003 Alleghany 004 Anson 005 Ashe 006 Avery 007 Beaufort 008 Bertie 009 Bladen 010 Brunswick 011 Buncombe 012 Burke 013 Cabarrus 014 Caldwell 015 Camden 016 Carteret 017 Caswell 018 Catawba 019 Chatham 020 Cherokee 021 Chowan 022 Clay 023 Cleveland 024 Columbus 025 Craven 026 Cumberland 027
35. ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 REFERRALS September 13 2004 FRO4 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 08 24 2004 FRD0350 MAINTAIN CLIENT 09 28 38 INDIVIDUAL ID 000000000 _ NAME SSN DOB 00 00 0000 SEX RACE ETHNICITY _ LANGUAGE ADDRESS TYPE PHYS _ COUNTY CODE ___ PHONE NUMBER EXT TYPE HOME _ F1 HELP F2 CLEAR F3 EXIT F6 ADD F9 UPDATE F12 CANCEL From the Maintain Client screen enter the Name SSN if no ssn enter zeroes Sex Race you may enter up to 5 codes Ethnicity Language Address and County Code Phone Number is optional Press the F6 key The Maintain Client screen is redisplayed with the individual ID number assigned and the message CCIPN65D Person and Address Created Successfully Press the F12 key The Name List screen is redisplayed with the individual Enter the S by the individual under the Sel column and press ENTER The Referral Detail 1 screen is displayed with the individual ID assigned and selected 5 In the PROGRAM field key the code the identifies the benefits program to which the suspected overpayment applies 6 In the CASE ID field key the individual s Case ID 7 In the REFERRAL DATE field key the date the referral was received using the 10 character date format MM DD YYYY ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 REFERRALS September 13 2004
36. F6 CORRECT F8 REFUND F9 REVERSE F12 CANCEL i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 COLLECTIONS March 1 2005 IX UTILIZING F4 If you do not know the code or value for a field you can use the F4 key which will display a list of codes or values for selection This field attribute is only available in those fields that contain a plus sign to the right of the field To enter field details using F4 1 In the field that contains a plus sign to the right of the field key equal sign and press F4 The specific code list screen displays 2 To select a code or value tab to the appropriate code value in the S column and key s 3 Press Enter The previous screen displays with the field populated with the selected code or value 4 Continue entering or updating the screen details X NAME SEARCH When you are working with referrals and are uncertain of the individual ID use the Name Search function This searching method provides you with the capability to search CNDS for an individual ID number There are 4 search criteria You can only select one search method 0 Name Sex Date of Birth only 1 SSN social security number only 2 Individual ID only 3 Case ID only A Name Search Function Key Descriptions KEY DESCRIPTION F1 To access EPICS on line help F3 To exit and return to the Main Menu F4 To clear the search criteria fields F11 To display the Maintain Clie
37. QUARTERLY STATUS OF CLAIMS REPORT PURPOSE This report shows the status of Food Stamp claims for a quarter ACTION REQUIRED For review and balancing purposes REPORT SCHEDULE Runs on a quarterly basis REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is available in XPTR RETENTION PERIOD Administrative Value 2 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX FRD505 FIELD DESCRIPTIONS F REPORTS March 1 2005 TRANSFERS BETWEEN COUNTIES FIELD DESCRIPTION COUNTY Name of the county FRAUD Fraud misrepresentation IPV NON FRAUD Household Error IHE NON FRAUD Agency Error AE TOTAL Total dollar amount for collections Line 7A thru Line 11 LINE 1 This line is used to show the beginning BEGINNING BALANCE ACTIVE balance and the total number of all active CLAIMS claims in the state county for each heading IPV Fraud IHE Non Fraud AE Non Fraud These figures are calculated by using the ending balance of the prior quarter for each heading IPV Fraud IHE Non Fraud AE Non Fraud LINE 2A This line is used to show the total dollar amount Current Balance at the time of the transfer and the number of claims transferred between the counties for the given quarter for each heading IPV Fraud IHE Non Fraud AE Non Fraud This line should show the sum of Line 2Ai 2Aii LINE 2Al TRANSFER OUT
38. REPORT REPORT PURPOSE This report shows Food stamp claims that have been overcollected except for TOP and DOR ACTION REQUIRED For review purposes only REPORT SCHEDULE Runs on the first of each month ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 REPORT SECURITY LEVEL This report is viewable at the Owner county level REPORT DISTRIBUTION This report is mailed and is available in XPTR RETENTION PERIOD Three years FRD410 FIELD DESCRIPTIONS FIELD DESCRIPTION COUNTY Three character code uniquely identifying the county and its name PROGRAM The code that identifies that Food Stamps Program FS PROGRAM CASE ID Up to 9 characters Identifies the Program Case ID associated with the overcollection COUNTY CASE NO 7 character county case number INDIVIDUAL ID 10 character number of the debtor provided by CNDS NAME The full name of the debtor Last Name First Name Middle Initial OVERCOLLECTION AMOUNT 8 digit number identifying the current overcollection amount on the claim 7 FRD 416 CONSOLIDATED REPORT OF PAYMENTS REPORT PURPOSE This report shows Food Stamp monthly collections only This report does not show TOP reversals and therefore should not be used for total Food Stamp collection amount PLEASE USE THE FRD 441 FOR COLLECTION TOTALS This report is used for the 209 report The 209 Report is a federal report comp
39. To display the Debtor Detail screen F12 To cancel or return to the previous screen 31 Vi ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CLAIMS SEPTEMBER 13 2004 TOP PROCESS FOOD STAMPS ONLY A EPICS creates the Letter of Overissuance to the debtor s for any Food Stamp claim s that has been substantiated and deemed that there is a balance owed back to the State If the debtor makes payments as agreed upon or settles the account no further action is taken If the debtor does not make any payments or settles the account the TOP process begins B EPICS creates a file to show all Food Stamp accounts that are eligible for intercept and submits them to TOP NOTE If the county wishes to initially block an individual from being selected for intercept they can set the TOP Intercept Ind field on the Debtor Detail screen to H L S or X Once this code has been removed the debtor can be submitted for intercept if they meet the remaining requirements C Eligibility Requirements Must be a debtor on a claim TOP Intercept Ind field on the Debtor Detail screen is not currently set to H L S or X by the county Referral Status must be in CO Collections or TE Terminated Claim Type must be IPV IHE or AE Claim debtor s total for a claim must be a minimum of 25 00 Debtor must be 60 days delinquent Delinquency is defined as making a 10 or 25 00 whichever is gr
40. X Code reason for deleting the debtor TOP Intercept Code used to set X Ind individual up for Federal Tax Intercept 21 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CLAIMS JULY 1 2004 Field Description Required System Optional Generated TOP Intercept Set by the county X Appeal Ind when a debtor request an appeal that suspends tax intercept until the outcome of the hearing Address Req Date Address X request sent to TOP FS Appeal Ind Set by the county X to block an individual from being selected for FS Recoupment on this particular referral B Debtor Detail Function Keys Function Key Description F1 To access EPICS on line help F3 To exit and return to the Main Menu F4 To display a list F5 To display the Repayment Approach Summary screen F6 To add a debtor save F9 To update debtor detail information F10 To delete a debtor State Level Only F11 To display the Maintain Client screen F12 To cancel or return to the previous screen C To Add A Debtor TO A Claim 1 From the MAIN MENU key the number 3 in the ENTER OPTION field and press Enter The CLAIMS MENU displays 2 From the CLAIMS MENU key the number 3 in the ENTER OPTION field and press Enter The CLAIM DETAIL screen displays 3 In the REFERRAL ID field key the referral ID and press Enter The claim information di
41. a disqualification in the state of North Carolina 1 From the MAIN MENU key the number 5 in the ENTER OPTION field and press Enter The DISQUALIFICATION INQUIRY screen displays Key the SSN of the individual and press ENTER The DISQUALIFICATION LIST displays NOTE If there are multiple individuals associated to the SSN a message displays ENTERED SSN HAS MULTIPLE CLIENTS INVOKE SEARCH Key an S in the selection column of the disqualification you wish to display and press Enter The DISQUALIFICATION DETAIL screen displays To delete the disqualification press the F10 function key A confirmation message will display confirming you are deleting this disqualification Press the F10 function key again The screen clears with the exception of the demographic information To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 DISQUALIFICATIONS July 1 2004 UTILIZING F4 If you do not know the code or value for a field you can use the F4 function key which displays a list of codes or values for selection This field attribute is only available for those fields that contain a plus sign to the right of the field To enter field details using F4 1 In the field that contains a plus sign to the right of the field type equal sign and press the F4 function key The specific code list screen displays 2 To sel
42. a field you may use the and F4 key to display a list of codes or values for the selection This field attribute is only available on those fields that contain a plus sign to the right of the field In the REFERRAL ID field key the ID and press Enter The referral displays In the METHOD OF COLLECTION field key the collection method You may use the equal key and F4 key to obtain the list of codes From the list of codes enter an S under the SELECT column by the appropriate code Press ENTER The code selected is brought forward to the METHOD OF COLLECTION field In the PAYOR NAME field verify payor s name If necessary select a different payor ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 COLLECTIONS March 1 2005 NOTE The PAYOR NAME field defaults to the case head payee name If the case head payee is not making the payment change the name to the appropriate payor To accomplish this enter and press the F4 function key to select the appropriate debtor f In the PAYMENT AMOUNT field key the dollar amount of the payment g In the DATE RECEIVED field key the date the payment was received NOTE The DATE RECEIVED field defaults to today s date unless changed h In the PAYMENTS COMMENTS field enter a description of the payment if necessary i To add save the payment press the F6 function key NOTE The RECEIPT NUMBER field is system generated upon adding the payment and
43. based on the start date and period of the disqualification 16 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays F Display A Disqualification List 1 From the MAIN MENU key the number 5 in the ENTER OPTION field and press Enter The DISQUALIFICATION INQUIRY screen displays NOTE If you do not know the code or value for a field you can use the F4 function key which displays a list of codes or values for selection This field attribute is only available for those fields that contain a plus sign to the right of the field 2 Key the SSN of the individual and press ENTER The disqualification list displays This screen displays the SSN keyed State DQ number and Program This screen displays all states for the SSN entered NOTE If there are multiple individuals associated to the SSN a message displays ENTERED SSN HAS MULTIPLE CLIENTS INVOKE SEARCH 3 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays G Display A Disqualification 1 From the MAIN MENU key the number 5 in the ENTER OPTION field and press Enter The DISQUALIFICATION INQUIRY screen displays 2 Key the SSN of the individual and press ENTER The disqualification list displays This list will show all of the states for that the SSN is disqualified from i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 DISQUALIFICATIONS July 1 2004 NOTE If there are
44. cancel or return to the previous screen B The NOTEPAD DETAIL screen is utilized to add update and view NOTEPAD information e g title description date created date last updated and description of the note entry Notepad Detail Function Key Descriptions Key Description F3 To exit and return to the Main Menu F6 To add a new note save F7 To display the previous screen page down F8 To display the next screen page up F9 To update a note F10 To delete a note F12 To cancel or return to the previous screen 1 To add a note to a referral the referral must already exist in EPICS NOTE The notepad feature becomes Read Only once a referral is in Collections CO Closed CL or Terminated TE status a To add a note to the Notepad 1 From the MAIN MENU key the number 2 in the Enter Option field and press Enter The REFERRAL MENU displays 2 From the REFERRAL MENU key the number 2 in the Enter Option field The REFERRAL DETAIL 1 screen displays ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 REFERRALS September 13 2004 3 In the REFERRAL ID field key the referral ID of the referral that you need to add a note and press Enter The referral details display 4 Press the F5 function key The NOTEPAD SUMMARY screen displays FR25 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 05 25 2004 FRD0250 NOTEPAD SUMMARY 15 03 18 REFFERAL I
45. column LINE 18 CLAIMS REACTIVATED This line is used to show all claims that have been reactivated during the given quarter for each heading IPV Fraud IHE Non Fraud AE Non Fraud LINE 19 BALANCE FOR ACTIVE CLAIMS This line is used to show the ending balance amount and number for active claims for a given quarter for each heading IPV Fraud IHE Non Fraud AE Non Fraud Dollar Amount Formula Line 3 Active Claims Subtotal Line 4 New Claims Est Line 5 Category Transfers Line 16 Subtotal of Collections Line 18 Claims Reactivated Note Line 17 Closed Claims is only a count and therefore is not included in the Dollar Amount formula for Line 19 but it is included in the Number formula for Line 19 Number Formula Line 3 Active Claims Subtotal Line 4 New Claims Est Line 5 Category Transfers Line 16 Subtotal of Collections line 17 Closed Claims Line 18 Claims Reactivated 20 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 FIELD DESCRIPTION LINE 20 This line is used to show the number and SUBTOTAL dollar amount of all active and terminated claims for the given quarter for each heading IPV Fraud IHE Non Fraud AE Non Fraud Dollar Amount Formula Line 19 Balance for Active Claims Line 12 Terminated Claims Number Formula Line 19 Balance for Active Claims Line 12 Termin
46. display the previous screen page up F8 To display the next screen page down F12 To cancel or return the previous screen Change C ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS 1 2004 DISQUALIFICATIONS Disqualification Detail Field Descriptions July 1 2004 FIELD DESCRIPTION REQUIRED SYSTEM GENERATED OPTIONAL SOCIAL SECURITY NUMBER 9 digit number for the individual s social security number X NAME The full name last name first name of the individual being disqualified ADDRESS The address of the individual being disqualified LAST ACTIVITY Field used to describe the last activity Add Change etc and date of the activity made to the disqualification INDIVIDUAL ID The individual ID of the person being disqualified NC Disqualification only DATE OF BIRTH The date of birth for the individual being disqualified SEX The sex of the individual being disqualified DQ STATE The state where the individual is disqualified from DQ COUNTY 3 digit number from 000 100 used to identify what county the individual is disqualified from NC Disqualification only ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 DISQUALIFICATIONS July 1 2004 FIELD DESCRIPTION REQUIRED SYSTEM GENERATED OPTIONAL DQ INVESTIGATOR A unique number assign
47. disqualified from FS or TANF NAME The full name of the person being disqualified Last Name First Name SSN 9 digit Social Security Number of the person being disqualified PROGRAM CASE ID Up to 9 characters Identifies the Program Case ID associated with the disqualification DQ PERIOD The length of time the disqualification will be implied DQ END DATE The date MM DD YYYY the disqualification will end H AFDC TANF REPORTS q FRD 401 EIS RECOUPMENT ERROR REPORT REPORT PURPOSE This report shows all TANF AFDC recoupments collected that do not have matching claims in EPICS to which the funds can be applied When a recoupment is greater than 99 00 the recoupment will also show on this report ACTION REQUIRED Determine which EPICS claim for which the funds were deducted and apply the amount in EPICS to the correct claim using the payment code LR If recoupments were deducted in error supplemental benefits should be issued to the debtor and the recoupment information should be removed from the EIS 8125 form REPORT SCHEDULE Runs by the 15 of the month REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is mailed and is available in XPTR RETENTION PERIOD Three years a ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 FRD401 FIELD DESCRIPTIONS FIELD DESCRIPTION
48. ending balances for a specified referral via the PAYMENT HISTORY BY REFERRAL screen ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 A COLLECTIONS Payment History By Referral Field Descriptions FIELD DESCRIPTION REQUIRED March 1 2005 SYSTEM GENERATED OPTIONAL REFERRAL ID 10 digit number generated by the system upon creation of a referral X NAME Last name first name and middle initial of the case head payee IND ID Unique ID associated with the case head payee supplied by CNDS SSN Case head payee s social security number DOB Case head payee s date of birth SEX Case head payee s sex COUNTY 3 digit number from 000 100 representing the county the debtor is currently assigned to for the referral PROGRAM Code that identifies the benefits program to which the referral applies CASE ID Program Case ID associated with referral COUNTY CASE County case number associated with the referral CURRENT BALANCE Current balance of the claim 17 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 COLLECTIONS March 1 2005 FIELD ORIGINAL OP OI BALANCE DESCRIPTION REQUIRED Original overpayment or overissuance amount of the claim SYSTEM OPTIONAL GENERATED 1 character code used to select a referral for viewing
49. gross adjusted and net amount for AFDC CROPs collected from the county for the month quarter and year TOTALS The total dollar amount of funds collected for TANF claims for the month quarter and year FOOD STAMP REVERSALS The gross adjusted and net amount of recoupments RECOUPMENTS collected on Food Stamp IPV IHE and AE claims for the month quarter and year Also shows the incentive amount for the month quarter and year CASH The gross adjusted and net amount of cash collected for Food Stamp claims for the month quarter and year Also shows the incentive amount for the month quarter and year 44 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 FIELD DESCRIPTION DOR The gross adjusted and net amount collected from NC Debt Setoff for the month quarter and year Also shows the incentive amount for the month quarter and year TOP OFFSET FOOD STAMP COUPONS The gross adjusted and net amount collected from TOP OFFSET for the month quarter and year Also shows the incentive amount for the month quarter and year The gross net adjusted and net amount of Food Stamp Coupons collected for Food Stamp claims for the month quarter and year Also shows the incentive amount for the month quarter and year OFFSET The gross adjusted and net amount of Food Stamp offsets collected for Food Stamp claims for the month quarter
50. in which the overpayment took place CURRENT BALANCE Up to 9 characters Current amount due on the claim AMOUNT INTERCEPTED The amount of money intercepted as a result of NC Debt Setoff for the selected referral INTERCEPT DATE The date the money was intercepted by DOR NOTICE DATE The date the NC Debt Setoff 30 Day Notice was sent to the debtor 25 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 COLLECTIONS March 1 2005 B NC Debt Setoff Pending Function Keys KEY DESCRIPTION F1 To access EPICS on line help F3 To exit and return to the Main Menu F4 To display a list F5 To flow to the Claim Detail Screen for the selected Referral F6 To flow to the Debtor Detail Screen for the selected Referral F7 To display the previous screen page up F8 To display the next screen page down F9 To update the Appeal information F10 To flow to the Payment History by Individual screen F11 To flow to the Payment History by Referral screen F12 To cancel or return to the previous screen C Set Or Update An Appeal Flag When a client requests an appeal within the 30 day period you must set the appeal flag Likewise when the appeal status has changed you must update the appeal field 1 From the MAIN MENU key the number 4 in the Enter Option field and press Enter The COLLECTIONS MENU displays DEBT SETOFF PENDING screen disp
51. in the case are equally and financially responsible for any all claims Consequently it is required that the investigator records debtor details in EPICS for each claim If the courts have determined that an overpayment is to be divided among more than one debtor they must have separate referrals In that case they would not be listed as debtors on each other s referral They would be debtors on their separate referrals only A Debtor Detail Screen Field Descriptions Field Description Required System Generated Optional Referral ID 10 digit number generated by the system upon creation of a referral X Referral Type 1 character code that identifies the type of referral Referral Status 2 character code for the status of a referral Name Last name first name and middle initial of the case head payee Ind ID Unique ID associated with the case head payee supplied by CNDS 19 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS SEPTEMBER 13 2004 Change 2 2004 CLAIMS Field Description Required System Generated Optional SSN Case head payee s social security number X DOB Case head payee s date of birth Sex Case head payee s sex County 3 digit number with the values from 000 100 representing the issuing county in which the overpayment took place Program Code that identif
52. information to identify those debtors who are delinquent If a debtor becomes delinquent e g neglects to pay a scheduled payment he she is subject to tax intercept unless the recoupment is made against his her existing benefits However if the debtor realized he she missed the payment and repaid the payment in the next scheduled installment he she is removed from the delinquency list and is not subject to tax intercept For Food Stamps and Work First if a claim results in a criminal court hearing and the client is receiving benefits recoupment cannot be automatically established unless the judge issues the court order for recoupment This date should be entered in the Criminal Judgement Date field on the Claim Detail Screen The investigator must set the Payment Method to R for EPICS to process the recoupment If the Claim Type located on the Debtor Detail screen is set to IPV and the Substantiation Method is equal to S A or D the investigator must set the Payment Method to R for EPICS to process the recoupment If the investigator is unsuccessful in obtaining a signed agreement with the debtor the investigator can pursue involuntary means of obtaining the funds from the debtor However it is required to document the involuntary means in EPICS as well via the REPAYMENT APPROACH screen EPICS allows multiple debtors to be attached to a claim You must enter a repayment approach for each debtor attached to a claim 42
53. key the date of the compromise NOTE The DATE RECEIVED field defaults to today s date unless changed In the PAYMENTS COMMENTS field enter a description of the compromise if necessary To add save the compromise press the F6 function key NOTE The RECEIPT NUMBER field is system generated upon adding the compromise and the OP OI BALANCE field reflects the new balance To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays 2 To undo a Compromised Amount FS Only Once a Compromised Amount has been entered the field becomes protected and must be adjusted through the payment screen ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 COLLECTIONS March 1 2005 You may need to adjust the amount for reasons such as entered in error You cannot enter a dollar amount for undoing a compromised amount The system will automatically adjust add back the exact dollar amount of the compromised amount to the current balance a From the MAIN MENU key the number 4 in the Enter Option field and press Enter The COLLECTIONS MENU displays In the ENTER OPTION field key the number 1 and press Enter The PAYMENTS screen displays In the REFERRAL ID field key the ID and press Enter The referral displays In the METHOD OF COLLECTION field key the code AJUC Adjustment Uncompromised Amount In the PAYOR NAME field verify payor s name If necessary select a differ
54. of the field To select and view the payment locate the payment entry and key an S to the left of the payment and press Enter The payment displays NOTE If there are multiple payments you may need to view more than one screen Press the F8 function key to view the next screen and press the F7 function key to return to the previous screen View the payment details NOTE The PAYMENTS screen is read only Thus you cannot make edits updates If you decide a payment needs to be adjusted return back to the COLLECTIONS MENU and select option 1 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays or Press the F12 function key to return back to the Payment History screen Vi PAYMENT HISTORY BY INDIVIDUAL You can view a list of historical payment information e g receipt number claim ID and payment amount for a specified individual ID via the PAYMENT HISTORY BY INDIVIDUAL screen a ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS COLLECTIONS Change 1 2005 March 1 2005 A Payment History By Individual Screen Field Descriptions FIELD DESCRIPTION REQUIRED SYSTEM GENERATED OPTIONAL INDIVIDUAL ID Unique ID associated with the debtor supplied by CNDS X NAME Last name first name and middle initial of the debtor for which payment history is to be viewed SSN Debtor s social security number DOB Debtor s date of birth S
55. one of four ways which is outlined on the screen Press ENTER The Name List screen displays FR78 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 08 24 2004 FRDO750 Name Search 09 17 59 Last Name First Name Middle Initial _ Sex Code _ Date Of Birth SSN Individual ID _ Case ID To search use either 1 Last Name First Name Sex Code and Date of Birth only or 2 SSN only or 3 Individual ID only or 4 Case ID only F3 EXIT F4 CLEAR F12 CANCEL 23 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS F1 HELP F3 EXIT F7 PREV F8 NEXT F11 CLIENT F12 CANCEL Change 2 2004 CLAIMS SEPTEMBER 13 2004 FR78 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 08 24 2004 FRDO770 NAME LIST 09 21 33 Results for Sel SSN Last Name First Name MI DOB Sex Indiv ID EIS Cnty FSIS Cnty Program Case ID Race Ethnicity Language If the individual is displayed enter an S by the name under the Sel column Press Enter The Debtor Detail screen is displayed with individual ID and demographic data for the ID selected Press the F6 key to add the debtor If the individual is not displayed and an individual ID number must be assigned press the F11 key The Maintain Client screen displays FRO4 SSN DOB FRDO350 MAINTAIN CLIENT 09 28 38 INDIVIDUAL ID 000000000 _ NAME ADDRESS NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 08 24 2004 00 00 0000 SEX _ RACE ETHNICITY
56. previous screen displays with the data from the search Continue entering or updating the screen details ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CASE MAINTENANCE September 13 2004 106 CASE MAINTENANCE Change 2 2004 September 13 2004 l THIS CHAPTER PROVIDES INSTRUCTIONS AND INFORMATION FOR e The Maintenance Menu options e The Maintenance Menu function keys e The County Transfer fields e Displaying the County Transfer function keys e Transferring a Referral e The Case Reassignment fields e The Case Reassignment function keys e Reassigning a Case Referral e The Caseload Reassignment fields e The Caseload Reassignment function keys e Reassigning a Caseload e Name Search Name List Maintain Client e Entering field values using the F4 function key Change 2 2004 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS MAINTENANCE MENU CASE MAINTENANCE September 13 2004 The EPICS Maintenance Menu allows counties to transfer cases from one county to another allows supervisors to manage county workers cases caseloads and reassign as needed and allows direct entry into the Name Search process to search assign individual ID numbers and change update the individual s address phone number A Maintenance Menu Options Option Description 1 COUNTY TRANSFER To transfer an individual s cases s from one county to another 2 CASE REASSIGNMENT To reass
57. ten 10 work days business days 8 The claim must be delinquent a Identify all payments made in the last sixty 60 days b Payments not considered are AJCA AJCD AJCI AJUC EX EB FSC R LR All payments that are considered C O S N CN T CT are added together d All adjustments that are considered which is ADJ are added together e The sum of all considered payments minus the sum of all considered adjustments equals the net payment f If the net payment is greater than zero the person is not delinquent B EPICS determines all claim debtors for the claims identified and determines from the Common Data Database CNDS which debtors are included in an active Food Stamp case In addition the claim debtors must meet the following criteria 1 2 3 4 The Claim Debtor is not deleted The Claim Debtor Food Stamp Appeal indicator is not X The Claim Debtor Repayment Approach is R if the claim has a criminal judgement The Claim Debtor Repayment Approach is R if the Claim Category is IPV and the Substantiation Method is A S or D C EPICS sends to FSIS the case ID for the active Food Stamp case the claim category and the claim balance for each debtor in the active Food Stamp case Based on the claim category FSIS uses the appropriate percentage to recoup from the FSIS case D EPICS posts Food Stamp recoupments the last work night of the month and posts recoupment money to the claims sorted by
58. the OP OI BALANCE field reflects the new balance If another payment needs to be posted to the same referral press the F2 function key to clear the screen and repeat above steps Continue this process until all payments for the specific referral have been posted j To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays 2 To add a payment by Individual ID A collector can apply a payment to an individual ID If more than one referral is associated to the individual ID EPICS distributes the money among all referrals for that individual ID If a single program is tied to the Individual ID all moneys are applied to the oldest claim first If multiple programs are tied to the Individual ID the moneys are divided amongst all programs paying on the oldest claim first NOTE Ifthe method of collection is STATE TAX INTERCEPT it is required to apply the payment by debtor individual ID a From the MAIN MENU key the number 4 in the Enter Option field and press Enter The COLLECTIONS MENU displays b In the ENTER OPTION field key the number 1 and press Enter The PAYMENTS screen displays ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 COLLECTIONS March 1 2005 NOTE If you do not know the code or value for a field you can use the and F4 keys to display a list of codes or values for the selection This field attribute is only available on those fields tha
59. to the oldest claim first If the payment is cash and all open claims in CO status are associated to different programs the payment is equally divided amongst each of the programs paying on the oldest claim first ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 COLLECTIONS March 1 2005 e In the PAYMENT AMOUNT field key the dollar amount of the payment f In the DATE RECEIVED field key the date the payment was received NOTE The DATE RECEIVED field defaults to today s date unless changed g If necessary enter data in the optional fields h To add save the payment press the F6 function key NOTE The RECEIPT NUMBER field is system generated upon adding the payment i To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays D Display a Payment By Receipt Number a From the MAIN MENU key the number 4 in the Enter Option field and press Enter The COLLECTIONS MENU displays In the ENTER OPTION field key the number 1 and press Enter The PAYMENTS screen displays In the RECEIPT field key the number and press Enter or the F7 function key The payment displays NOTE Multiple payments tied to one receipt can not be displayed using the Payment screen The error message MULTIPLE REFERRALS FOR RECEIPT GO TO PAYMENT HISTORY BY REF IND is displayed To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays E Compromised A
60. updated status of the appeal To save and update the screen press the F9 function key To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays 35 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CLAIMS SEPTEMBER 13 2004 Vil DOR Process FOOD STAMPS MEDICAID AND WORK FIRST A EPICS creates a file with the latest current balances that are eligible for intercept and submits them to DOR NOTE Ifthe NC Debt Setoff Indicator is space or Y and the county wishes to initially block an individual from being selected for intercept they can set the NC Debt Setoff field on the Debtor Detail screen to H L or S the X code can only be entered by State Staff Once this code has been removed the debtor can be submitted for intercept if they meet the remaining requirements B Eligibility Requirements Must be a debtor on a claim NC Debt SETOFF Ind field on the Debtor Detail screen is not currently set to H L S or state staff by the county Referral Status must be in CO Collections or TE Terminated and FS only Claim Type must be IPV or IHE Claim Debtor must be delinquent For FS only Delinquency is defined as making a 10 or Cash Payment amount totals 25 00 whichever is greater of the total DOR eligible claim balances within the last 60 days Debtor must not have a recoupment in the past 60 days TANF and FS Claim Debtor s
61. 0 APPENDIX C PAYMENT CODES Change 1 2004 July 1 2004 A METHOD OF COLLECTION TYPE DESCRIPTION AJCA Adjustment Compromise Amount AJCD Adjustment Decrease Current Balance AJCI Adjustment Increase Current Balance AJUC Adjustment Uncompromise Amount C Cash EB Electronic Benefit Transfer EBT FSC Food Stamp Cash FS Only Begin FS recoupment next month This allows payments until recoupment begins when the repayment agreement contains a payment method of R EX Expungement LR Local Recoupment AFDC TANF FS Only N State Intercept O Offset against Restored FS benefits Food Stamps Only R Recoupment S Stamps Food Stamps Only T Federal Intercept Food Stamps Only B APL IND NC TAX INTERCEPT APPEAL INDICATOR DESCRIPTION Payment Correction State staff only Appeal Denied Other Request for Appeal Waived Appeal Appeal in favor of Debtor ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 appendix d disqualification codes July 1 2004 2300 APPENDIX D DISQUALIFICATION CODES Change 1 2004 July 1 2004 NOTE Appendix D applies to WF and FS only A DISQUALIFICATION NUMBER IPV NUMBER DESCRIPTION 1 First 2 Second 3 Third B DISQUALIFICATION METHOD METHOD DESCRIPTION A Court of Appeals C DQ Consent Agreement D
62. 004 FRDO350 MAINTAIN CLIENT 11 14 29 INDIVIDUAL ID 000000000 _ NAME SSN DOB 00 00 0000 SEX RACE EE ETHNICITY _ LANGUAGE __ ADDRESS TYPE PHYS_ COUNTY CODE ___ PHONE NUMBER EXT TYPE HOME _ F1 HELP F2 CLEAR F3 EXIT F6 ADD F9 UPDATE F12 CANCEL 9 In the NAME field enter the individual s full name 10 In the SSN field enter the individual s social security number If no SSN enter zeroes 11 In the DOB SEX RACE up to 5 codes Ethnicity and Language fields key the individual s appropriate information 12 In the ADDRESS field key the individual s address NOTE If the address is unknown enter the following for the client s address EPICS as the street name Unknown NC 11111 as the City State and Zip Code 13 In the COUNTY CODE field key the individual s county number 14 In the PHONE NUMBER field key the individuals phone number if known 15 Press the F6 function key EPICS assigns the new individual ID to the debtor and the number is subsequently stored in CNDS 16 Press the F12 function key The NAME LIST screen displays 40 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CLAIMS JULY 1 2004 17 In the S column select the individual from the list and press Enter The DEBTOR DETAIL screen displays 18 To add the individual as a debtor press the F6 function key 19 To exit and return to the MAIN MENU press th
63. 005 APPENDIX F REPORTS March 1 2005 FRD428 FIELD DESCRIPTIONS TOTALS FIELD DESCRIPTION COUNTY NAME The name of the county the report applies to AFDC PROGRAM The gross adjusted and net amount of recoupments RECOUPMENTS collected on AFDC claims for the month quarter and year Also shows the incentive amount for the month quarter and year CASH The gross adjusted and net amount of cash collected for AFDC claims for the month Also shows the incentive amount for the month quarter and year DOR The gross adjusted and net amount collected from NC Debt Setoff for the month quarter and year Also shows the incentive amount for the month quarter and year CROPS The gross adjusted and net amount for AFDC CROPs collected from the county for the month quarter and year The total dollar amount of funds collected for AFDC claims for the month quarter and year TANF PROGRAM RECOUPMENTS The gross adjusted and net amount of recoupments collected on TANF claims for the month quarter and year Also shows the incentive amount for the month CASH The gross adjusted and net amount of cash collected for TANF claims for the month quarter and year Also shows the incentive amount for the month quarter and year DOR The gross adjusted and net amount collected from NC Debt Setoff for the month quarter and year Also shows the incentive amount for the month quarter and year CROPS The
64. 03 The current date is 3 3 03 A Y may be entered The calculated date has not expired i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CLAIMS JULY 1 2004 b The original TO Date was 5 31 02 The calculated date was 05 2003 A Y had previously been keyed for the indicator The TO Date is changed to 02 28 03 The indicator is reset to space The new calculated date is 2 2003 The current date is 3 3 03 A Y may not be entered The calculated date has expired In the OVERPAYMENT AMOUNT field key the overpayment amount The CURRENT BALANCE field is updated by EPICS with the amount keyed 1 If the OVERPAYMENT AMOUNT must be changed after the claim was initially established enter the corrected or revised amount in the OVERPAYMENT AMOUNT field Press F9 to update EPICS populates the CURRENT BALANCE field with the increase or decreased amount The appropriate AJCI or AJCD entry is displayed on the payment history screens The OVERPAYMENT AMOUNT cannot be decreased to zero If a zero amount is entered the following error message is displayed OVERPAYMENT AMOUNT MUST BE GREATER THAN 0 00 If payments or adjustments have been posted and the difference between the existing CURRENT BALANCE and the initial overpayment is greater than the decrease to the overpayment amount EPICS does not allow the change to the OVERPAYMENT AMOUNT field The following error message is displayed
65. 05 FRD204 FIELD DESCRIPTIONS APPENDIX F REPORTS March 1 2005 FIELD DESCRIPTION COUNTY Three character code uniquely identifying the county and its name PROGRAM Identifies the Program associated with the referral REF ID 10 digit ID generated by EPICS upon creation of a referral PROGRAM CASE ID Up to 9 characters Identifies the Program Case ID associated with the referral NAME The full name of the casehead on the referral Last Name First Name Middle Initial DATE RECEIVED Date the referral is keyed into EPICS CASEWORKER NO A county assigned number of the caseworker assigned to the case REFERRAL SOURCE Code identifying the source of the overpayment overissuance REFERRAL TYPE Code identifying the type of referral NUMBER OF DAYS IN PENDING STATUS The number of days that have elapsed before the claim reached CO status 6 FRD 206 OVERRIDE EXCEPTIONS REPORT REPORT PURPOSE This report was created for the State Controller s Office It is used by auditors to ensure that counties only use this override feature when they have sufficient documentation to substantiate the overpayment This report is sorted by Program ACTION REQUIRED No action required Used for Audit and Management purposes REPORT SCHEDULE Runs weekly on Tuesdays REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is availa
66. 09 2003 The correct amount of the overpayment overissuance is 150 00 This is a decrease of 250 00 Since the decrease to the overpayment amount is more than the difference between the existing overpayment amount and the existing current balance once the F9 key is pressed the following error message is displayed OVERPAYMT AMT LESS THAN COLLECTIONS PAYMT CORRECTIONS MAY BE NECESSARY Reverse out the entire 200 00 payment by completing a payment correction Key the correct amount of 150 00 in the OVERPAYMENT AMOUNT field This corrects the CURRENT BALANCE to 150 00 Re key the payment of 200 00 that was reversed out This results in the claim being paid in full The claim was over collected and a refund of 50 00 must be issued to the debtor NOTE The overpayment field can never be less than the current balance field If this occurs you must adjust the overpayment field prior to adjusting the current balance field 13 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CLAIMS JULY 1 2004 i If the CLAIM TYPE is IPV the SUBSTANTIATION METHOD is required You may use the equal key and F4 key to obtain the list of codes From the list of codes enter an S under the SELECT column by the appropriate code Press ENTER The code selected is brought forward to the SUBSTANTIATION METHOD field Code Value A Court of Appeals C DQ Consent Agreement D District C
67. 1 2004 I The CURRENT BALANCE field is populated by EPICS with the amount entered in the OVERPAYMENT AMOUNT field 1 A claim balance may require an adjustment when an incorrect entry was made to the balance prior to January 1 2004 or when an invalid claim cannot be deleted due to previous adjustments When such adjustments are needed fax a request on county letterhead to the appropriate State DMA or DSS staff For Medicaid claims fax requests to Brenda Porter or Shara Britt at 919 715 7706 For Food Stamp claims fax requests to FAEP Program Integrity staff at 919 733 0645 For AFDC and Work First claims fax requests to the Family Support and Child Welfare Services section at 919 715 6714 Include on the fax request Casehead Name Referral ID Debtor Individual ID Reason for Adjustment Correct Balance Amount Signature of Supervisor 2290p If an AFDC or Work First claim cannot be collected because the debtor cannot be located or because the debtor is deceased the balance of the claim must be adjusted to zero a Do not terminate the AFDC Work First claim Send a written request on county letterhead to the Family Support and Child Welfare Services section at 2408 Mail Service Center 325 N Salisbury St Raleigh NC 27699 2408 b Include on the request Casehead Name Referral ID Program Case ID Overpayment Period Current Claim Balance Reason For Claim Write Off 15 ENTERPRISE PROGRAM INTEG
68. 13 2004 Vi NAME SEARCH NAME LIST The Name Search Name List option allows direct entry into the Name Search process From the Maintenance Menu enter option 4 FRO9 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 08 25 2004 FRD0090 MAINTENANCE MENU 08 13 02 1 County Transfer 2 Case Reassignment 3 Caseload Reassignment 4 Name Search Name List Enter Option _ F1 HELP F3 EXIT A Assign An Individual ID Number 2 Complete a name search on the individual for which an individual ID number is required You may search in one of four ways which is outlined on the screen FR78 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 08 25 2004 FRDO750 Name Search 08 15 02 Last Name First Name Middle Initial _ Sex Code _ Date Of Birth SSN Individual ID _ Case ID To search use either 1 Last Name First Name Sex Code and Date of Birth only or 2 SSN only or 3 Individual ID only or 4 Case ID only F3 EXIT F4 CLEAR F12 CANCEL j ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CASE MAINTENANCE September 13 2004 2 Press Enter The Name List screen displays FR78 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 08 25 2004 FRDO770 NAME LIST 08 16 14 Sel SSN F1 HEL Results for TEST REL F 19570921 EIS Cnty FSIS Cnty Program Case ID Race Ethnicity Language Last Name First Name MI DOB Sex Indiv ID P F3 EXIT F7 PREV F8 NEXT F11 C
69. 33 14 REFERRAL ID More NAME IND ID SSN DOB SEX COUNTY __ PROGRAM CASE ID COUNTY CASE CURRENT BALANCE 0 00 ORIGINAL OP OI BALANCE 0 00 AMOUNT AMOUNT OVER S CREATE DT RECEIVE DT RECEIVED APPLIED METH WRKR COLLECTION F1 HELP F3 EXIT F4 LIST F7 PREV F8 NEXT F12 CANCEL 3 In the REFERRAL ID field key the ID and press Enter The payment history information displays if a history exists 4 View the information NOTE If there are multiple payments you may need to view more than one screen Press the F8 function key to view the next screen and press the F7 function key to return to the previous screen if necessary 5 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays 19 Change 1 2005 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS COLLECTIONS March 1 2005 D View Payment Details By Referral 1 From the MAIN MENU key the number 4 in the Enter Option field and press Enter The COLLECTIONS MENU displays In the ENTER OPTION field key the number 2 and press Enter The PAYMENT HISTORY BY REFERRAL screen displays In the REFERRAL ID field key the ID and press Enter The payment history information displays NOTE If you do not know the code or value for a field you can use the and F4 keys to display a list of codes or values for the selection This field attribute is not available for all fields but only those fields that contain a plus sign to the right
70. 4 T TAX INTERCEPT COORDINATOR The individual designated to coordinate tax intercept activities for a specified county TERMINATED A claim that has been terminated TITLE The title of the Notepad entry TRANSFERRED The action taken to move a client s EPICS case from one county to another TRANSFER DATE The date MM DD YYYY the claim was transferred from one county to another TYPE OF CLAIM Identifies the type of overpayment claim See Appendix U UNASSIGNED One of the codes used for Referral Status USER ID The RACF ID used to log into the Mainframe ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 Change 1 2004 July 1 2004 A REFERRAL TYPE APPENDIX A REFERRAL CODES 2000 APPENDIX A REFERRAL CODES July 1 2004 TYPE DESCRIPTION F Front End O Other P Project Recall R Regular B REFERRAL STATUS STATUS DESCRIPTION AC Accepted CL Closed CO Collections IN Investigation OT Out of State Transfer PE Pending TE Terminated UN Unassigned ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 APPENDIX A REFERRAL CODES July 1 2004 C PROGRAM CODES CODE DESCRIPTION AAFC Aid to families with dependent children AFDC and Now Work First Medicaid only AFDC Aid to families with dependent children FS Food Stamps HSF Foster
71. AIMS WITH Lists AFDC claims that have overpayments prior to OVERPAYMENT MONTHS 1 1 97 PRIOR TO 1 1 97 AFDC NUMBER OF CLAIMS EST The total number of AFDC claims established CO status DOLLAR AMOUNT OF The current balance total for all AFDC claims CLAIMS EST established CO TOTAL CLAIMS The total number of AFDC claims existing for the county RECOUPMENT COLLECTION The total dollar amount of recoupments collected on AMOUNT AFDC claims for the quarter CASH COLLECTION AMOUNT The total dollar amount of cash collected on AFDC claims for the quarter OUTSTANDING BALANCE The total dollar amount owed on AFDC claims CLAIMS WITH Lists TANF claims that have overpayments after OVERPAYMENT MONTHS 1 1 97 AFTER 1 1 97 TANF NUMBER OF CLAIMS EST The total number of TANF claims established CO status DOLLAR AMOUNT OF The current balance total for all TANF claims CLAIMS EST established CO TOTAL CLAIMS The total number of TANF claims existing for the county RECOUPMENT COLLECTION The total dollar amount of recoupments collected on AMOUNT TANF claims for the quarter CASH COLLECTION AMOUNT The total dollar amount of cash collected on TANF claims for the quarter OUTSTANDING BALANCE The total dollar amount owed on TANF claims l REPORTS FOR ALL PROGRAMS 1 FRD 104 COUNTY REFUND REPORT REPORT PURPOSE This report shows overcollections on claims with the exception of DOR and TOP It includes p
72. ALS July 1 2004 Field Description Required System Optional Generated SUSPECTED Up to 10 characters X AMOUNT dollar amount of the suspected overpayment SUSPECTED OP OI 10 character date X PERIOD MM DD YYYY BEGINNING Suspected start date of DATE the suspected overpayment SUSPECTED OP OI 10 character date X PERIOD ENDING MM DD YYYY DATE suspected end date of the suspected overpayment CASE WORKER ID 5 character number of X the caseworker currently assigned to the case Also known as the IM Worker District ASSIGN 1 character Indicator X REFERRAL set to Y when the supervisor assigns the referral to an investigator ASSIGNMENT 10 character date X DATE MM DD YYYY the referral was assigned to an investigator ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS July 1 2004 Change 1 2004 REFERRALS Field Description Required System Generated Optional INVESTIGATOR ID 5 character ID that corresponds to the investigator assigned to this referral by the supervisor X ACCEPT REFERRAL 1 character indicator set to Y when the investigator accepts their referral ACCEPTANCE DATE 10 character date MM DD YYYY the referral was accepted by the investigator COLLECTOR Up to 5 character ID for the county worker currently responsible for collecting funds Note Defaults to the investigator s number unless changed OPEN INVESTIGATION
73. ANF U P CLAIMS NUMBER AND PERCENTAGE OF U P CLAIMS IN THE REPORT MONTH FOR AFDC FOOD STAMPS MEDICAID TANF DOLLAR AMT OF TOTAL DOLLAR AMOUNT OF ALL U P CLAIMS IN THE U P CLAIMS REPORT MONTH FOR AFDC FOOD STAMPS MEDICAID TANF UNSUB CLOSED NUMBER AND PERCENTAGE OF UNSUB CLOSED CLAIMS CLAIMS IN THE REPORT MONTH FOR AFDC FOOD STAMPS MEDICAID TANF DELETED NUMBER AND PERCENTAGE OF DELETED REFERRALS REFERRALS IN THE REPORT MONTH TOTAL TOTAL NUMBER AND PERCENTAGE OF PENDING ESTABLISHED CLAIMS U P CLAIMS UNSUB CLOSED CLAIMS AND DELETED REFERRALS IN THE REPORT MONTH FOR AFDC FOOD STAMPS MEDICAID TANF ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 12 FRD 420 CASELOAD DETAILS BY INVESTIGATOR ID COUNTY CODE REPORT PURPOSE This report is used to show all referrals assigned to an investigator It shows all referrals in Pending PE Accepted AC Investigation IN Collections CO and Terminated TE status Within this report is an Investigator and County Roll Up Page of Pending Referrals It displays the number of referrals still pending in each program AFDC FS Medicaid and TANF Also a State Roll Up Page displaying referrals still pending and the number established in each program AFDC FOOD STAMPS MEDICAID and TANF ACTION REQUIRED A management tool for supervisory and investigative staff REPORT SCHEDULE Runs on the first of th
74. AY NOTICE WERE SENT THE 30 DAY REPORT NOTICE FRD433 LETTER OF LISTS ALL DEBTORS WHO MONTHLY OVERISSUANCE HAVE BEEN SENT LOIS FRD441 COLLECTIONS SHOWS EPICS CLAIM MONTHLY REPORT PAYMENTS FRD501 LIST OF ACTIVE LISTS ACTIVE CLAIMS QUARTERLY CLAIMS FRD503 CLAIMS BY SOURCE SHOWS THE TOTAL CLAIMS QUARTERLY CODE BY SOURCE CODE FRD509 CASES CLOSED LISTS CLAIMS THAT HAVE QUARTERLY TERMINATED BEEN CLOSED TERMINATED MAILED TRANSFERRED TRANSFERRED AND DELETED AND DELETED ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 F FOOD STAMPS REPORTS 1 FRD221 1 TOP PRE OFFSET ADDRESS UNPROCESSABLE REPORT REPORT PURPOSE This report is used to show food stamps claims that were submitted for TOP for pre offset address request but were not processable by TOP ACTION REQUIRED TOP provides rejection codes for claim debtors that are on the Pre offset Address Unprocessable Report The rejection codes with an explanation are 01 SSN Mismatch 02 Name Mismatch and 03 Unspcified Codes 01 and 02 can be corrected However code 03 cannot be corrected due to lack of information to determine what exactly is being rejected REPORT SCHEDULE Runs on a weekly basis REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is available in XPTR RETENTION PERIOD Three Years FRD221 1 FIELD DESCRIPTIONS
75. C COLLECTIONS This line is used to show any collections that have been collected from one category ina quarter and changed to another category within the subsequent quarter This number may reflect a positive or negative figure This line is not to be included in any formulas It is for information purposes only LINE 16 SUBTOTAL This line is used to show the subtotal of all collections during the given quarter for each heading IPV Fraud IHE Non Fraud AE Non Fraud Dollar Amount Formula Line 11 Total Collected Line 12 Terminated Claims Line 13 Non Cash Adjustments Line 14 Cash Adjustments Number Formula Line 12 Terminated Claims 19 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 FIELD DESCRIPTION LINE 16 CONT D Note Line 11 Total Collected Line 13 Non Cash Adjustments and Line 14 Cash Adjustments only have dollar amounts and therefore are not included in the Number formula for Line 16 but they are included in the Dollar Amount formula for Line 16 LINE 17 CLOSED CLAIMS This line is used to show all claims closed during the given quarter for each heading IPV Fraud IHE Non Fraud AE Non Fraud Closed is defined as receiving payment in full or compromised amount down to zero only Terminated claims are not included The count for all U and P claims that are closed is included under the IHE
76. C 8 Number Formula Line 2C 4 AJIT 2C 6 Deleted Line 2C 5 AJOT Line Note Line 2C 1 AJCI Line 2C 2 AJCD Line 2C 3 AJUC and Line 2C 7 AJUP do not increase decrease the number of claims for a county unless the following happens LINE 2E EXPUNGEMENTS If the Current Balance for a claim is adjusted down AJCD to 0 00 and closes out OR a U or P claim is closed AJUP by the county these claims will be included in the Number Amount on Line 17 This will prohibit double counting An AJCI and AJUC will increase the Current Balance amount for a claim but not increase the number of claims This line is used to show the number and total dollar amount of expungements EX payment code that have occurred during the given quarter LINE 3 SUBTOTAL This line is used to show the subtotal dollar amount and number of all active claims for the given quarter for each heading IPV Fraud IHE Non Fraud AE Non Fraud Dollar amount formula Line 1 Beg Balance Line 2A Transfers Line 2B Compromise Line 2D Keying Adjustments Line 2E Expungements Number formula Line 1 Beg Balance Line 2A Transfers Line 2D Keying Adjustments Note Line 2B Compromise and Line 2E Expungements do not increase decrease the number of claims for a county unless the following happens 15 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS Ma
77. CONTROL SYSTEM EPICS Change 2 2004 CASE MAINTENANCE September 13 2004 f Ethnicity 1 The valid Ethnicity codes are Code Description _ ___ C Hispanic Cuban H Hispanic Other M Hispanic Mexican American N Not Hispanic or Latino P Hispanic Puerto Rican U Unreported rofl If no Ethnicity code is entered the field is highlighted and the following error message is displayed MANDATORY FIELD DATA IS MISSING 3 If an invalid Ethnicity code is entered the following error message is displayed INVALID ETHNICITY CODE CHECK MANUAL ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CASE MAINTENANCE September 13 2004 g Language The valid Language codes are Code Description AR Arabic CA Cambodian CH Chinese EN English FC French Creole FR French GE German GR Greek GU Gujarati HI Hindi HM Hmong HU Hungarian IT Italian JA Japanese KO Korean LA Laotian MI Miao MK Mon Khmer OT Other PC Portuguese Creole PE Persian PG Portuguese PO Polish RU Russian SC Serbo Croation SP Spanish TA Tagalog TH Thai UR Urdu VI Vietnamese 2 If no Language code is entered the field is highlighted and the following error message is displayed MANDATORY FIELD DATA IS MISSING a If an invalid Language code is entered the field is highlighted and the following error message is displaye
78. CREATE DT Date the payment was made against the claim RECEIVE DT Amount of the payment made against the claim AMOUNT RECEIVED AMOUNT APPLIED Total dollar amount received for payment this amount may be different than amount applied Total dollar amount applied to towards the payment this amount may be different than amount received METH WRKR Means by which the money is collected The worker number for the individual entering the payment OVERCOLLECTION Difference between amount received and amount applied this is generally a refund 18 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 COLLECTIONS March 1 2005 Payment History By Referral Function Keys KEY DESCRIPTION F1 To access EPICS on line help F3 To exit and return to the Main Menu F4 To display a list F7 To display the previous screen F8 To display the next screen F12 To cancel or return to previous screen C Display A List Of Payment History By Referral 1 From the MAIN MENU key the number 4 in the Enter Option field and press Enter The COLLECTIONS MENU displays 2 In the ENTER OPTION field key the number 2 and press Enter The PAYMENT HISTORY BY REFERRAL screen displays FR43 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 08 24 2004 FRD0430 PAYMENT HISTORY BY REFERRAL 11
79. D REFERRAL TYPE REFERRAL STATUS NAME INDIVIDUAL ID SSN DOB SEX COUNTY PROGRAM CASE ID COUNTY CASE REFERRAL DATE INVESTIGATOR ID S TITLE DESCRIPTION DATE CREATED DATE LAST UPDATED 00 00 0000 00 00 0000 00 00 0000 00 00 0000 00 00 0000 00 00 0000 00 00 0000 00 00 0000 00 00 0000 00 00 0000 F1 HELP F3 EXIT F6 ADD F7 PREV F8 NEXT F12 CANCEL 5 Press the F6 function key The NOTEPAD DETAIL screen displays FR31 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 05 25 2004 FRD0270 NOTEPAD DETAIL 15 21 10 REFFERAL ID REFERRAL TYPE REFERRAL STATUS NAME INDIVIDUAL ID SSN DOB SEX COUNTY PROGRAM CASE ID COUNTY CASE REFERRAL DATE INVESTIGATOR ID TITLE DESCRIPTION ___ DATE CREATED DATE LAST UPDATED F3 EXIT F6 ADD F9 UPDATE _ F10 DELETE F12 CANCEL 6 In the TITLE DESCRIPTION field key a title to the note that will describe your entry i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 REFERRALS September 13 2004 7 Press TAB 8 In the space provided key the referral notes 9 To add save press the F6 function key NOTE The DATE CREATED field is system generated with today s date The DATE LAST UPDATED field will populate with a system generated date of the last edit 10 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays b To display and update a note in Notepad 1 From the MAIN MENU ke
80. Defines the current status of the referral See Appendix A REFERRAL TYPE Defines the type of referral a client has Regular Project Recall Front End Other See Appendix A REFERRING PERSON Name of the person providing the investigator with the referral NOTE This person can be anonymous REFERRING PERSON PHONE The referring person s phone number REGION Code used to identify the region within the state where the county is located GLOSSARY July 1 2004 REGULAR REFERRAL A code used for Type of Referral REPAYMENT AGREEMENT A formal document signed by the debtor indicating the method in which the overpayment amount will be repaid S SERVICE CODE Code identifying the type of Medicaid Services provided during the overpayment period See Appendix B SEX Code indicating the sex of the client or debtor See Appendix B SOCIAL SECURITY NUMBER The client s or debtor s social security number START DATE Effective date MM DD YYYY a new user is assigned to an authorized user detail group SUBSTANTIATION METHOD Method by which the allegation was substantiated as IPV See Appendix B SUSPECTED AMOUNT The suspected amount of money involved in the alleged overpayment overissuance SUSPECTED OVERPAYMENT OVERISSUANCE PERIOD The suspected beginning and ending date of the alleged overpayment overissuance ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 GLOSSARY July 1 200
81. E July 1 2004 In the INDIVIDUAL ID field key the individual s ID you wish to transfer and press Enter The individual s demographic information and all referrals for that county display NOTE If you do not know the code or value for a field you can use the F4 function key which displays a list of codes or values for selection This field attribute is only available for those fields that contain a plus sign to the right of the field If you wish to view a particular referral before you transfer the individual place an S in the S column of the referral you wish to view and press the F5 function key The Referral Detail 1 screen displays with the referral you selected Press the F12 function key to return to the COUNTY TRANSFER screen In the S column key an S beside the case s you wish to transfer NOTE Only those cases with an S beside them will transfer In the TRANSFER TO COUNTY field enter the county code the individual is being transferred to In the EFFECTIVE DATE OF TRANSFER key the date the case s is to be effectively assigned to the new county NOTE The referral appears on the new county s Referral list on the date of the effective transfer in a TR status The referral is assigned to investigator XYZ and therefore the county s supervisor will need to reassign the referral to the appropriate investigator via Case Reassignment Press the F11 function key to transfer the individual A message dis
82. EFERRAL ID 10 digit ID generated by EPICS upon the creation of a referral PROGRAM Identifies the Program associated with the referral CLAIM CAT Up to 3 characters code that specifies the type of claim DATE EST Date the claim was established CO status BEGINNING CLAIM AMT The original amount of the overpayment over issuance LAST PMT DATE The last date a payment was made LAST PMT TYPE Identifies the last type of payment made on the claim LAST PMT AMT The amount of the payment made that will be applied to the balance TOTAL ALL PMTS Total dollar amount of all payments made on the claim BALANCE Total dollar amount that is outstanding on the claim NAME The full name of the debtor owing the money Last Name First Name Middle Initial ADDRESS The complete address where the debtor currently resides 15 FRD 428 FRD 428Q AND FRD428Y COUNTY COLLECTION REPORT REPORT PURPOSE FRD428M This report shows monthly collection and incentive amounts FRD428Q This report shows quarterly collection and incentive amounts FRD428Y This report shows yearly collection and incentive amounts ACTION REQUIRED Review for accuracy REPORT SCHEDULE This report is scheduled to run on the first of the month REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is available in XPTR RETENTION PERIOD Three Years ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2
83. EFERRAL LIST screen displays ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 REFERRALS July 1 2004 In the INVESTIGATOR ID field type 99999 and press Enter In the S column next to the referral key an S and press Enter The REFERRAL DETAIL 1 screen displays In the ASSIGN REFERRAL field key an Y to assign the referral In the INVESTIGATOR ID field key the investigator ID of the investigator who will accept the referral To save the updates press the F9 function key NOTE The ASSIGNMENT DATE field is system generated with today s date The REFERRAL STATUS field automatically populates with a PE pending code To return to the REFERRAL LIST screen press the F12 function key The REFERRAL LIST screen displays or To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays 3 Users with State Level access can query by specific county and view referrals Supervisors can view all referrals within their county To display a referral list and view referral details by County State Level and Supervisor access only a From the MAIN MENU key the number 2 in the Enter Option field and press Enter The REFERRAL MENU displays From the REFERRAL MENU key the number 1 in the Enter Option field The REFERRAL LIST screen displays 2 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 REFERRALS July 1 2004 FR23 NC DHHS ENTERP
84. EM EPICS Change 1 2004 ADMINISTRATION COUNTY DETAIL July 1 2004 G To update County Detail Information 1 9 10 From the MAIN MENU key the number 1 in the ENTER OPTION field and press Enter The ADMINISTRATION MENU displays From the ADMINISTRATION MENU key the number 4 in the ENTER OPTION field and press Enter The COUNTY DETAIL screen displays In the COUNTY field key the county code and press Enter The remaining fields automatically populate NOTE If you do not know the code or value for a field you can use the F4 function key which displays a list of codes or values for selection This field attribute is only available for those fields that contain a plus sign to the right of the field In the COUNTY ADDRESS field key the new address for the county if applicable In the COUNTY TELEPHONE field key the new telephone number for the county if applicable In the COUNTY EXT Field key the new extension for the county if applicable Enter the 10 digit COUNTY FAX NUMBER if applicable Enter up to 42 alpha numeric COMMENTS if applicable To complete the update press the F9 function key To exit and return to the MAIN MENU press the F3 function key The MAIN MENU appears H UTILIZING F4 If you do not know the code or value for a field you can use the F4 key which displays a list of codes or values for selection This field attribute is not available for all fields but only those fiel
85. ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 TABLE OF CONTENTS July 1 2004 TABLE OF CONTENTS Change 1 2004 July 1 2004 EPICS USER S MANUAL Pages EPICS 100 ADMINISTRATION COUNTY DETAIL 1 5 EPICS 101 GETTING STARTED EPICS LOGON AND LOGOFF PROCEDURES 1 5 EPICS 102 REFERRALS 1 36 EPICS 103 CLAIMS 1 54 EPICS 104 COLLECTIONS 1 42 EPICS 105 DISQUALIFICATIONS 1 15 EPICS 106 CASE MAINTENANCE 1 14 EPICS 1900 GLOSSARY 1 6 EPICS 2000 APPENDIX A REFERRAL CODES 1 5 EPICS 2100 APPENDIX B CLAIM CODES 1 3 EPICS 2200 APPENDIX C PAYMENT CODES 1 EPICS 2300 APPENDIX D DISQUALIFICATION CODES 1 EPICS 2400 APPENDIX E CASE MAINTENANCE CODES 1 3 EPICS 2500 APPENDIX F REPORTS 1 61 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 ADMINISTRATION COUNTY DETAIL July 1 2004 100 ADMINISTRATION COUNTY DETAIL Change 1 2004 July 1 2004 l THIS CHAPTER e Describes the Administration Menu options e Describes the Administration Menu function keys e Describes the County Detail Field Descriptions e Describes the County Detail Function Keys e Describes how to display County Detail Information e Describes how to update County Detail Information e Describes how to enter field details using F4 key ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 ADMINISTRATION COUNTY DETAIL July 1 2004 ADMINISTRATION MENU All security access for the EPICS syst
86. EVER be reactivated with TOP This value can only be entered by State level users After a debtor has reached Stage C Certification Code D can be used to block a debtor from being intercepted if he has satisfied the 10 or 25 00 rule of all TOP eligible claims or if he has been recouped Once the debtor no longer meets the 10 or 25 00 rule or recoupment status the D automatically is reset to C by the system and the certification process continues SET OR UPDATE AN INTERCEPT INDICATOR FLAG If a client should not be submitted for Federal Tax Intercept due to a hearing or litigation status the county can set a flag to block the initial processing of the intercept 1 From the MAIN MENU key the number 3 in the Enter Option field and press Enter The CLAIMS MENU displays 2 From the CLAIMS MENU key the number 3 in the ENTER OPTION field and press Enter The CLAIM DETAIL screen displays 3 In the REFERRAL ID field key the referral ID and press Enter The claim information displays 4 Press the F5 function The DEBTOR SUMMARY screen displays with a list of debtors NOTE If there are numerous debtors for this claim press the F8 function key to view the next screen of debtors To go back to the previous screen of debtors press the F7 function key 5 In the List column key a s to the left of the debtor and press the F9 function key or Enter to display the debtor s information The DEBTOR DETAIL screen displays 6 In the T
87. EX Debtor s sex RECEIPT 1 character code used to select a referral The receipt number associated with the payment PAY DATE Date the payment was made REFERRAL 10 digit number generated by the system upon creation of a referral METH Method the payment was made AMOUNT APPLIED Amount of the payment applied to referral claim CHECK No Check number if payment was made by check TOP cycle number if payment was made by TOP intercept 21 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 COLLECTIONS March 1 2005 FIELD DESCRIPTION REQUIRED SYSTEM OPTIONAL GENERATED OVERCOLLECTION Difference X between amount received and amount applied this is generally a refund B Payment History By Individual Function Keys KEY DESCRIPTION F1 To access EPICS on line help F3 To exit and return to the Main Menu F4 To display a list F7 To display the previous screen F8 To display the next screen F12 To cancel or return to the previous screen C Display A List Of Payment History By Individual 1 From the MAIN MENU key the number 4 in the Enter Option field and press Enter The COLLECTIONS MENU displays 2 In the ENTER OPTION field key the number 3 and press Enter The PAYMENT HISTORY BY INDIVIDUAL screen displays FR41 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL S
88. FECTIVE DATE OF TRANSFER field 9 In the EFFECTIVE DATE OF TRANSFER field key date the case s is to be effectively assigned to the new investigator 10 In the COMMENTS field enter any comments regarding the reassignment you wish to add 11 Press the F11 function key to transfer the case s A message displays at the bottom of the screen Action completed successfully and an x will appear beside the case s you selected in the S column 12 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS CASE MAINTENANCE Change 1 2004 V CASELOAD REASSIGNMENT July 1 2004 There will be circumstances e g an investigator retires moves on to other responsibilities within Program Integrity or elsewhere leaves Program Integrity voluntarily or involuntarily etc that requires their entire workload to be transferred to another investigator The Caseload Reassignment screen allows the supervisors to perform this function A Caseload Reassignment Field Definitions FIELD DESCRIPTION REQUIRED SYSTEM OPTIONAL GENERATED TRANSFER A unique number X FROM assigned by the county INVESTIGAOR to identify the investigator currently assigned to the case NAME 1 TIME The full name of the X investigator currently assigned to the case TRANSFER TO A unique number X INVESTIGA
89. History By Referral e The Payment History By Individual field descrip e The Payment History By Individual function keys e Displaying a list of Payment History By Individual e Viewing payment Details Payment History By Individual e The NC Debt Setoff Pending function keys e Setting or Updating a DOR appeal flag Change 1 2005 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Setting DOR O appeal flag COLLECTIONS TOP Payments Online Posting Correction Refund Reversal Entering field details using F4 key Searching for an individual ID EIS Recoupment Process FSIS Recoupment Process COLLECTIONS MENU A Collections Menu Options OPTION DESCRIPTION 1 Payments Adjustments To enter payments or adjustments Reversals 2 Payment History by Referral To view payment history by referral 3 Payment History by Individual To view payment history by individual 4 NC Debt Setoff Pending Intercept To view apply and update pending NC tax intercepts B Collections Menu Function Keys KEY DESCRIPTION F1 To access EPICS on line help F3 To exit and return to the Main Menu PAYMENTS Payments can be received from many sources such as the individual Recoupments Tax Intercept etc It is required that these payments be recorded and maintained in EPICS The PAYMENTS screen provides the investigator or collector with a means for entering payments and updating claim balances March 1 2005
90. ICS HISTORY by Case Head screen displays 50 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CLAIMS SEPTEMBER 13 2004 FR33 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 08 24 2004 FRD0330 EPICS HISTORY 11 24 53 BY CASE HEAD More INDIVIDUAL ID NAME SSN DOB SEX REFERRAL OP OP PERIOD S ID ST DATE PROG AMOUNT FROM TO BALANCE CAT F1 HELP F3 EXIT F4 LIST F7 PREV F8 NEXT F12 CANCEL 3 In the INDIVIDUAL ID field key the ID and press Enter The referral information displays 4 View the list of information NOTE You may need to view multiple screens of referral history To view the next screen of referral history press the F8 function key Press the F7 function key to display the previous screen of referral history 5 Key an S in the selection field to the left of the Referral ID to view the Claim Detail screen of a particular referral Press the F12 function key to return back to the EPICS History by Debtor screen 6 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays 5 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 xI CLAIMS EPICS HISTORY BY DEBTOR SEPTEMBER 13 2004 The EPICS HISTORY by Debtor feature provides you with a means of viewing all referrals associated with a specific individual ID for a particular Debtor Utilizing this feature enables you to quickly access and verify an individua
91. ITY CONTROL SYSTEM EPICS Change 1 2004 REFERRALS July 1 2004 Field Description Required System Optional Generated DATE 10 character field X indicating the date the referral was received PROGRAM Up to 4 characters Xx Code for the benefit program associated with the referral NAME LAST Case head payee s last X name up to 30 characters NAME FIRST Case head payee s first x name up to 10 characters INDIVIDUAL ID 10 character numbers X of the case head payee provided by CNDS B Referral List Function Keys Key Description F1 To access EPICS on line help F3 To exit and return to Main Menu F4 To display a list F6 To display a selected referral F7 To display the previous screen page down F8 To display the next screen page up F12 To cancel or return to the previous screen C State Level and Supervisor Users Supervisors or designated person must assign referrals to the investigators in their county If the supervisor does not know the referral ID number of an unassigned referral they can display a list of unassigned referrals for the county in which they are assigned 1 To display a referral list of unassigned referrals and view referral details Supervisor only a 18 From the MAIN MENU key the number 2 in the Enter Option field and press Enter The REFERRAL MENU displays ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change
92. L This report is viewable at the owner county level REPORT DISTRIBUTION This report available in XPTR RETENTION PERIOD Three Years FRD106 FIELD DESCRIPTIONS FIELD DESCRIPTION PROGRAM The program associated with the overcollection COUNTY NAME The name of the county the report applies to CLIENT The full name of the debtor the overcollection occurred on Last First Middle Initial INTEREST START DATE The date interest began occurring on the money taken from the debtor REFUND AMOUNT The estimated amount to be refunded to the debtor ESTIMATED INTEREST DUE The estimated interest due back to the debtor ESTIMATED TOTAL DUE The estimated total amount the debtor will receive COUNTY SUBTOTAL The estimated amount refund interest and total due for the county 4 FRD 160 O APPEAL IND REPORT PURPOSE This report is to keep a history of all debtors who have had the NC Debt Setoff Appeal Indicator set to O At the end of each date the Os should be captured as shown on the report as that as of date ACTION REQUIRED Review this report for accuracy REPORT SCHEDULE Runs on a daily basis REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is available in XPTR RETENTION PERIOD Three Years ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 FRD160 FIELD DESCRIPTIONS APPENDIX F REPORTS Ma
93. L SYSTEM 02 24 2004 FRDO150 DISQUALIFICATION DETAIL 12 26 23 SSN LAST ACTIVITY NAME ADDRESS INDIVIDUAL ID DATE OF BIRTH SEX DQ INFORMATION REFERRAL INFORMATION DQ STATE 0 2 REFERRAL ID PROGRAM DQ COUNTY COUNTY CASE REF COUNTY DQ INVESTIGATOR PGM CASEID REF INVEST DQ COUNTY CASE CONTACT INFORMATION XFER DQ COUNTY FIPS CODE DQ OFFENSE CODE _ OFFICE DQ NUMBER lt KEY gt TITLE DQ METHOD TELEPHONE DQPERIOD FAXNUM DQ DECISION DATE lt KEY gt COMMENTS DQ START DATE DQ END DATE NON NC INFO F1 HELP F2 CLEAR F3 EXIT F4 LIST F5 XFER DQ COUNTY F6 ADD FQ9 UPDATE F10 DELETE F11 KEY CHANGE F12 CANCEL NOTE The DQ State and DQ County fields will be populated with NC and the county from which the person signed on is located These fields cannot be modified 4 Key the referral ID in the REFERRAL ID field number for the individual being disqualified and press Enter The Program County Case Ref County Pgm Case ID and Ref Invest fields populated based on the referred ID entered NOTE Ensure you enter the correct Referral ID number This value can not be changed once the Disqualification has been successfully added 5 In the INVESTIGATOR field key the County Case Number assigned to the disqualification This value may be different from the Ref Invest 6 In the DQ COUNTY CASE field key the County Case Number assigned to the dis
94. LIENT F12 CANCEL 3 If the individual is not displayed press the F11 function key to display the Maintain Client screen FR04 FRD035 SSN DOB INDIVIDUAL ID 000000000 _ NAME ADDRESS NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 08 25 2004 0 MAINTAIN CLIENT 08 18 43 00 00 0000 SEX _ RACE ETHNICITY _ LANGUAGE _ TYPE PHYS_ COUNTY CODE ___ PHONE NUMBER EXT TYPE HOME_ F1 HELP F2 CLEAR F3 EXIT F6 ADD F9 UPDATE F12 CANCEL k ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 4 CASE MAINTENANCE September 13 2004 From the Maintain Client screen key a Name b SSN if no ssn enter zeroes C Date of Birth d Sex e Race Up to 5 race codes may be entered 1 The valid race codes are A Asian B Black or African American American Indian or Alaska Native P Native Hawaiian Or Other Pacific Islander U Unknown W White 2 Multiple race codes are not allowed if one of the race codes is U The following error message is displayed MULTIPLE VALUES FOR RACE CODE IS NOT ALLOWED IF ONE OF THEM IS A U 3 If no race code is entered the field is highlighted and the following error message is displayed MANDATORY FIELD DATA IS MISSING 4 If an invalid race code is entered the following error message is displayed INVALID RACE CODE CHECK MANUAL i ENTERPRISE PROGRAM INTEGRITY
95. M INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CLAIMS JULY 1 2004 xII UTILIZING F4 If you do not know the code or value for a field you can use the F4 function key which will display a list of codes or values for selection This field attribute is only available for those fields that contain a plus sign to the right of the field To Enter Field Details Using F4 A In the field that contains a plus sign to the right of the field key equal sign and press the F4 function key The specific code list screen displays B To select a code or value tab to the appropriate code value in the S column and key s C Press Enter The previous screen displays with the field populated with the selected code or value D Continue entering or updating the screen details 55 Change 1 2004 XIII ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS CLAIMS JULY 1 2004 NAME SEARCH If you do not know the Individual ID of a person you may use the Name Search feature The Name Search feature is available on any screen where the Individual ID field has a plus sign to the right of it Using this feature allows you to search for an individual when you only have a Social Security Number Case ID or Name Sex and DOB of a person A Name Search Function Key Descriptions Key Description F1 To access EPICS on line help F3 To exit and return to the Main Menu F4 To clear the search criteria fie
96. MONTH 11 FRD408 REFERRALS CLAIMS ESTABLISHMENT AND BACKLOG REPORT FOR MONTH CCYY REPORT PURPOSE This report is used to display statistics of Referrals created with a Date of Discovery in the report month and statistics of Referrals Pending Established U P Claims Unsub Closed Claims and Deleted Referrals in the report month ACTION REQUIRED No action required Statistical report s ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 REPORT SCHEDULE Runs the end of the month REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is available in XPTR Two hardcopies of the report are created and provided to the Division of Medical Assistance and the Division of Social Services RETENTION PERIOD Three Years FRD408 FIELD DESCRIPTIONS FIELD DESCRIPTION COUNTY COUNTY NAME REFERRALS NUMBER OF REFERRALS CREATED WITH A DATE OF CREATED DISCOVERY IN THE REPORT MONTH FOR AFDC FOOD STAMPS MEDICAID TANF PENDING NUMBER AND PERCENTAGE OF PENDING REFERRALS REFERRALS AS OF THE LAST DAY OF THE REPORT MONTH ESTABLISHED NUMBER AND PERCENTAGE OF ESTABLISHED CLAIMS CLAIMS IN THE REPORT MONTH FOR AFDC FOOD STAMPS MEDICAID TANF DOLLAR AMT OF TOTAL DOLLAR AMOUNT OF ALL ESTABLISHED EST CLAIMS CLAIMS IN THE REPORT MONTH FOR AFDC FOOD STAMPS MEDICAID T
97. N END DATE Ending date MM DD YYYY for the disqualification Applies to WF and FS only E EFFECTIVE DATE OF TRANSFER Date MM DD YYYY the referral is to be effectively assigned to the new investigator or county EIS FSIS ADDRESS The client s address that is posted in EIS FSIS END DATE The end date MM DD YYYY of the assignment to the county EPICS ADDRESS An address that Program Integrity uses that is different from the address in EIS FSIS ESTABLISHMENT DATE Date MM DD YYYY the claim was originally established FAX NUMBER The client s fax number FIRST NAME The clients or debtor s first name from Name Search CNDS FREQUENCY Defines how often the client is expected to make payments See Appendix B FRONT END REFERRAL Code used for the type of referral that resulted from an application with questionable information GLOSSARY July 1 2004 INDIVIDUAL ID The clients ID from which the last activity occurred Name Search CNDS INITIAL BALANCE DUE Total amount of the established overpayment INADVERTENT HOUSEHOLD ERROR A claim type used by all Programs Known to Medicaid as a Client Error INTENTIONAL PROGRAM VIOLATION A claim type used by all Programs Known to Medicaid as Fraud INVESTIGATION Process to determine the validity of the allegations INVESTIGATOR ID The ID of the investigator currently assigned to the case L LAST ACTIVITY The activity code that was l
98. NTS COMMENTS field enter a description of the increase if necessary To add save the increase press the F6 function key To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays G To Decrease The Current Balance STATE LEVEL ACCESS ONLY The CURRENT BALANCE can only be decreased by State staff The error message INSUFFICIENT AUTHORIZATION RESTRICTED TO STATE PI STAFF ONLY CONTACT STATE PI is displayed should you attempt to adjust the CURRENT BALANCE If an adjustment is needed to decrease the Current Balance fax the request to For AFDC and Work First Claims Family Support and Child Welfare Services section at 919 715 6714 Include on the fax request Casehead Name Referral ID Debtor Individual ID Reason for Increase of Balance Correct Balance Amount Signature of Supervisor Hoang 3 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 COLLECTIONS March 1 2005 For Medicaid Claims DMA Program Integrity staff at 919 715 7706 Include on the fax request Casehead Name Referral ID Debtor Individual ID Reason for Increase of Balance Correct Balance Amount Signature of Supervisor gt on For Food Stamp Claims FAEP Program Integrity staff at 919 733 0645 Include on the fax request a Casehead Name b Referral ID C Debtor Individual ID d Reason for Increase of Balance e Correct Balance Amount f Signature of Supervisor 1 Fro
99. NU key the number 2 in the Enter Option field and press Enter The REFERRAL DETAIL 1 screen displays 3 In the REFERRAL ID field key the referral ID you need to transfer and press Enter The referral displays NOTE If you do not know the referral ID you can use the F4 key which displays the REFERRAL LIST screen 4 In the REFERRAL STATUS field enter OT for Out of State Transfer 5 To complete the transfer press the F9 function key 6 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays E To Reopen a Referral from Out of State Status Food Stamps Only A referral that has been in OT Out of State status may need to be reopened by the county if the client moves back to the originating state For example a client moved from Bertie County to VA and the county issued an Out of State transfer The client then moves back from VA to Bertie County Once the county is aware that the client is back the referral should be reopened in EPICS 1 From the MAIN MENU key the number 2 in the Enter Option field and press Enter The REFERRAL MENU displays 2 From the REFERRAL MENU key the number 2 in the Enter Option field and press Enter The REFERRAL DETAIL 1 screen displays 3 In the REFERRAL ID field key the rederral ID you need to reopen and press Enter The referral displays ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 REFERRALS July 1 2004 NOTE If you
100. O Date of the OP OI period This field is an optional field and may be entered for all Medicaid claims except for those programs listed below The valid values for this field is Y Yes N No or space If a Y is entered the claim appears on the Medicaid Profile Follow up Case Management Report 12 months after the TO Date 1 The program code cannot be AFDC FS TANF MICuJ MICL MICS MQBB or MQBE If the indicator of Y is entered with one of these program codes the following error message is displayed MEDICAID PROFILE INDICATOR NOT ALLOWED INVALID PRORAM CODE 10 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 2 CLAIMS JULY 1 2004 The claim type must be IHE or IPV If the indicator is entered and the claim type is not IHE or IPV the following error message is displayed MEDICAID PROFILE INDICATOR NOT ALLOWED INVALID CLAIM TYPE A Y is allowed for all OP OI periods displayed on the claim if the calculated date has not expired and meets the above criteria For example the current date is 3 03 03 The TO Date of the OP OI period is 03 31 02 The calculated date is 3 2003 The claim displays on the Medicaid Profile Follow up Case Management Report created the last work night in March 2003 The indicator is not allowed if the calculated date has expired If the indicator is keyed and the calculated date has expired the following error message is d
101. ON COUNTY NAME Name identifying the county INVESTIGATOR ID 5 character ID that corresponds to the investigator assigned to the claim NAME The full name of the debtor Last Name First Name Middle Initial PROGRAM Identifies the Program associated with the referral NOTICE BALANCE AMOUNT INTERCEPTED The balance owed on the claim by the debtor at the time the notice is created The amount intercepted from NC Debt Setoff MULTICOUNTY Indicates the debtor has claims in other counties and has been sent 30 day notices there also ADDRESS USED FOR 30 DAY The address used on the 30 day notice for the claim debtor SSN The social security number of the debtor INDIVIDUAL ID The 10 character number associated with the debtor 18 FRD 433 LETTER OF OVERISSUANCE REPORT REPORT PURPOSE This report is used to show all debtors who have been sent a Letter of Overissuance LOI from a newly established claim This report may be used to track when recoupments will begin on active claim debtors when all selection criteria are met as well as other purposes as defined in this manual ACTION REQUIRED Counties should review this report Counties may also use this report to determine when the appeal period expires REPORT SCHEDULE Runs on a daily basis REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is available in XPTR
102. OP INTERCEPT IND field key the code that describes why the debtor should not be submitted for the initial processing of intercept T To save and update the screen press the F9 function key 8 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays SET OR UPDATE AN APPEAL FLAG When a client requests an appeal within the 60 day period you must set the appeal flag Likewise when the appeal status has changed you must update the appeal field 1 From the MAIN MENU key the number 3 in the Enter Option field and press Enter The CLAIMS MENU displays 34 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 2 CLAIMS SEPTEMBER 13 2004 From the CLAIMS MENU key the number 3 in the ENTER OPTION field and press Enter The CLAIM DETAIL screen displays In the REFERRAL ID field key the referral ID and press Enter The claim information displays Press the F5 function The DEBTOR SUMMARY screen displays with a list of debtors NOTE If there are numerous debtors for this claim press the F8 function key to view the next screen of debtors To go back to the previous screen of debtors press the F7 function key In the List column key as to the left of the debtor and press the F9 function key or Enter to display the debtor s information The DEBTOR DETAIL screen displays In the TOP INTERCEPT APPEAL IND field key the code for the type of appeal the debtor is requesting or the
103. PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 GETTING STARTED May 1 2004 1 Logon to EPICS The MAIN MENU displays Figure S ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM RUI FRD0010 MAIN MENU 1 Administration Menu 4 Collections Menu 2 Referral Menu 5 Disqualifications 3 Claims Menu 6 Maintenance Menu FI HELP F12 CICS CLEAR SCREEN NOTE For procedures on how to logon to EPICS see Il 2 In the Enter Option field key the number of the MAIN MENU option and press Enter A menu displays with a list of options from which to choose 3 Proceed with adding updating or viewing data Change 1 2004 IV ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS GETTING STARTED May 1 2004 EXITING EPICS When exiting EPICS you must logoff properly from the session If you neglect to do so you may have difficulty logging back into EPICS or the system may lock Ensure all work has been added and updated successfully before you logoff A To Exit EPICS Via a Terminal 1 To return to the MAIN MENU press the F3 function key The MAIN MENU displays NOTE From any screen in EPICS you can press the F3 function key to return to the MAIN MENU To exit EPICS press the F12 function key A PIE menu displays Press the F3 function key A blank CICS screen displays Key logoff and press Enter The STATE BANNER screen displays or Enter another transaction B To Exit EPICS Via a Personal Comput
104. R A Y is displayed when there is only one individual ID number present in EPICS with a duplicate SSN and the debtor was submitted to DOR COUNTY TOTAL PAGE A total for the county by program of the possible interception amount if the debtor could have been sent to DOR or the status is CL STATE ROLL UP PAGE A total of all counties by program of the possible interception amount if the debtor could have been selected and sent to DOR or the status is CL State Level Access Only 34 March 1 2005 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 9 APPENDIX F REPORTS March 1 2005 FRD 240 ZERO SSN REPORT REPORT PURPOSE This report is used to show all debtors that have an SSN of all zeros 000 00 0000 ACTION REQUIRED Debtors SSNs that can be corrected via other legacy systems should be accomplished Debtors who maintain an all zero SSN can not be processed for TOP or DOR REPORT SCHEDULE Runs on a weekly basis REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is available in XPTR RETENTION PERIOD Three Years FRD240 FIELD DESCRIPTIONS FIELD DESCRIPTION COUNTY NAME The name identifying the county PERSON The full name of the client Last Name First Name Middle Initial and their Individual ID REFERRAL 10 digit ID generated by EPICS upon the creation of a referral and the
105. REFERRAL ID REFERRAL TYPE _ REFERRAL STATUS __ NAME INDIVIDUAL ID SSN DOB RACE _ SEX COUNTY PROGRAM CASE ID COUNTY CASE REFERRAL DATE INVESTIGATOR ID LIST OF DEBTORS SSN IND ID NAME F1 HELP F3 EXIT F4 LIST F7 PREV F8 NEXT F9 DEBTOR DETAIL F12 CANCEL NOTE If there are numerous debtors for this claim press the F8 function key to view the next screen of debtors To go back to the previous screen of debtors press the F7 function key 5 In the List column key an s to the left of the debtor and press the F9 function key or Enter to display the debtor s information The DEBTOR DETAIL screen displays 6 View the details 7 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays 28 V ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CLAIMS SEPTEMBER 13 2004 DEBTOR SUMMARY You can view a list of debtors associated with a specific referral from the Debtor Summary screen A Debtor Summary Screen Field Descriptions Field Description Required System Optional Generated Referral ID 10 digit number X generated by the system upon creation of a referral Referral Type 1 character code X that identifies the type of referral Referral Status 2 character code X for the status of a referral Name Last name first xX name and middle initial of the case head payee Ind ID Unique ID X ass
106. REFERRAL MENU 15 18 47 1 Referral List 2 Referral Detail 3 Create New Referral Enter Option _ Fi HELP F3 EXIT 2 In the ENTER OPTION field key the number 3 and press Enter The REFERRAL DETAIL 1 screen displays FR19 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 03 24 2000 FRDO190 REFERRAL DETAIL 1 08 06 17 REFERRAL ID REFERRAL TYPE _ REFERRAL STATUS __ NAME INDIVIDUAL ID SSN DOB 00 00 0000 SEX _ ORIGINATING COUNTY ___ OWNER ___ PROGRAM CASE ID 000000000 COUNTY CASE REFERRAL DATE 00 00 0000 DATE OF DISCOVERY 00 00 0000 REFERRING PERSON REFERRING PERSON PHONE REFERRAL SOURCE __ NATURE OF REFERRAL _ SUSPECTED AMOUNT 0 00 SUSPECTED OP OI PERIOD 00 00 0000 to 00 00 0000 CASE WORKER ID ASSIGN REFERRAL _ ASSIGNMENT DATE 00 00 0000 INVESTIGATOR ID ACCEPT REFERRAL _ ACCEPTANCE DATE 00 00 0000 COLLECTOR OPEN INVESTIGATION _ OPEN DATE 00 00 0000 OVERRIDE USERID CLOSE REFERRAL DATE CLOSED 00 00 0000 OVERRIDE COUNTY ___ REASON CLOSED OVERRIDE DATE 00 00 0000 F1 HELP F2 CLEAR F3 EXIT F4 LIST F5 NTESUM F6 ADD F9 UPD F10 DTL2 F11 SPINOFF F12 CANCEL ACTION COMPLETED SUCCESSFULLY i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 REFERRALS July 1 2004 NOTE If you do not know the code or value for a field you can use the F4 key which displays a list of codes or values for selection This field attribute is only
107. REFERRAL TYPE field key the code for the type of referral In the INDIVIDUAL ID field key the case head payee s ID 3 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 REFERRALS September 13 2004 If you do not know the case head payee s ID press the equal sign and F4 key The Name Search screen displays You may search in one of four ways which is outlined on the screen Press ENTER The Name List screen displays FR78 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 08 24 2004 FRDO750 Name Search 09 17 59 Last Name First Name Middle Initial _ Sex Code _ Date Of Birth SSN Individual ID _ Case ID To search use either 1 Last Name First Name Sex Code and Date of Birth only or 2 SSN only or 3 Individual ID only or 4 Case ID only F3 EXIT F4 CLEAR F12 CANCEL FR78 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 08 24 2004 FRD0770 NAME LIST 09 21 33 Results for Sel SSN Last Name First Name MI DOB Sex Indiv ID EIS Cnty FSIS Cnty Program Case ID Race Ethnicity Language F1 HELP F3 EX IT F7 PREV F8 NEXT F11 CLIENT F12 CANCEL If the individual is displayed enter an S by the name under the Sel column Press Enter The Referral Detail 1 screen is displayed with individual ID that was selected If your individual is not displayed and an individual ID number must be assigned press the F11 key The Maintain Client screen displays 29
108. RIOD 3 character code identifying the length of the disqualification DQ DECISION DATE The date the disqualification was made DQ START DATE The beginning date for the disqualification DQ END DATE The ending date for the disqualification FIPS CODE A four digit number indicating the zip code ext OFFICE The county s organizational name responsible for the disqualification verification TITLE The title of the division responsible for the disqualification verification ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 DISQUALIFICATIONS July 1 2004 FIELD DESCRIPTION REQUIRED SYSTEM OPTIONAL GENERATED TELEPHONE The area code and X local phone number of the county worker responsible for the disqualification verification EXT The phone number X extension of the county worker responsible for the disqualification verification FAX NUM A 10 digit Fax Number X from the County Detail Screen COMMENTS Up to 42 characters of X free form text brought forward from the County Detail screen and from out of state disqualification if any were entered NON NC INFO Key field used by other X states to track information D Disqualification Inquiry Function Keys KEY Description F1 To access EPICS on line help F2 To clear the screen with the exception of demographic information F3 To exi
109. RISE PROGRAM INTEGRITY CONTROL SYSTEM 06 29 2004 FRD0230 REFERRAL LIST 11 44 33 INVESTIGATOR ID COUNTY __ More REFERRAL S REFERRAL TYPESTAT DATE PROGRAM LASTNAME FIRST INDIVID ID F1 HELP F3 EXIT F4 LIST F6 DETAIL F7 PREV F8 NEXT F12 CANCEL G In the INVESTIGATOR ID field delete the investigator ID number d If you have State Level access you must enter the county you wish to view NOTE Supervisors cannot modify the county field It will default to the county in which they are assigned e Press Enter to display all the referrals owned by the county with the exception of unassigned referrals f To view referral details key a s in the S column next to the referral and press Enter or the F6 function key The REFERRAL DETAIL 1 screen displays g To view REFERRAL DETAIL 2 screen press the F10 function key The REFERRAL DETAIL 2 screen displays h To return to the previous screen press the F12 function key The REFERRAL DETAIL 1 screen displays i To return to the REFERRAL LIST screen press the F12 function key The REFERRAL LIST screen displays or To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 REFERRALS July 1 2004 D FRO3 FRDO030 REFERRAL MENU 11 47 23 County Level Access Users A user who has County Level access to EPICS i e Investigators can only query by their inv
110. RITY CONTROL SYSTEM EPICS Change 1 2004 4 c CLAIMS JULY 1 2004 These requests are sent to the State Controller s Office or the Attorney General s office for approval to write off the claims Upon approval State DSS staff adjusts the claim balance to zero to close the claim If a Medicaid claim cannot be collected due to the death of the debtor and no collection from the estate is possible the balance of the claim must be adjusted to zero a d Do not terminate the Medicaid claim Document the date of death and the reason the claim cannot be collected in the ALLEGATIONS field of the Referral Detail 2 screen Send or fax a request on county letterhead to Brenda Porter or Shara Britt to close the claim Fax number 919 715 7706 Mail Address DMA Quality Assurance Section MSC 2501 Raleigh NC 27699 2501 Include on the request Casehead Name Referral ID Program Case ID Reason Claim Uncollectable Upon approval of the request State DMA PI staff adjusts the claim balance to zero to close the claim If a Food Stamp claim cannot be collected due to the death of the only debtor terminate the claim To save and update the CLAIM DETAIL press the F9 function key To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays or To continue with debtor detail information press the F5 function key The DEBTOR DETAIL screen displays 16 ENTERPRISE PROGRAM INTEGRIT
111. ROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 GLOSSARY July 1 2004 1900 GLOSSARY Change 1 2004 July 1 2004 18 PAYMENT DUE DATE The client s first payment due date A ACCEPTANCE DATE The day MM DD YYYY the investigator accepts the referral ADDRESS TYPE The type of address the client uses e g Physical address See Appendix A AGENCY ERROR An overissuance made to a client caused by the County or State AGENCY ERROR TYPE Defines the type of agency error as State or County See Appendix B ALIAS NAMES One or more alternate names for the client ALIAS SOCIAL SECURITY NUMBERS One or more social security numbers used by the client ALLEGATIONS A description of the alleged fraud ASSIGNMENT DATE The day MM DD YYYY the referral was assigned to the investigator C CASE ID The Program Case ID associated with the referral CASEWORKER ID A unique number that identifies the caseworker Also known as the IMC ID number CASE REASSIGNMENT The ability to reassign a case from one investigator to another CASELOAD REASSIGNMENT The ability to reassign an entire caseload from one investigator to another CHECK NUMBER The number of the check received from the payor CIVIL JUDGEMENT DATE Date MM DD YYYY that indicates when a civil judgement was entered against the debtor CLAIM Established overpayment subject to collection process CLAIM TYPE The type of overpayme
112. RTS March 1 2005 FRD213 FIELD DESCRIPTIONS FIELD DESCRIPTION COUNTY NAME The name of the county the report applies to INVESIGATOR ID ID that corresponds to the investigator assigned to the referral NAME The full name of the casehead on the referral Last Name First Name Middle Initial PROGRAM Identifies the Program associated with the referral SSN 9 digit social security number for the debtor INDIVIDUAL ID 10 character number of the claim debtor REFERRAL ID 10 digit ID generated by EPICS upon creation of a referral PGM CASE ID Up to 9 characters Identifies the Program Case ID associated with the referral CLAIM BALANCE CLAIM CATETGORY The current balance due on the claim Up to 3 characters code that specifies the type of claim STATUS 2 letter code indicating the current status of the referral 8 FRD 214 DOR DUPLICATE SSN REPORT PURPOSE This report identifies those individuals in EPICS that contain duplicate social security numbers SSN or duplicate SSN and multiple individual ID numbers If there are duplicate SSN s and multiple individual ID numbers present in EPICS the individual is not selected for Debt Setoff DOR ACTION REQUIRED Before any correction removal of an SSN or change of individual ID number coordination must be made with the EIS and or FSIS worker To correct the SSN use the name change function in EIS or FSIS CNDS is updated immediate
113. SER LIST screen The STARTING REFERRAL ID field is an option field You may enter the referral ID that you are reassigning or the referral ID you wish to begin with The referral ID entered is displayed first in the list of referrals If no STARTING REFERRAL ID is entered all referrals are displayed If the maximum number of scrollable pages are displayed the error FRDWROC REACHED MAXIMUM NUMBER OF SCROLLABLE PAGES PLEASE REQUERY is displayed NOTE You may enter the STARTING REFERRAL ID or remove the STARTING REFERRAL ID at any point however you must press the ENTER key after entering a new referral ID or removing the referral ID Use your Tab key to advance to the NEW INVESTIGATOR field In the NEW INVESTIGATOR field enter the ID of the investigator who the case s are being reassigned to and press the Enter key The full names of both investigators and the cases of the current investigator displays In the S column key an S beside the case s to be reassigned i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CASE MAINTENANCE July 1 2004 NOTE If you wish to view a particular referral before you transfer it to the new investigator key an s in the S column of the referral you wish to view and press the F5 function key The Referral Detail 1 screen displays with the referral you selected Press the F12 function key to return to the COUNTY TRANSFER screen 8 Use your Tab key to advance to the EF
114. SSIGNMENT COMMENTS F1 HELP F3 EXIT F4 LIST F11 REASSIGN F12 CANCEL 3 In the TRANSFER FROM INVESTIGATOR field enter the investigator ID whose caseload you are reassigning NOTE If you do not know the code or value for a field you can use the and F4 function keys to display a list of codes or values for the selection This field attribute is only available for those fields that contain a plus sign to the right of the field If you choose this option you will have to select the investigator from the AUTHORIZED USER LIST screen 4 Use your Tab key to advance to the TRANSFER TO INVESTIGATOR field i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CASE MAINTENANCE July 1 2004 5 In the TRANSFER DATE TO INVESTIGATOR field enter the ID of the investigator who the caseload is being reassigned to and press the Enter key The full names of both investigators display 6 In the EFFECTIVE DATE OF TRANSFER field key date the caseload is to be effectively assigned to the new investigator 7 In the COMMENTS field enter any comments regarding the reassignment you wish to add 8 Press the F11 function key to transfer the caseload A message displays at the bottom of the screen Action completed successfully 9 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays j ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CASE MAINTENANCE September
115. State source The Notepad Summary function keys ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 REFERRALS July 1 2004 The Notepad Detail function keys Adding a note in Notepad Displaying and updating a note in Notepad Deleting a note in Notepad Entering field details using F4 key Searching for an individual ID Name Search feature Change 1 2004 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS REFERRAL MENU REFERRALS July 1 2004 A referral is the origination point for a claim in EPICS Referral information e g an individual who may or may not be committing a fraudulent act is obtained in Program Integrity from several sources such as phone calls or letters The Referral function provides the Program Integrity Staff with a method of recording viewing and updating referral information The Referral menu contains three options from which to choose Option Description 1 Referral List To display a list of existing referrals 2 Referral Detail To display and update a known specific referral 3 Create New Referral To add a new referral Referral Menu Function Keys Key Description F1 To access EPICS on line help F3 To exit and return to Main Menu ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 REFERRALS July 1 2004 ll ADD ANEW REFERRAL Upon a receipt of a new referral it is required that the Prog
116. T DEBTORS THAT HAVE WEEKLY ALL ZEROS FOR THE SSN FRD407 TIMELINESS RPT DISPLAYS REFERRALS THAT MONTHLY CONTAIN A DATE OF DISCOVERY THAT IS SEVEN 7 MONTHS PRIOR TO THE RUN DATE OF THE REPORT ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS E AFDC TANF FOOD STAMP AND MEDICAID REPORTS Continued March 1 2005 REPORT REPORT NAME REPORT DESCRIPTION FREQUENCY NUMBER FRD408 REFERRALS CLAIMS DISPLAYS STATISTICS OF MONTHLY ESTABLISHMENT REFERRALS CREATED WITH A AND BACKLOG DATE OF DISCOVERY IN THE REPORT FOR REPORT MONTH AND MONTH CCYY STATISTICS OF REFERRALS PENDING ESTABLISHED U P CLAIMS UNSUB CLOSED CLAIMS AND DELETED REFERRALS IN THE REPORT MONTH FRD420 CASELOAD DETAILS LISTS EPICS REFERRALS MONTHLY BY INVESTIGATOR ASSIGNED TO AN ID COUNTY CODE INVESTIGATOR FRD421 CASELOAD DISPLAYS THE OVERALL MONTHLY STATISTICS BY CASELOAD INFORMATION BY INVESTIGATOR ID INVESTIGATOR ID FRD425 INVESTIGATORS LISTS CLAIM DEBTORS THAT MONTHLY MAINTENANCE ARE DELINQUENT MAILED REPORT DELINQUENCY FRD428M_ COUNTY LISTS COUNTY CLAIM MONTHLY FRD428Q_ COLECTIONS COLLECTIONS AND QUARTERLY FRD428Y REPORT INCENTIVES FOR THE YEARLY APROPRIATE PROGRAMS AND LISTS FOOD STAMP REVERSALS FRD429 NCDEBT EXEMPT LIST CLAIMS THAT HAVE BEEN WEEKLY EXEMPT FROM DOR PROCESSING FRD431 NC DEBT SETOFF 30 LISTS CLAIM DEBTORS THAT BI WEEKLY D
117. TERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 3 REFERRALS July 1 2004 The REFERRAL STATUS field automatically changes to AC accepted To return to the REFERRAL LIST screen press the F12 screen press the F12 function key The REFERRAL LIST screen displays or To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays If a referral is in AC accepted status and ready for investigation the investigator may open the referral Opened referrals maintain a status of IN investigation To open a referral via the Referral List a From the MAIN MENU key the number 2 in the Enter Option field and press Enter The REFERRAL MENU displays From the REFERRAL MENU key the number 1 in the Enter Option field and press Enter The REFERRAL LIST screen displays Press Enter The referral list for the investigator displays Locate the accepted referral NOTE Accepted referrals maintain a status of AC To select the referral key as in the S column and press Enter The REFERRAL DETAIL 1 screen displays In the OPEN INVESTIGATION field key an Y to open the investigation To save the updates press the F9 function key NOTE The OPEN DATE field is system generated with today s date The REFERRAL STATUS field changes to an IN Investigation status To return to the REFERRAL LIST screen press the F12 function key The REFERRAL LIST screen displays or To ex
118. TERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CLAIMS JULY 1 2004 b Work First Agency Error Code The county can enter C County State Staff can only enter S State County level personnel should contact the DSS office for the S code type to be entered f In the OP OI PERIODS fields enter the OP OI beginning and ending dates using the 10 character format MM DD YYYY NOTE You can enter up to four OP OI periods Program OP Ol Criteria AFDC Beginning and end dates must be before January 1997 TANF Due to TANF program funding methods claims must be divided into 2 periods January 1997 through September 1997 and October 1997 through the present If the beginning date period falls within the January 1997 though September 1997 time frame then the ending date must also fall within that range This enables EPICS to interface with the accounting systems based on the funding for each MICK Beginning and ending dates for NCHC must be on or after 10 1 98 If you attempt to enter an overpayment period that is not included in these funding boundaries a message displays when you press F9 to update The system guides you to the correct periods within the funding boundaries from one claim and create a new referral for the other overpayment periods outside the first boundary The MEDICAID PROFILE INDICATOR is used to request a follow up Medicaid Recipient Profile 12 months after the T
119. TOR assigned by the county to identify the investigator the case is being reassigned to NAME 2 TIME The full name of the X investigator the case is being reassigned to EFFECTIVE The date the caseload X DATE OF is to be effectively TRANSFER assigned to the new investigator COMMENTS A description of why the X transfer is occurring B Caseload Reassignment Function Keys FUNCTION Description F1 To access EPICS on line help F3 To exit and return to the Main Menu F4 To display a list F11 To transfer the caseload to a new investigator F12 To cancel and return to the previous screen C Reassign A Caseload To A New Investigator 1 From the MAIN MENU key the number 6 in the ENTER OPTION field and press Enter The MAINTENANCE MENU displays 12 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CASE MAINTENANCE September 13 2004 FROQ NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 06 29 2004 FRD0090 MAINTENANCE MENU 11 32 38 1 County Transfer 2 Case Reassignment 3 Caseload Reassignment 4 Name Search Name List Enter Option _ F1 HELP_F3 EXIT 2 From the MAINTENANCE MENU key the number 3 in the ENTER OPTION field and press Enter The CASELOAD REASSIGNMENT SCREEN displays FR51 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 06 29 2004 FRLR CASELOAD REASSIGNMENT 11 37 46 REASSIGN FROM INVESTIGATOR NAME REASSIGN TO INVESTIGATOR NAME EFFECTIVE DATE OF REA
120. This is the Date of Discovery from the referral ESTABLISHED DATE This is the date the claim was established ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 FIELD DAYS PENDING DESCRIPTION If the category is S U P or US and closed or deleted the Days Pending is the number of days from the Date of Discovery to the date that the referral was closed or deleted Day one is the day after the Date of Discovery with the closed or deleted date being the last day included If the category is AE includes SIE IPV or IHE and closed deleted terminated transferred in or transferred out the Days Pending is the number of days from the Date of Discovery to the Establishment Date Day one is the day after the Date of Discovery with the Establishment Date being the last day included STATUS 2 letter code indicating the current status of the referral ACTION This identifies if the referral is closed terminated a transfer in a transfer out or deleted s
121. To Access Via a PC Personal Computer 1 From your Windows Desktop double click the Mainframe icon 2 From the State Banner screen key CICSSCC4 and press Enter The CICS screen displays 3 In the Userid field key your RACF ID 4 Press Tab 5 In the bill cde field key FRP DHR 6 Press Tab 7 In the Password field key your password 8 Press Enter A blank CICS screen displays 9 Key FRO1 and press Enter The EPICS MAIN MENU displays NOTE The 0 in FR01 is a number value i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 GETTING STARTED May 1 2004 MAIN MENU The EPICS MAIN MENU provides you with a list of six options from which to choose These options define the six major functionalities within EPICS Depending on your security authorization you can select an option from the list and view create or update data A Main Menu Options Option Description 1 Administration Menu To enter security updated DHHS Customer Support Only 2 Referral Menu To process referrals 3 Claims Menu To process claims 4 Collections To process payments 5 Disqualifications To process disqualifications 6 Maintenance Menu To transfer and reassign cases B Main Menu Function Keys Option Description F1 To access EPICS on line help F2 To exit EPICS C To Access a Main Menu Option After you complete the EPICS logon procedures select a MAIN MENU option to add update or view data in EPICS ENTERPRISE
122. UTION This report is available in XPTR RETENTION PERIOD Three Years 48 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 FRD441 FIELD DESCRIPTIONS FIELD DESCRIPTION COUNTY NAME The name of the county the report applies to REFERRAL ID 10 digit ID generated by EPICS upon creation of a referral PROGRAM Code that identifies the benefits program to which the payment applies PAY RECEIPT The receipt number for the payment entered in EPICS this is a system generated number NAME The full name of the debtor making the payment Last Name First Name Middle Initial CLAIM CATEGORY Up to 3 characters code that specifies the type of claim DATE ENTERED The date the payment was actually created in EPICS Note This date may be different from the Date Received field in EPICS PAY RCV DATE Date the county enters as being received defaults to current date unless changed PAY TYPE The method of collection for the payment made PAY AMOUNT The amount of the payment made that is applied to the balance CLAIM BALANCE The current balance on the claim after all payments have been subtracted TOTAL BY PROGRAM The total amount of dollars received for the specified program COUNTY TOTAL The grand total of payments made for all programs 20 FRD 501 LIST OF ACTIVE CLAIMS REPORT PURPOSE This report shows all active claims in the co
123. Update An O Code Appeal Flag There are times when a debtor was selected for DOR intercept and should not have been The O code was created to generate an automatic refund to a debtor 1 From the MAIN MENU key the number 4 in the Enter Option field and press Enter The COLLECTIONS MENU displays 2 In the ENTER OPTION field key the number 4 and press Enter The NC DEBT SETOFF PENDING screen displays FR45 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 02 28 2001 FRD0450 NC DEBT SETOFF PENDING INTERCEPTS 10 57 34 MORE SSN NAME IND ID DOB SEX APL CURRENT AMOUNT INTERCEPT NOTICE S IND PGM REFERRAL EST DATE CNTY BALANCE INTERCEPTD DATE DATE PF1 HELP PF3 EXIT PF4 LIST PF5 CLAIM DTL PF6 DEBTOR DTL PF7 PREV PF8 NEXT PF9 UPDATE PF10 PYMT INDU PF11 PYMT REFERAL PF12 CANCEL i Change 1 2005 VIII ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS 3 COLLECTIONS March 1 2005 In the SSN field key the SSN of the debtor and press Enter The referrals eligible for appeal or pending referrals that have been appealed will appear In the S column key an S beside the referral that requires an appeal to be set or the appeal that needs to be updated NOTE There may be multiple screens to view If necessary press the F8 function key to view the next screen of individuals and press the F7 function key to view the previous screen of individuals In the APL IND field key the code O
124. Y CONTROL SYSTEM EPICS Change 1 2004 2 CLAIMS JULY 1 2004 To Delete a Claim State Level access only A claim is never completely deleted from EPICS However a function exists to disassociate the claim to the referral performing a soft delete If an invalid claim is entered in error employees with State Level access only can perform a soft delete Prior to soft deleting a claim you should enter adjustments for payments received on the claim in order for the funds to be returned back to the debtor s similar to the procedures for making a refund Lastly all debtors assigned to the claim must be soft deleted from the claim NOTE Payments against AFDC claims can not be adjusted After you perform the soft delete for a claim it can be retrieved from the database only for specific reporting functions A deletion date is assigned to the claim but does not display on the screen County level personnel should contact the DSS DMA office for deletion of a claim a From the MAIN MENU key the number 3 in the ENTER OPTION field and press Enter The CLAIMS MENU displays b From the CLAIMS MENU key the number 3 in the ENTER OPTION field and press Enter The CLAIM DETAIL screen displays C In the REFERRAL ID field key the referral ID and press Enter The claim information displays d Press the F10 function key e In the DELETE REASON CODE field key the reason code that explains why the claim is being deleted
125. YMENT CORRECTION screen displays Complete a payment correction by pressing F6 CORRECT f Enter the REFUND AMOUNT and REFUND FEE Press F8 REFUND A confirmation message is displayed WAS REFUND FEE ENTERED CONFIRM BY PRESSING F8 Press F8 again The payment is adjusted out and displays as ADJ D Top Payment Reversal A notice is generated when a TOP Payment Reversal is manually completed 1 From the MAIN MENU select option 4 COLLECTIONS MENU 2 From the COLLECTIONS MENU select option 3 PAYMENT HISTORY BY INDIVIDUAL 3 On the PAYMENT HISTORY BY INDIVIDUAL screen key the individual ID number and press ENTER The payment history for that individual displays 4 Enter an S by the TOP payment for which a correction is needed The PAYMENTS screen displays Press F8 CORRECT Press ENTER 5 The TOP PAYMENT CORRECTION screen displays Press F9 REVERSAL E TOP Payment Correction Screen FR39 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 03 02 2004 FRDO392 TOP PAYMENT CORRECTION 15 44 01 ORIGINAL RECEIPT 0000220516 DATE RECEIVED 03 08 2002 PAYMENT AMOUNT 999 80 METHOD OF COLLECTION T___ PAYOR NAME CORRECTION METHOD OF COLLECTION ADJ PAYMENT AMOUNT 999 80 REFUND AMOUNT 0 00 CORRECTION DATE 03 02 2004 REFUND FEE RECEIPT 0000000000 RECEIPT 0000000000 PAYMENT COMMENT PAYMENT CORRECTION FOR RECEIPT 0000220516 TO REFUND YOU MUST FIRST DO PAYMENT CORRECTION F3 EXIT
126. YSTEM EPICS CASE MAINTENANCE Change 2 2004 A County Transfer Field Descriptions September 13 2004 FIELD DESCRIPTION REQUIRED SYSTEM GENERATED OPTIONAL INDIVIDUAL ID 10 digit individual ID of the person cases being transferred X COUNTY Three character code uniquely identifying the county the case is being transferred from NAME The full name of the full individual whose case s is being transferred SSN The SSN of the individual whose case s is being transferred DOB The DOB of the individual whose case s is being transferred SEX The sex of the individual whose case s is being transferred The selection field for viewing the details for a specified referral REFERRAL ID 10 digit number generated by the system upon creation of a referral ST A code representing the status of the referral PROGRAM The benefit program in which the individual currently has an overpayment INVESTIGATOR ID A unique number assigned by the county to identify the investigator currently assigned to the case TRANSFER TO COUNTY Three character code uniquely identifying the county the case s is being transferred to EFFECTIVE DATE OF TRANSFER The date the case s is to be effectively assigned to the new county ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change
127. YSTEM 02 03 02 FRD 0410 PAYMENT HISTORY BY INDIVIDUAL 13 01 17 INDIVIDUAL ID MORE NAME SSN DOB SEX OVER S RECEIPT PAYDATE REFERRAL METH AMOUNT APPLIED CHECKNO COLLECTION F1 HELP F3 EXIT F4 LIST F7 PREV F8 NEXT F12 CANCEL 3 In the INDIVIDUAL ID field key the ID and press Enter The payment history list displays if a history exists 2 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 COLLECTIONS March 1 2005 4 View the list NOTE If there are multiple payments you may need to view one than 1 screen Press the F8 function key to view the next screen of history and press the F7 function key to return to the previous screen of history if necessary 5 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays D View Payment Details By Individual 1 From the MAIN MENU key the number 4 in the Enter Option field and press Enter The COLLECTIONS MENU displays 2 In the ENTER OPTION field key the number 3 and press Enter The PAYMENT HISTORY BY INDIVIDUAL screen displays 3 In the INDIVIDUAL ID field key the ID and press Enter The payment history information displays 4 To select and view the payment key an S in the S column to the left of the payment entry NOTE If there are multiple payments you may need to view more than 1 screen Press the F8 function key to view the next screen of history and press the F7 function key to return to the pre
128. alification will begin PROGRAM CASE ID Up to 9 characters Identifies the Program Case ID associated with the disqualification REFERRAL 10 digit ID generated by the system upon creation of a referral associated with the disqualification ACT CODE Code describing the last activity made to the Disqualification record Add Key Change Update or Transfer ACT DATE Date MM DD YYYY describing when the last activity to the Disqualification record was made 2 FRD 422 INVESTIGATOR S MAINTENANCE REPORT DISQUALIFICATION ENDING REPORT PURPOSE This report reflects those disqualifications that end in the upcoming month ACTION REQUIRED Counties should review this report Counties should use this report to remove the disqualification status on clients whose disqualification period ends during the report month and enter the correct status REPORT SCHEDULE Runs on a monthly basis end of the month REPORT SECURITY LEVEL This report is viewable at the owner county level i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 REPORT DISTRIBUTION This report is available in XPTR and is now 15 versions to the counties RETENTION PERIOD Three Years FRD422 FIELD DESCRIPTIONS FIELD DESCRIPTION DQ COUNTY Three character code and name uniquely identifying the county PROGRAM Identifies the program the person has been
129. and year Also shows the incentive amount for the month quarter and year EBT DEBITS The gross adjusted and net amount of Food Stamp EBT Debits collected for Food Stamp claims for the month quarter and year Also shows the incentive amount for the month quarter and year FOOD STAMP REVERSALS The gross adjusted and net amount of recoupments RECOUPMENTS reversals on Food Stamp IPV IHE and AE claims for the month quarter and year Also shows the reversal incentive amount for the month quarter and year TOTALS The total dollar amount of funds collected and reversed for Food Stamp claims for the month quarter and year 16 FRD 429 NC DEBT EXEMPT REPORT PURPOSE This report is used to show all claim debtors that were exempt from DOR ACTION REQUIRED When the exemption code is no longer applicable the county must change it The county can only enter codes H L or S State staff must enter the X code REPORT SCHEDULE Runs on a weekly basis REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is only available in XPTR s ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 RETENTION PERIOD Three Years FRD429 FIELD DESCRIPTIONS FIELD DESCRIPTION COUNTY NAME Three character code identifying the county INVESTIGATOR ID that corresponds to the in
130. anic M Hispanic Mexican American N Not Hispanic or Latino P Hispanic Puerto Rican U Unreported ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 APPENDIX B CLAIM CODES September 13 2004 I LANGUAGE CODE DESCRIPTION sd AR Arabic CA Cambodian CH Chinese EN English FC French Creole FR French GE German GR Greek GU Gujarati HI Hindi HM Hmong HU Hungarian IT Italian JA Japanese KO Korean LA Laotian MI Miao MK Mon Khmer OT Other PC Portuguese Creole PE Persian PG Portuguese PO Polish RU Russian SC Serbo Croation SP Spanish TA Tagalog TH Thai UR URDU VI Vietnamese J DELETE REASON CODE DEBTOR CODE DESCRIPTION B Bankruptcy D Death no estate E Entered in error or individual not financially responsible O Other ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 APPENDIX B CLAIM CODES September 13 2004 K NC DEBT SETOFF NC TAX INTERCEPT INDICATOR DEBTOR DESCRIPTION Hearing in process Litigation in process State Controller Waived Permanently Excluded Due Process 30 Day Period Claim was selected for setoff L FEDERAL TAX INTERCEPT INDICATOR FOOD STAMPS ONLY DEBTOR INDICATOR DESCRIPTION Address Request for Pre Offset Begin 60 Day Notice Perio
131. ast performed on the disqualification LAST ACTIVITY DATE Date on which the last activity occurred LAST NAME The client or debtor s last name from Name Search CNDS METHOD OF COLLECTION The means by which the overpayment is collected See Appendix C ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 MIDDLE INITIAL The client s or debtor s middle initial of the full name N NAME The Last Name First Name Middle Initial of the client or debtor NATURE OF REFERRAL Code used to designate the nature of suspected See Appendix A NEW INVESTGIATOR The investigator ID and full name of the new investigator being assigned to the specified cases NUMBER OF PAYMENTS The total number of payments required by the debtor to pay off the balance of the claim O OPEN DATE Date MM DD YYYY The investigator opened the case ORIGINATING COUNTY The ID for the county in which the suspected overpayment took place OTHER REFERRAL A code used for Type of Referral OVERPAYMENT AMOUNT The established amount due from the claim OVERPAYMENT BEGIN DATE Start date of the overpayment OVERPAYMENT END DATE End date of the overpayment OVERPAYMENT PERIOD Actual beginning and ending date of the overpayment GLOSSARY July 1 2004 OVERPAYMENT OVERISSUANCE PERIOD Actual beginning and ending date of the overpayment overissuance OVERPAYMENT OVERISSUANCE BALANCE Cu
132. ate Match New Mexico NV Interstate Match Nevada NY Interstate Match New York OH Interstate Match Ohio OK Interstate Match Oklahoma OR Interstate Match Oregon OT Out of State Transfer PA Interstate Match Pennsylvania RI Interstate Match Rhode Island SC Interstate Match South Carolina SD Interstate Match South Dakota TN Interstate Match Tennessee TX Interstate Match Texas UT Interstate Match Utah ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 APPENDIX A REFERRAL CODES July 1 2004 SOURCE DESCRIPTION VA Interstate Match Virginia VT Interstate Match Vermont WA Interstate Match Washington WI Interstate Match Wisconsin WV Interstate Match West Virginia WY Interstate Match Wyoming 01 Quality Control QC Review Referral 02 Employee Security Commission ESC 03 Audit Finding 04 County Discovery 05 Department of Motor Vehicle DMV Match 06 Financial Resource Report IRS Match 07 Management Evaluation ME 08 Repayment of Benefits Continued Pending Hearing Decision 09 Citizens Report 11 Law Enforcement Agency Report 12 SDX 13 Bendex 14 Unemployment Insurance Benefits IEVS 15 Beneficiary Earnings Exchange Report BEER 16 Credit Bureau Match 17 Veteran s Administration Match 18 Electronic Benefit Transfer EBT 19 Disas
133. ate a referral After the referral is created return to the REFERRAL DETAIL 1 screen to access SPIN OFF If the REFERRAL DETAIL 2 screen is displayed press the F12 function key From the REFERRAL DETAIL 1 screen press the F11 function key NOTE The spin off function clears the REFERRAL ID REFERRAL STATUS PROGRAM ID CASE ID COUNTY CASE SUSPECTED AMOUNT SUSPECTED OP OI PERIOD fields It also clears the ALLEGATIONS field on the REFERRAL DETAIL 2 screen In the PROGRAM field key the code the identifies the benefits program to which the suspected overpayment applies In the CASE ID field key the individual s Case ID In the REFERRAL DATE field change the date if necessary In the DATE OF DISCOVERY field change the date if needed In the REFERRAL PERSON field change the name of the person who provided the referral information if necessary i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 8 10 11 12 13 14 15 REFERRALS July 1 2004 In the REFERRAL SOURCE field change the code that represents the source of violation if necessary In the NATURE OF REFERRAL field change the code that represents the nature of violation if necessary If applicable enter modify data in all optional fields on REFERRAL DETAIL 1 screen To add save the referral details press the F6 function key The REFERRAL DETAIL 2 screen displays In the ALLEGATIONS field key a description o
134. ated Claims G REPORTS FOR FS TANF 1 FRD 419 MONTHLY LISTING OF DISQUALIFIED RECIPIENTS RECORDS REPORT PURPOSE This report is a cumulative list of all disqualified individuals in the county ACTION REQUIRED For review purposes only REPORT SCHEDULE Runs on a monthly basis 1 of each month REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is available in XPTR RETENTION PERIOD Three Years i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 FRD419 FIELD DESCRIPTIONS APPENDIX F REPORTS March 1 2005 FIELD DESCRIPTION COUNTY NAME The name of the county the report applies to COUNTY NBR Three character code uniquely identifying the county PRGM Identifies the program the person has been disqualified from FS or TANF NAME The full name of the person being disqualified Last Name First Name SSN 9 digit Social Security Number of the person being disqualified BIRTH DATE The date the individual being disqualified was born MM DD YYYY SEX 1 character code for the individual being disqualified M or F DQ METHOD 1 character code identifying the method by which the disqualification was established DECISION DATE DQ NO The date MM DD YYYY the disqualification was decided The disqualification number of offense 1 2 or 3 START DATE The date MM DD YYYY the disqu
135. automatically populate with Change and the Current Date 6 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays l Enter A Key Change You can only enter a Key change for a disqualification in the state of North Carolina i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 DISQUALIFICATIONS July 1 2004 1 From the MAIN MENU key the number 5 in the ENTER OPTION field and press Enter The DISQUALIFICATION INQUIRY screen displays NOTE If you do not know the code or value for a field you can use the F4 function key which displays a list of codes or values for selection This field attribute is only available for those fields that contain a plus sign to the right of the field 2 Key the SSN of the individual and press ENTER The disqualification list displays NOTE If there are multiple individuals associated to the SSN a message displays ENTERED SSN HAS MULTIPLE CLIENTS INVOKE SEARCH 3 Key an S in the selection column of the disqualification you wish to display and press Enter The DISQUALFICATION DETAIL screen displays with the individual s information you selected filled in 4 Change the DQ Number or DQ Decision Date fields as necessary 5 To save the changes press the F11 function key NOTE The Last Activity field will automatically populate with Key Change and the Current Date 6 To exit and return to the MAIN MENU
136. available for those fields that contain a plus sign to the right of the field 3 In the REFERRAL TYPE field key the code for the type of referral Code Value F Front End O Other P Project Recall R Regular 4 In the INDIVIDUAL ID field key the case head payee s ID 5 In the PROGRAM field key the code that identifies the program to which the suspected overpayment applies You may use the equal key and F4 key to obtain the list of codes From the list of codes enter an S under the SELECT column by the appropriate code Press ENTER The code selected is brought forward to the PROGRAM field 6 In the CASE ID field key the individual s Case ID If the case ID program cannot be validated the following error message is displayed CASE ID IS NOT FOUND REVIEW CASE OR CALL EPICS AUTOMATION The override function can only be completed by State Staff Program Integrity Staff when applicable a Food Stamps 1 For R O and P referral types the CASE ID entered on the screen must exist in the FSIS Active Master file or the FSIS Inactive Master file Any transaction code type is acceptable 2 For F referral types the Case ID entered on the screen must exist in the FSIS Active Master file and must have a transaction code of 1 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 10 REFERRALS July 1 2004 b AFDC TANF 1 For R O and P referral typ
137. ble in XPTR RETENTION PERIOD Three Years ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 FRD206 FIELD DESCRIPTIONS FIELD DESCRIPTION PROGRAM The program associated with the override COUNTY The name of the county the report applies to CLIENT NAME The full name of the casehead payee the referral applies to Last Name First Name Middle Initial CASE ID Up to 9 characters Identifies the Program Case ID associated with the referral OVERPAYMENT PERIOD 10 character date identifying the begin and ending dates of the overpayment MM DD YYYY CLAIM AMOUNT The current balance due on the claim OPERATOR ID RACE ID of the person implementing the override DATE OVERRIDDEN 10 character date the override took place MM DD YYYY 7 FRD 213 CLAIMS SELECTED FOR NC DEBT SETOFF REPORT PURPOSE This report list claim debtors for all programs that have been selected for NC Debt Setoff ACTION REQUIRED No action required unless the select status has changed If the status changes reset the NC Debt Setoff Indicator flag on the Debtor Detail Screen REPORT SCHEDULE Run on a weekly basis REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is available in XPTR RETENTION PERIOD Three Years ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPO
138. coupment appears on the FRD401 EIS Recoupment Error Report due to the following errors No Claim to post money Individual not a debtor in EPICS Recoupment Amount Exceeds 99 Invalid Recoupment Amount Apply Payment Error Either 1 Post the recoupment in EPICS using LR Method of Collection 2 Issue supplemental benefits through EIS 3 Both a and b EIS recoupments are posted the 15 of each month in EPICS XII FSIS RECOUPMENT PROCESS A EPICS identifies all FS claims that are eligible for recoupment To be eligible for recoupment 1 The Referral Status must equal CO 2 The Program must be FS 3 The Claim Balance must be greater than zero Calculation of the balance in EPICS for the FSIS case is completed by determining the oldest claim for all debtors that are associated with the particular FSIS case a If the oldest claim is IPV the balance is the sum of all IPV claims b If the oldest claim is AE the balance is the sum of AE IHE and SIE claims Cc If the oldest claim is IHE the balance is the sum of AE IHE and SIE claims d If the oldest claim is SIE the balance is the sum of AE IHE and SIE claims i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 COLLECTIONS March 1 2005 4 The Claim has not been deleted 5 The Claim Category must be IPV IHE AE or SIE 6 The Claim Substantiation Method is not S or D 7 The Letter of Overissuance date must be the current date minus
139. creen C Reassign A Case s To A New Investigator 1 From the Main Menu key the number 6 in the Enter Option field and press Enter The MAINTENANCE MENU displays FRO9 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 06 29 2004 FRDOOSO MAINTENANCE MENU 11 32 38 1 County Transfer 2 Case Reassignment 3 Caseload Reassignment 4 Name Search Name List Enter Option _ F1 HELP F3 EXIT ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CASE MAINTENANCE July 1 2004 2 From the MAINTENANCE MENU key the number 2 in the Enter Option field and press Enter The CASE REASSIGNMENT screen displays FR47 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 02 24 2004 FRCR CASE REASSIGNMENT 11 11 04 CURRENT INVESTIGATOR 4 STARTING REFERRAL ID CASE EFFECTIVE S REFERRAL ST PROG IND ID CLIENT NAME ASSIGNED REASSIGNMENT NEW INVESTIGATOR EFFECTIVE DATE OF REASSIGNMENT COMMENTS F1 HELP F3 EXIT F4 LIST F5 DETAIL F7 PREV F8 NEXT F11 REASSIGN F12 CANCEL In the INVESTIGATOR ID field enter the investigator s ID whose case s s are being reassigned NOTE If you do not know the code or value for a field you can use the F4 function key which displays a list of codes or values for selection This field attribute is only available for those fields that contain a plus sign to the right of the field If you choose this option you will have to select the investigator from the AUTHORIZED U
140. current balance for same program type must total a minimum for 50 00 C Claim Debtor s NC Debt Setoff flag on the Debtor Detail screen is set to Y indicating that the individual was selected for setoff This process is done automatically by a batch job D DOR receives the file and processes the Tax Refund job E DOR returns the results to EPICS by individual s SSN and the program s eligible for intercept F DHHS reconciles the funds and processes the eventual posting of payments NOTE Atthis point the debtor s money has been intercepted and is placed in a holding place until the process is complete Any exemption codes entered will not stop the money from being taken but will generate a refund once the process is complete G EPICS sends out a 30 day notice to the debtor The debtor s NC Debt Setoff flag on the Debtor Detail screen is set to D indicating that the individual is in the 30 Day period process H All names that are in the 30 Day process appear on the NC Debt Setoff Pending Intercept under Collections Menu NOTE These names will remain on this list until the appeal complete payment has been posted or refund has been issued 36 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CLAIMS SEPTEMBER 13 2004 l The debtor now can waive the right to appeal or request an appeal 1 If the debtor waives the right to appeal the payment is processed immediately
141. d Certified Request on Top file Certified But Deferred Due to Delinquency Rule Exempt TOP During 60 Day Notice Due to Repayment Hearing in Progress Blocks Certification Inactivate request on Top file Litigation in Progress Blocks Certification Permanently close offset request State Controller waived Blocks Certification XN VT LM OO gt Permanently blocked Certification M FEDERAL TAX INTERCEPT APPEAL INDICATOR DEBTOR INDICATOR DESCRIPTION N Appeal Denied Appeal in favor of the County R Request for Appeal W Waived Appeal Y Appeal in favor of Debtor N FREQUENCY REPAYMENT APPROACH FREQUENCY DESCRIPTION B Bi Weekly M Monthly Q Quarterly W Weekly ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 APPENDIX B CLAIM CODES September 13 2004 O PAYMENT METHOD REPAYMENT APPROACH METHOD DESCRIPTION A Garnishment Article 60 ADJ Adjustment C Cash CI Civil Court CR Criminal Court EB EBT Food Stamps only G Garnishment H Garnishment Hatch Act N State Intercept O Offset Food Stamps only R Recoupment S Stamps Food Stamps only T Federal Intercept V Voluntary Payroll deduction ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 APPENDIX C PAYMENT CODES July 1 2004 220
142. d INVALID LANGUAGE PREF CODE CHECK MANUAL i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CASE MAINTENANCE September 13 2004 h Address If the address is not entered the field is highlighted and the following error message is displayed MANDATORY FIELD DATA IS MISSING i Address Type The Address Type field is populated by EPICS with PHYS and is protected i County Code If the three digit County Code is not entered the field is highlighted and the following error message is displayed MANDATORY FIELD DATA IS MISSING k Phone Number The Phone Number field is an optional field Phone Number Type The Phone Number Type field is populated by EPICS with HOME and is protected m Press the F6 function key to assign the individual ID number When the assignment is successful the individual ID number is displayed in the Individual ID field and following message is displayed Person and Address Created Successfully n Press the F12 function key twice to return to the Maintenance Menu Press the F3 function key to return to the Main Menu i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 B CASE MAINTENANCE September 13 2004 Update of Individual Demographic Data All demographic data is protected and cannot be changed updated thru EPICS Demographic data must be changed updated in either EIS or FSIS thru the Name Change function Change Address And Or Phone Number
143. d key the ID of the debtor you need to add a repayment agreement against and press Enter In the PAYMENT AMOUNT field key the amount the debtor will pay each time a payment is made In the FREQUENCY field key a frequency code indicating how often the debtor will make payments In the PAYMENT METHOD field key a method by which the debtor will pay In the 1st PAYMENT DUE DATE field key the date the debtor s first payment is due In the REPAYMENT AGREEMENT field key an Y yes or N no whether a Repayment Agreement has been signed with the debtor NOTE If the repayment agreement has been signed and you keyed Y in the REPAYMENT AGREEMENT field key a date in the DATE SIGNED field indicating when the debtor signed the actual repayment agreement To update the repayment agreement information press the F9 function key NOTE The NUMBER OF PAYMENTS field is calculated automatically To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays D Update Repayment Approach Information 1 If you are entering from the CLAIMS MENU key the number 4 in the ENTER OPTION field and press Enter or If you are entering from the DEBTOR DETAIL screen press the F5 function key The REPAYMENT APPROACH screen displays along with the debtor s current repayment agreement In the REFERRAL ID field key the referral number that is associated to the claim and press Tab NOTE If you do not know the c
144. do not know the referral ID you can use the F4 key which displays the REFERRAL LIST screen 4 In the REFERRAL STATUS field enter CD for Collection NOTE All fields become unprotected with exception of the client s demographic information and the assign accept and open fields The referral is assigned to the original investigator If the referral needs to be reassigned to another investigator the supervisor must do this via Case Reassignment 5 To complete the transfer press the F9 function key 6 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays F To Create a Referral from an Out of State Source If a county receives an allegation against a client from an out of state source the referral must be entered in EPICS For example Gates County receives a phone call from a person in VA that someone in their county is committing a suspected fraud This is considered a Transfer from Out of State referral 1 From the MAIN MENU key the number 2 in the Enter Option field and press Enter The REFERRAL MENU displays From the REFERRAL MENU key the number 3 in the Enter Option field and press Enter The REFERRAL DETAIL 1 screen displays NOTE If you do not know the code or value for a field you can use the F4 key which displays a list of codes or values for selection This field attribute is only available for those fields that contain a plus sign to the right of the field In the
145. ds that contain a plus sign to the right of the field To enter field details using F4 1 In the field that contains a plus sign to the right of the field type equal sign and press F4 The specific code list screen displays To select a code or value navigate to the appropriate code value in the S column and type s Press Enter The previous screen displays with the field populated with the selected code or value Continue entering or updating the screen details s ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 GETTING STARTED July 1 2004 101 GETTING STARTED Change 1 2004 July 1 2004 l THIS CHAPTER e Describes how to access EPICS e Describes Main Menu options e Describes Main Menu function keys e Describes how to access a Main Menu option and e Describes how to exit EPICS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 GETTING STARTED July 1 2004 ll ACCESSING EPICS You can access EPICS via a terminal or personal computer A To Access EPICS Via a Terminal 1 Open the Mainframe State Banner screen 2 From the State Banner screen key CICSSCC4 and press Enter 3 In the Userid field key your RACF ID 4 Press Tab 5 In the bill cde field key FRP DHR 6 Press Tab 7 In the Password field key your password 8 Press Enter A blank CICS screen displays 9 Key FRO1 and press Enter The EPICS MAIN MENU displays NOTE T
146. e F3 function key The MAIN MENU displays D Update Maintain Client Information 1 From the MAIN MENU key the number 3 in the ENTER OPTION field and press Enter The CLAIMS MENU displays 2 From the CLAIMS MENU key the number 3 in the ENTER OPTION field and press Enter The CLAIM DETAIL screen displays 3 In the REFERRAL ID field key the referral ID and press Enter The claim information displays 4 Press the F5 function key The DEBTOR SUMMARY screen displays 5 Key an S in the selection field to the left of the debtor that you need to update and press the F9 function key or Enter The DEBTOR DETAIL screen displays 6 Press the F11 function key The MAINTAIN CLIENT screen displays 7 Update the ADDRESS or PHONE NUMBER fields 8 To save the update press the F9 function key 9 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays or To return to the DEBTOR DETAIL screen press the F12 function key 1 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CLAIMS JULY 1 2004 IX REPAYMENT APPROACH Each debtor is responsible for repayment of the debt It is the responsibility of the investigator to attempt and negotiate a repayment agreement with the debtor It is required that the repayment agreement information e g amount of each payment frequency first payment due and payment method be recorded in EPICS via the Repayment Approach screen EPICS utilizes this
147. e as a suffix or last letter of the program code i e MAAC MAAN and MAFF ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 APPENDIX A REFERRAL CODES July 1 2004 D REFERRAL SOURCE SOURCE DESCRIPTION AK Interstate Match Alaska AL Interstate Match Alabama AZ Interstate Match Arizona CA Interstate Match California CO Interstate Match Colorado CT Interstate Match Connecticut DC Interstate Match District of Columbia DE Interstate Match Delaware FL Interstate Match Florida GA Interstate Match Georgia HI Interstate Match Hawaii IA Interstate Match lowa ID Interstate Match Idaho IL Interstate Match Illinois IN Interstate Match Indiana KS Interstate Match Kansas KY Interstate Match Kentucky LA Interstate Match Louisiana MA Interstate Match Massachusetts MD Interstate Match Maryland ME Interstate Match Maine MI Interstate Match Michigan MN Interstate Match Minnesota MO Interstate Match Missouri MS Interstate Match Mississippi MT Interstate Match Montana NC Interstate Match North Carolina ND Interstate Match North Dakota NE Interstate Match Nebraska NH Interstate Match New Hampshire NJ Interstate Match New Jersey NM Interst
148. e for the fraud Overpayment 10 character date X End Date MM DD YYYY of the end date for the fraud Initial Balance Up to 9 character xX Due amount of the overpayment Date Entered 10 character date X the repayment agreement is entered in EPICS Payment Up to 9 X Amount characters debtor s monthly payment 44 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS JULY 1 2004 Change 1 2004 CLAIMS Field Description Required System Generated Optional Frequency 1 character code representing how often the debtor is expected to make payments X Number of Payments Up to 3 characters represents the total number of payments required by the debtor to pay off the balance of the claim Payment Method Up to 4 characters method by which the debtor will use to make a payment 1 Payment Due Date 10 character date MM DD YYYY when the debtor s first payment is due Repayment Agreement 1 character code Y or N indicating that the repayment agreement has not been signed Date Signed 10 character date MM DD YYYY required when the repayment agreement was signed Defaults to current date 45 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CLAIMS SEPTEMBER 13 2004 B Repayment Approach Function Keys Function Key Description F1 To access EPICS on lin
149. e given quarter This number may reflect a positive or negative figure Dollar Amount Formula Line 3 Active Claim Subtotal Line 4 New Claims Established Line 5 Category Transfers ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 FIELD DESCRIPTION LINE 6 CONT D Number Formula Line 3 Active Claim Subtotal Line 4 New Claims Established Line 5 Category Transfers LINE 7A CHECK CASH M O This line is used to show all voluntary payments made in the form of cash check or money order for each heading IPV Fraud IHE Non Fraud AE Non Fraud made during the given quarter LINE 7B TOP PRE OFFSET Voluntary payments C Cash This code would also be used for check or money order FSC Food Stamp Cash This line is used to show all voluntary payments made by the debtor during the 60 day notice period Stage B for the given quarter This number is All C Payments that have occurred during the report quarter The Claim Debtor related to the payment if Federal Tax Intercept Notice date is prior to the payment AND if the payment date is within 60 days of the notice date this payment is considered a TOP Pre Offset Payment These payments are included in Line 7a 7C TOP INTERCEPT This line is used to show all TOP payments made for each heading IPV Fraud IHE Non Fraud AE Non Fra
150. e help F2 To clear the screen F3 To exit and return to the Main Menu F4 To display a list F9 To add update a repayment agreement information F12 To cancel or return to the previous screen C Enter Repayment Approach Information For A Debtor You can access the REPAYMENT APPROACH screen from the CLAIMS MENU or the DEBTOR DETAIL screen 1 If you are entering from the CLAIMS MENU key the number 4 in the ENTER OPTION field and press ENTER The Repayment Screen displays or If you are entering from the DEBTOR DETAIL screen press the F5 function key The REPAYMENT APPROACH screen displays FR31 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 08 24 2004 FRDO310 REPAYMENT APPROACH 11 2231 REFERRAL ID REFERRAL TYPE _ REFERRAL STATUS __ DEBTOR NAME IND ID SSN DOB SEX COUNTY PROGRAM CASE ID COUNTY CASE REFERRAL DATE INVESTIGATOR ID OVERPAYMENT BEGIN DATE OVERPAYMENT END DATE INITIAL BALANCE DUE 0 00 DATE ENTERED 08 24 2004 PAYMENT AMOUNT 0 00 FREQUENCY _ NUMBER OF PAYMENTS ___ PAYMENT METHOD 1ST PAYMENT DUE DATE REPAYMENT AGREEMENT _ DATE SIGNED F1 HELP F2 CLEAR F3 EXIT F4 LIST F9 UPDATE F12 CANCEL 2 In the REFERRAL ID field key the referral number of the individual you need to add a repayment and press the Tab key 46 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 3 10 CLAIMS JULY 1 2004 In the INDIVIDUAL ID fiel
151. e month REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is available in XPTR RETENTION PERIOD Three Years FRD420 FIELD DESCRIPTIONS FIELD DESCRIPTION COUNTY Three character code identifying the county INVESTIGATOR ID that corresponds to the investigator assigned to the referral REFERRAL ID 10 digit ID generated by EPICS upon the creation of a referral REFERRAL STATUS 2 character code identifying the current status of the referral PROGRAM Identifies the Program associated with the referral PROGRAM CASE ID Up to 9 characters Identifies the Program Case ID associated with the referral i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 FIELD DESCRIPTION CLIENT NAME The full name of the client Last Name First Name Middle Initial DATE OF DISCOVERY This is the Date of Discovery that is displayed on the Referral Detail 1 screen ASSIGNMENT DATE 10 character date MM DD YYYY the referral was assigned to the investigator TYPE 1 character code identifying the type of referral ESTABLISHED DATE 10 character date in which the claim was created in EPICS system generated date DAYS IN PENDING STATUS For those claims in CO and OT status this is the number of days that pended from the Date of Discovery to the Establishment Date Day one i
152. e total dollar amount of cash collected on AFDC claims for the quarter OUTSTANDING BALANCE The total dollar amount owed on AFDC claims CLAIMS WITH OVERPAYMENT MONTHS AFTER 1 1 97 TANF Lists TANF claims that have overpayments after 1 1 97 NUMBER OF CLAIMS EST The total number of TANF claims established CO status DOLLAR AMOUNT OF The current balance total for all TANF claims CLAIMS EST established CO TOTAL CLAIMS The total number of TANF claims existing for the county RECOUPMENT COLLECTION The total amount of recoupments collected on TANF AMOUNT claims for the quarter CASH COLLECTION AMOUNT OUTSTANDING BALANCE The total dollar amount of cash collected on TANF claims for the quarter The total dollar amount owed on TANF claims 27 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 2 FRD 105 TOP AND DOR REFUND REPORT REPORT PURPOSE This report shows all overcollections on claims for DOR and TOP and what is to be refunded back to the debtor The DOR and TOP refunds will be made by the State Controller s Office ACTION REQUIRED Review for accuracy If the overcollected amount should not be refunded the appropriate State Office should be contacted immediately This may happen if a cash payment was posted incorrectly in the county REPORT SCHEDULE The report is scheduled to run on a daily basis REPORT SECURITY LEVEL
153. eater cash payment of the total TOP eligible claim balances within the last 60 days Debtor must not have a recoupment in the past 60 days Claim can not be greater than 10 years old beginning from the date the Letter of Overissuance was issued unless there is a Civil Criminal Judgement date D Debtor s TOP Intercept Indicator field is set to an A and the ADDRESS REQ date is updated indicating the Pre Offset Address Request was submitted This is done by a nightly update job At this point the certification process has begun TOP receives the file and processes for Tax Refund job 1 The ADDRESS REQ date field is updated with the date the TOP INTERCEPT IND is set to A This tracks the 181 days since the address request was submitted to TOP 2 The ADDRESS REQ date is protected and is removed when the system changes the TOP INTERCEPT IND from A to B 3 The date is removed if on the 181 day the TOP INTERCEPT IND is still A Ifall criteria are met the system again requests an address Once the address is requested from TOP the ADDRESS REQ data is again populated and the TOP INTERCEPT IND is set from space to A 4 The ADDRESS REQ date remains if the worker changes the TOP INTERCEPT IND from A to H S L or X 32 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CLAIMS SEPTEMBER 13 2004 5 If the ADDRESS REQ date is present and the date
154. ect a code or value tab to the appropriate code value in the S column and type s 3 Press Enter The previous screen displays with the field populated with the selected code or value 4 Continue entering or updating the screen details IV ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 DISQUALIFICATIONS July 1 2004 NAME SEARCH When you are working with referrals and are uncertain of the individual ID use the Name Search function This searching method provides you with the capability to search CNDS for an individual ID number There are 4 search criteria You can only select one search method e Name Sex Date of Birth only SSN social security number only Individual ID only e Case ID only A Name Search Function Key Descriptions Key Description F1 To access EPICS on line help F3 To exit and return to the Main Menu F4 To clear the search criteria fields F11 To display the Maintain Client screen F12 To return to the previous screen B Search An Individual ID Using The Name Search Function 1 In the INDIVIDUAL ID field key and press F4 The NAME SEARCH screen displays Select a search method and key the appropriate information in the field s To initiate the search press Enter The Name List screen displays with all records that match your search criteria In the Sel column key an S in the field next to the appropriate individual and press Enter The
155. ected is brought forward to the REFERRAL SOURCE field ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 REFERRALS July 1 2004 11 In the NATURE OF REFERRAL field key the code that represents the nature of violation You may use the equal key and F4 key to obtain the list of codes From the list of codes enter an S under the SELECT column by the appropriate code Press ENTER The code selected is brought forward to the NATURE OF REFERRAL field Code Value E Earned Income O Other R Reserve U Unearned Income 12 If applicable enter data in the optional fields NOTE To determine which fields are optional see Referral Detail 1 Field Descriptions 13 To add save the data on the REFERRAL DETAIL 1 screen and continue entering required data on REFERRAL DETAIL 2 screen press the F6 function key The REFERRAL DETAIL 2 screen displays FR21 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 06 29 2004 FRD0210 REFERRAL DETAIL 2 11 40 03 REFERRAL ID ALIAS NAMES EIS FSIS ADDRESS S Name S EPICS ADDRESS TYPE PHYS_ ALIAS SOCIAL SECURITY NUMBERS 0000 S SSN S TYPE PHONE NUMBER EXT ALLEGATIONS F1 HELP F3 EXIT F4 LIST F6 ADD F9 UPDATE F12 CANCEL NOTE EPICS attempts to validate the data ensuring all required fields are populated If not the system informs you of the fields that require details and wil
156. ed by the county to identify the investigator assigned to the case NC Disqualification only X DQ COUNTY CASE 7 digit case number used by the county NC Disqualification only XFER DQ COUNTY 3 digit number from 000 100 used to identify where the disqualification is being transferred NC Disqualification only REFERRAL ID 10 digit number generated by the system upon creation of a referral NC Disqualification only PROGRAM The benefit program the individual is being disqualified from COUNTY CASE 7 digit case number used by the county NC Disqualification only REF COUNTY 3 digit code between the values of 000 and 100 used to show which county currently owns the referral NC Disqualification only PGM CASE ID The case ID of the associated program NC Disqualification only ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS DISQUALIFICATIONS Change 1 2004 July 1 2004 FIELD DESCRIPTION REQUIRED SYSTEM GENERATED OPTIONAL REF INVEST 5 character ID that corresponds to the investigator assigned to the referral NC Disqualification only X DQ METHOD 1 character code identifying the method by which the disqualification is established NC Disqualification only DQ The disqualification number of offense DQ OFFENSE CODE A 1 digit alpha code identifying the type of offense DQ PE
157. eferral ID Debtor Individual ID Reason for Increase of Balance Correct Balance Amount Signature of Supervisor roang For Food Stamp Claims FAEP Program Integrity staff at 919 733 0645 Include on the fax request a Casehead Name b Referral ID C Debtor Individual ID d Reason for Increase of Balance e Correct Balance Amount f Signature of Supervisor 1 From the MAIN MENU key the number 4 in the Enter Option field and press Enter The COLLECTIONS MENU displays 2 In the ENTER OPTION field key the number 1 and press Enter The PAYMENTS screen displays 3 In the REFERRAL ID field key the ID and press Enter The referral displays 4 In the METHOD OF COLLECTION field key the code AJCI Adjustment Increase Current Balance 2 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 5 9 10 COLLECTIONS March 1 2005 In the PAYOR NAME field verify payor s name If necessary select a different payor NOTE The PAYOR NAME field defaults to the case head payee name In the PAYMENT AMOUNT field key the dollar amount of the increase to be made to the current balance NOTE The overpayment field can never be less than the current balance field If this occurs you must adjust the overpayment field prior to adjusting the current balance field In the DATE RECEIVED field key the date of the increase NOTE The DATE RECEIVED field defaults to today s date unless changed In the PAYME
158. efund TOP payment correction is used to back out a payment that has been applied to a claim No notice is sent to the debtor in this situation 1 Correction a From the MAIN MENU select option 4 COLLECTIONS MENU b From the COLLECTIONS MENU select option 3 PAYMENT HISTORY BY INDIVIDUAL C On the PAYMENT HISTORY BY INDIVIDUAL screen key the individual ID number and press ENTER The payment history for that individual displays d Enter an S by the TOP payment for which a correction is needed The PAYMENTS screen displays Press F8 CORRECT Press ENTER e The TOP PAYMENT CORRECTION displays with the payment information selected Press F6 CORRECT The payment is adjusted out The claim balance increases If the claim is in closed status CL the system changes to open status CO 2 Refund Before a refund can be completed the payment needs to be backed out See above for Correction instructions a b From the MAIN MENU select option 4 COLLECTIONS MENU From the COLLECTIONS MENU select option 3 PAYMENT HISTORY BY INDIVIDUAL On the PAYMENT HISTORY BY INDIVIDUAL screen key the individual ID number and press ENTER The payment history for that individual displays Enter an S by the TOP payment for which a correction is needed The PAYMENTS screen displays Press F8 CORRECT Press ENTER i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 COLLECTIONS March 1 2005 e The TOP PA
159. elds are unprotected 1 All Programs Except FS The NC DEBT SETOFF field is the only field unprotected This field is updated with a Y by the system if the debtor has been selected for DOR Exempt codes may be entered if the debtor should not be part of the DOR selection For further instructions please see the DOR process section FS Program a POST HEARING NOTICE The investigator stops the TOP Intercept Process by updating the TOP Intercept Indicator when the debtor has requested a hearing When the hearing has been held and the decision is in favor of the county and the Post Hearing Demand Notice has been sent the investigator enters the date the notice was sent to the debtor EPICS tracks this date and restarts the TOP process 1 This field is only allowed when the program is FS 2 The date must be in MM DD CCYY format 3 The date may be prior to or equal to the current date If the date entered is greater than the current date the following error message is displayed 25 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CLAIMS JULY 1 2004 DATE BE MUST LESS THAN OR EQUAL TO THE CURRENT DATE 4 This date is used by EPICS to recalculate the 180 days before it sends the debtor to TOP to be certified Day one of the 180 day calculation is the day after the Post Hearing Notice date If the TOP Intercept Indicator for the debtor is either A or B at the time the Post Hearing Notice date is
160. em is maintained through the Administration Menu screen The DHHS Customer Support Center maintains this screen Each user s security access rights is defined and assigned to one or more authorized user groups An authorized user group is defined as the type of security currently identified by EPICS Each authorized group will allow the user to have create read update and or delete rights The county security officer with the assistance of the county supervisor is responsible for ensuring all users access rights for their county are up to date with the Customer Support Center The county security officer has read only access to option County Detail was formerly named Locality located under Disqualification and is located under Administration Counties will not have access to Group Detail Screen Detail or Authorized User Detail A Administration Menu Options Option Description 1 Group Detail To create an authorized user group and set security access rights 2 Screen Detail To define the screens of the system 3 Authorized User Detail To create a new user profile or update an existing user profile access to authorized user groups 4 County Detail To view update the specific contact information for a county ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 ADMINISTRATION COUNTY DETAIL July 1 2004 B Administration Menu Function Keys Function Key Description F1 T
161. ent Payment Over Issuance OP Ol periods current balance and overpayment amount is to update the CLAIM DETAIL screen A Claim Detail Field Descriptions Field Description Required System Optional Generated Referral ID 10 digit number X generated by the system Referral Type Code that identifies X the type of referral Referral 2 character code for X Status the status of a referral Name Last name first X name and middle initial of the case head payee Individual ID Unique ID X associated with the case head payee supplied by CNDS SSN Case head payee s X social security number DOB Case head payee s X date of birth Sex Case head payee s X Sex ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS CLAIMS Change 1 2004 JULY 1 2004 Field Description Required System Generated Optional County 3 digit number from 000 100 representing the issuing county in which the overpayment took place X Program Code that identifies the benefits program to which the referral applies Case ID Program Case ID associated with referral County Case County case number associated with the referral Referral Date Date the referral was received Investigator ID ID of the investigator assigned to the referral Current Balance Up to 9 characters Current amount due on the claim Service code 2 charac
162. ent payor NOTE The PAYOR NAME field defaults to the case head payee name In the DATE RECEIVED field key the date of the compromise NOTE The DATE RECEIVED field defaults to today s date unless changed In the PAYMENTS COMMENTS field enter a description of undoing compromise if necessary To add save the adjustment press the F6 function key NOTE The RECEIPT NUMBER field is system generated upon undoing the compromise and the OP OI BALANCE field reflects the new balance To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays F Increase Current Balance STATE LEVEL ACCESS ONLY The CURRENT BALANCE can only be increased by State staff The error message INSUFFICIENT AUTHORIZATION RESTRICTED TO STATE PI STAFF ONLY CONTACT STATE PI is displayed should you attempt to adjust the CURRENT BALANCE If an adjustment is needed to increase the Current Balance the county must fax the request to i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 COLLECTIONS March 1 2005 For AFDC and Work First Claims Family Support and Child Welfare Services section at 919 715 6714 Include on the fax request Casehead Name Referral ID Debtor Individual ID Reason for Increase of Balance Correct Balance Amount Signature of Supervisor Aoa ED For Medicaid Claims DMA Program Integrity staff at 919 715 7706 Include on the fax request Casehead Name R
163. entify the investigator currently assigned to the case STARTING 10 digit Referral ID X REFERRAL ID Number S The selection field for X reassigning or viewing a specified referral REFERRAL 10 digit number X generated by the system upon creation of a referral ST A code representing X the status of the referral PROGRAM The benefit program X in which the individual currently has an overpayment ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CASE MAINTENANCE September 13 2004 FIELD DESCRIPTION REQUIRED SYSTEM OPTIONAL GENERATED IND ID The Individual ID X corresponding to the case head payee listed on the referral CLIENT NAME The full name of the x client listed on the referral NEW The investigator ID and X INVESTIGATOR full name of the new investigator being assigned to the case s EFFECTIVE DATE The date the case is to X OF be effectively assigned REASSIGNMENT _ to the new investigator COMMENTS A description of why the X transfer is occurring B Case Reassignment Function Keys FUNCTION Description F1 To access EPICS on line help F3 To exit and return to the Main Menu F4 To display a list F5 To display the selected referral F7 To display the previous screens page up F8 To display the next screen page down F11 To transfer the case s to a new investigator F12 To cancel and return to the previous s
164. er PC 1 To return to the MAIN MENU press the F3 function key The MAIN MENU displays NOTE From any screen in EPICS you can press the F3 function key to return to the MAIN MENU To exit EPICS press the F12 function key A PIE menu displays Press the F3 function key A blank CICS screen displays Key logoff and press Enter The STATE BANNER screen displays or Enter another transaction ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 REFERRALS July 1 2004 102 REFERRALS Change 2 2004 September 13 2004 l THIS CHAPTER PROVIDES INSTRUCTIONS AND INFORMATION FOR The Referral Menu function keys e The Referral Detail 1 fields The Referral Detail 1 functions keys The Referral Detail 2 fields The Referral Detail 2 function keys Creating a referral Creating a referral using Spin off The Referral List fields a The Referral List function keys Displaying a list of unassigned referrals and view referral details Assigning a referral Displaying a referral list and view referral details by county Displaying a referral list and view referral details by Investigator ID Accepting a referral Opening a referral Displaying a referral using the Referral Detail option Updating a referral Closing a referral Transferring a Referral Out of State Reopening a Referral From Out of State Status Creating a Referral from an Out of
165. error in the tax intercept process or a change in tax status These funds are returned to the client debtor The PAYMENT CORRECTION screen is utilized to correct a payment In order for a correction to a payment to be made the system defaults to enter the entire incorrect amount back to the account The person entering the payments must then enter a new payment for the correct amount For example if you entered a 500 00 payment and the amount should have been 50 00 you would have to make a payment correction for the 500 00 which will make the balance increase and make separate new payment of 50 00 which will make the balance decrease EPICS does not allow payment corrections for an AFDC claim outside of the current month because AFDC is no longer a valid funding source To apply a payment adjustment A From the MAIN MENU key the number 4 in the Enter Option field and press Enter The COLLECTIONS MENU displays B In the ENTER OPTION field key the number 1 and press Enter The PAYMENTS screen displays NOTE If you do not know the code or value for a field you can use the F4 key which displays a list of codes or values for selection This field attribute is only available on those fields that contain a plus sign to the right of the field C In the REFERRAL ID field key the ID and press Enter The referral information displays Or In the DEBTOR INDIVIDUAL ID field key the ID and press Enter The debtor informat
166. es benefits must have been issued for the Case ID and Program entered on the screen 2 For F referral types the Case ID and Program entered on the screen must currently exist in the EIS pending application database NOTE Front end referral with a program code of AFDC can not be entered in EPICS C Medicaid 1 For R O and P referral types benefits must have been issued for at least one individual associated with the Case ID and Program entered on the screen 2 For F referral types the Case ID and Program entered on the screen must currently exist in the EIS pending application database In the REFERRAL DATE field key the date the referral was received using the 10 character date format MM DD YYYY In the DATE OF DISCOVERY field key the date of discovery This is a required field and must be in MM DD CCYY format a This date cannot be greater than the REFERRAL DATE b This date cannot be greater than the current date C This date can be prior to or the same as the REFERRAL DATE d This date can be changed if the referral status is not CL TE or OT In the REFERRAL PERSON field key the name of the person who provided the referral information In the REFERRAL SOURCE field key the code that represents the source of violation You may use the equal key and F4 key to obtain the list of codes From the list of codes enter an S under the SELECT column by the appropriate code Press ENTER The code sel
167. estigator ID and the county in which they are assigned The referral list allows an investigator to view a list of all their referrals and select those referrals in a PE Pending status to accept them from the supervisor A supervisor can also query by a particular investigator number within their county 1 To display a referral list and view referral details by investigator ID a From the MAIN MENU key the number 2 in the Enter Option field and press Enter The REFERRAL MENU displays NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 06 29 2004 1 Referral List 2 Referral Detail 3 Create New Referral Enter Option _ F1 HELP F3 EXIT b From the REFERRAL MENU key the number 1 in the Enter Option field The REFERRAL LIST screen displays NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 06 29 2004 FRD0230 REFERRAL LIST 11 44 33 INVESTIGATOR ID COUNTY More REFERRAL S REFERRAL TYPE STAT DATE PROGRAM LAST NAME FIRST INDIVID ID F1 HELP F3 EXIT F4 LIST F6 DETAIL F7 PREV F8 NEXT F12 CANCEL NOTE The INVESTIGATOR ID field defaults to the investigator ID number who is logged into the system The COUNTY field defaults to the county in which the user is assigned and cannot be modified i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 REFERRALS July 1 2004 C Press Enter The referral list for the investigator displays d To view referral d
168. etails key a s in the S column next to the referral and press Enter or the F6 function key The REFERRAL DETAIL 1 screen displays e To view REFERRAL DETAIL 2 screen press the F10 function key f To return to the previous screen press the F12 function key The REFERRAL DETAIL 1 screen displays g To return to the REFERRAL LIST screen press the F12 function key The REFERRAL LIST screen displays or To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays 2 To accept a referral via the Referral List Prior to working on the investigation of a referral in EPICS the investigator must accept the referral a From the MAIN MENU key the number 2 in the Enter Option field and press Enter The REFERRAL MENU displays From the REFERRAL MENU key the number 1 in the Enter Option field The REFERRAL LIST screen displays Press Enter The referral list for the investigator displays Locate the assigned referral NOTE Assigned referrals maintain a status of PE To select the referral key a s in the S column and press Enter The REFERRAL DETAIL 1 screen displays In the ACCEPT REFERRAL field key an Y to accept the referral In the COLLECTOR field key collector ID if different from the Investigator ID NOTE The COLLECTOR field defaults to the Investigator ID To save the updates press the F9 function key NOTE The ACCEPTANCE DATE field is system generated with today s date i EN
169. ewing purposes you must maintain all supporting documentation that warrants the override 14 In the ALLEGATIONS field key a descriptions of the alleged fraud 15 If applicable enter data in the optional fields NOTE To determine which fields are optional see Referral Detail 2 Field Descriptions 16 To add data in the optional fields key the appropriate code in the S column a ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 REFERRALS September 13 2004 17 To add save the referral press the F6 function key 18 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 REFERRALS September 13 2004 Vi NOTEPAD A After you add a referral you may record notes regarding the referral claim or investigation by using the Notepad feature which is accessed from the REFERRAL DETAIL 1 screen The NOTEPAD feature contains 2 screens NOTEPAD SUMMARY and NOTEPAD DETAIL The NOTEPAD SUMMARY screen lists all notepad entries for a particular referral displaying the note title description date created and date last updated Notepad Summary Function Key Descriptions Key Description F1 To access EPICS on line help F3 To exit and return to the Main Menu F6 To add a notepad entry save F7 To display a previous screen page down F8 To display the next screen page up F12 To
170. f To delete the claim press the F10 function key again The claim deletes and a deletion date is assigned to the claim but does not display on the screen g To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays To Reactivate a Claim FS Only Food Stamp claims that are in TE Terminated Status may be reactivated If reactivation is needed for another claim and program another referral must be keyed a From the MAIN MENU key the number 3 Claims Menu in the ENTER OPTION field The CLAIMS MENU displays 17 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CLAIMS JULY 1 2004 b From the CLAIMS MENU key the number 3 Claim Detail in the ENTER OPTION field The CLAIM DETAIL screen displays C Key the REFERRAL ID number and press ENTER The terminated referral displays d Press the F11 key The referral is redisplayed with the same information as at the time of termination however the following fields are unprotected and you may update Claim Type Agency Error Type OP OI Periods Overpayment Amount Substantiation Method e Press the F9 UPDATE key The claim is reactivated and the status is changed from TE to CO Collection f To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays i8 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 IV DEBTOR DETAIL CLAIMS JULY 1 2004 All adults debtors
171. f AE claims entered for the quarter sorted by source code Claims determined for the quarter are by the Referral Date AE AMOUNT The total dollar overpayment amount of AE claims entered for the quarter sorted by source code AE COLLECTION The total dollar amount collected on AE claims entered for the quarter sorted by source code TOTAL BY SOURCE The total number of claims entered for the quarter NUMBER sorted by source code Claims determined for the quarter are by the Referral Date TOTAL BY SOURCE The total dollar overpayment amount of claims AMOUNT entered for the quarter sorted by source code TOTAL BY SOURCE The total dollar amount collected on claims entered COLLECTION for the quarter sorted by source code 22 FRD 509 CASES CLOSED TERMINATED TRANSFERRED AND DELETED QUARTERLY REPORT PURPOSE This report shows all Food Stamps AFDC TANF and Medicaid claims that have been closed paid in full terminated closed with a balance transferred or deleted within the quarter It is used by the 209 report The 209 Report is a federal report completed at the state level The report is sorted by county program AFDC FOOD STAMPS MEDICAID TANF and in alphabetical order by client last name There is a County Summary page that summarizes the data for the county which includes the number for each closed terminated transferred and deleted referral claim during the quarter and the dollar amount j
172. f the alleged fraud If applicable enter change data in all optional fields REFERRAL DETAIL 2 screen To add save and the referral press the F6 function key To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 IV REFERRAL LIST REFERRALS July 1 2004 If you need to display and update e g accept a referral or edit referral information but do not know the referral ID use the Referral List option This feature provides three separate queries to help narrow your referral search Based on your preferences and EPICS access level County or State you can query the datebase to display a list of referrals that are unassigned assigned to a specific investigator or owned by a specific county A Referral List Field Descriptions Field Description Required System Generated Optional INVESTIGATOR ID Used to choose which list you wish to view unassigned investigator or county X COUNTY 3 character county code Used to define which county s list will display Note Defaults to the county of the person logged into the system 1 character field used to select and view a referral TYPE 1 character code indicating the type of referral STATUS 2 character code indicating the current status of the referral 17 ENTERPRISE PROGRAM INTEGR
173. he O in FRO1 is a number value B To Access Via a PC Personal Computer le From your Windows Desktop double click the Mainframe icon 2 From the State Banner screen key CICSSCC4 and press Enter The CICS screen displays 3 In the Userid field key your RACF ID 4 Press Tab 5 In the bill cde field key FRP DHR 6 Press Tab 7 In the Password field key your password 8 Press Enter A blank CICS screen displays 9 Key FR01 and press Enter The EPICS MAIN MENU displays NOTE The 0 in FRO1 is a number value ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 GETTING STARTED July 1 2004 lil MAIN MENU The EPICS MAIN MENU provides you with a list of six options from which to choose These options define the six major functionalities within EPICS Depending on your security authorization you can select an option from the list and view create or update data A Main Menu Options Option Description 1 Administration Menu To enter security updated DHHS Customer Support Only 2 Referral Menu To process referrals 3 Claims Menu To process claims 4 Collections To process payments 5 Disqualifications To process disqualifications 6 Maintenance Menu To transfer and reassign cases B Main Menu Function Keys Option Description F1 To access EPICS on line help F2 To exit EPICS C To Access a Main Menu Option After you complete the EPICS logon
174. he current amount due on the claim GLOSSARY July 1 2004 D DATE CLOSED Day MM DD YYYY the referral was closed DATE OF BIRTH DOB The day MM DD YYYY the person was born DATE RECEIVED Day MM DD YYYY the payment is received DATE SIGNED MM DD YYYY the repayment agreement was signed by the debtor DEBTOR S Person s financially responsible for the repayment of a claim DISQUALIFICATION S A penalty s invoked for a person convicted of an Intentional Program Violation The disqualification restricts a person from receiving benefits for a period of time as defined by program policy depending upon the number of offenses recorded for the person in the past Applies to WF and FS only DISQUALIFICATION NUMBER A number that identifies how many offenses an individual has had imposed Applies to WF and FS only See Appendix D DISQUALIFICATION METHOD The method by which the disqualification was established Applies to WF and FS only See Appendix D DISQUALIFICATION PERIOD A number of months identifying the length of the disqualification Applies to WF and FS only See Appendix D DISQUALIFICATION DECISION DATE Date MM DD YYYY a decision for the disqualifi cation was made Applies to WF and FS only ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 DISQUALIFICATION START DATE Beginning date MM DD YYYY for the disqualification Applies to WF and FS only DISQUALIFICATIO
175. hed Claims and Unsubstantiated Claims Pending Referrals This is the number of referrals in the report month with a status of UN AC PE or IN and there is no U P Creation Date present 37 March 1 2005 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 FIELD DESCRIPTION NUMBER OF UNTIMELY U P Claims This is the number of REFERRALS CONT D referrals claims in the report month with a Claim Category of U or P a Creation Date is present the status is UN AC PE IN or CO no Establishment Date is present and the U P Creation Date is greater than six 6 months from the Date of Discovery Established Claims This is the number of claims in the report month with a Claim Category of IPV IHE AE or SIE the status is CO CL TE or OT and the Establishment Date is greater than six 6 months from the Date of Discovery Unsubstantiated Claims This is the number of claims in the report month with a Claim Category of S US U or P the status is CL or TE and the Establishment Date or Closed Date is greater than six 6 months from the Date of Discovery Total Untimely This is the total of untimely Pending Referrals U P Claims Established Claims and Unsubstantiated Claims Percentage Completed This is the percentage of untimely referrals claims completed for the report month The TOTAL UNTIMELY number is divided by NUMBER OF REFERRALS FOR REPORT
176. hree Years FRD222 2 FIELD DESCRIPTIONS FIELD DESCRIPTION OFFSET CYCLE NO The TOP cycle number in century year week format associated with the certification COUNTY NAME The name of the county the report applies to NAME The full name of the casehead on the referral Last Name First Name Middle Initial PROGRAM Identifies the Program associated with the referral always FS SSN 9 digit social security number for the debtor INDIVIDUAL ID 10 character number of the claim debtor AMOUNT The current balance due on the claim DATE Date the certification occurred 4 FRD406 2 CLAIMS SELECTED FOR TOP PRE OFFSET ADDRESS REQUEST REPORT PURPOSE This report shows all Food Stamp claim debtors that are selected for TOP Pre Offset Address request ACTION REQUIRED No action is required unless the select status has changed If the status changes while in Stage A reset the Federal Tax Indicator flag on the Debtor Detail Screen should be set to the appropriate code H L S or X ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 REPORT SCHEDULE Runs on the 2 to the last Thursday of each month for the period February November REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is available in XPTR RETENTION PERIOD Three Years FRD406 2 FIELD DESCRIPTIONS FIELD
177. ice PCS Claim Type Q 09 Medicare Part A or Part B Premium 11 Nursing Home PCS in ACH Claim Type T 67 NC Health Choice Premium 71 Medicaid Transportation B CLAIM TYPE TYPE DESCRIPTION AE Agency Error IHE Inadvertent Household Error Client Error IPV Intentional Program Violation Fraud P Undetermined Pending Criminal Court S Suspected Claim SIE State Issuance Error Food Stamps only U Undetermined Pending ADH US Unsubstantiated C AGENCY ERROR TYPE TYPE DESCRIPTION C County S State D SUBSTANTIATION METHOD IPV METHOD DESCRIPTION Court of Appeals DQ Consent Agreement District Court Action Administrative Disqualification Hearing ADH Superior Court Action gzlolrlolo gt Waiver of ADH ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 APPENDIX B CLAIM CODES September 13 2004 E DELETE REASON CODE CLAIM CODE DESCRIPTION B Bankruptcy D Death no estate E Entered in error or individual not financially responsible O Other F SEX SEX DESCRIPTION F Female M Male G RACE CODE DESCRIPTION A Asian B Black or African American American Indian or Alaska Native U Unknown W White P Native Hawaiian or other Pacific Islander H ETHNICITY CODE DESCRIPTION C Hispanic Cuban H Hisp
178. ies the benefits program to which the referral applies Case ID Program Case ID associated with referral County Case County case number associated with the referral Referral Date Date the referral was received Investigator ID ID number of the investigator assigned to the referral LOI Date Date the Letter of Overissuance is sent to the debtor 20 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CLAIMS SEPTEMBER 13 2004 Field Description Required System Optional Generated 60 DAY This is the date the xX NOTICE 60 Day Notice is sent for the DOR process POST This is the date the X HEARING investigator enters NOTICE once the Post Hearing Demand Notice has been sent Debtor Unique ID X Individual ID associated with the Debtor provided by CNDS Debtor SSN Debtor s social X security number Debtor DOB Debtor s date of X birth Debtor Sex Debtor s sex X Debtor Race Debtor s race may X be up to 5 race codes Ethnicity Debtor s Ethnicity X Language Debtor s Language X Preference Debtor Phone Debtor s phone X Number number Debtor Ext Debtor s phone X extension Debtor Name Debtor s full name X first name last name and middle initial Debtor Debtor s address X Address NC Debt Setoff Code used to set X individual up for NC Tax Intercept Delete Reason Code indicating the
179. ifications recorded for the person EPICS allows the user to display and view all of the known states from which a person has been disqualified as well as record a new disqualification for an individual EPICS sends a file each month to USDA around the 2 or 3 of the month EPICS receives a monthly file around the 26 of the month from USDA that contains all other 50 states disqualifications and are loaded into EPICS The worker may view disqualifications by entering the individual s social security number on the Disqualification Inquiry screen There are two screens that require data entry to record a new disqualification DISQUALIFICATION INQUIRY screen and the DISQUALIFICATION DETAIL screen A Disqualification Inquiry Field Descriptions Field Description Required System Optional Generated SOCIAL 9 digit number for the X SECURITY individual s social NUMBER security number SELECTION 1 character code used X to select an existing disqualification to view STATE 2 character code X identifying the state where the disqualification occurred DQ NUMBER Number of offenses X PROGRAM ID Code identifying which X benefit program the individual is being disqualified B Disqualification Inquiry Function Keys KEY Description F1 To access EPICS on line help F2 To clear the screen F3 To exit and return to the Main Menu F4 To display a list F6 To add a new disqualification F7 To
180. ign an investigator s cases s to another investigator 3 CASELOAD REASSIGNMENT To reassign an investigator s case workload to another investigator 4 NAME SEARCH NAME LIST To search for an individual assign individual ID number and change update address phone number B Maintenance Menu Function Keys Function Key Description F1 To access EPICS on line help F3 To exit and return to the Main Menu ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CASE MAINTENANCE July 1 2004 COUNTY TRANSFER If a client moves from one county to another their claims will have to be transferred to the new county location Only those cases in collection status non court ordered and select Medicaid cases can be transferred from one county to another Any cases that have not completed the investigation phase must remain in the old county until a determination has been made Once the determination has been made and the claim is in collection status the case can be transferred to the new county location Transfers are not effective until the first day of the following month Select Medicaid cases is defined as Any case s the county supervisor deems necessary to transfer If for financial reasons the county supervisor does not want to transfer the case s the county is not required to transfer the Medicaid claim to another county ENTERPRISE PROGRAM INTEGRITY CONTROL S
181. im information displays 4 Press the F5 function key The DEBTOR SUMMARY screen displays with a list of debtor s 5 In the List column key a s to the left of the debtor and press Enter The Debtor Detail screen displays 6 Press the F10 function key 7 In the DELETE REASON CODE field key the reason code that explains why the debtor is being deleted 26 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 8 CLAIMS JULY 1 2004 To delete the debtor press the F10 function key again A date of the deletion will be assigned to the debtor but will not display on the screen To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays or To return to the DEBTOR SUMMARY screen press the F12 function key F Display List Of Debtors And View Debtor Details 1 From the MAIN MENU key the number 3 in the ENTER OPTION field and press Enter The CLAIMS MENU displays From the CLAIMS MENU key the number 3 in the ENTER OPTION field and press Enter The CLAIM DETAIL screen displays In the REFERRAL ID field key the referral ID and press Enter The claim information displays 27 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CLAIMS JULY 1 2004 4 Press the F5 function key The DEBTOR SUMMARY screen displays with a list of debtors FR37 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 06 29 2004 FRDO370 DEBTOR SUMMARY 11 51 44 MORE
182. in EPICS and if The Referral Status is CO The Program is AFDC or TANF The Current Balance is greater than zero 0 00 The Claim Type is IPV IHE AE SIE Pons They are excluded if 1 Claim is Deleted 2 Claim Debtor is Deleted 3 Claim Category is IPV and Substantiation Method is S A or D and the Repayment Approach Method of Collection is not equal to R 4 Criminal Judgement Date is greater than 0001 01 01 and the Repayment Approach Method of Collection is not equal to R 5 The Letter of Overpayment Date LOI must be 10 working business days greater than the run date If debtor s is found EPICS divides the recoupment amount equally amount the debtors on the AFDC or TANF case EPICS sorts all claims involved and posts to the oldest claim first for each debtor ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 COLLECTIONS March 1 2005 G K If no debtors eligible for recoupment are found the case is displayed on the FRD401 EIS Recoupment Error Report with the message NO CLAIM TO POST MONEY If there is an error applying the payment due to debtor referral combinations the case is displayed on the FRD401 EIS Recoupment Error Report with the message FRDC1APP APPLY PAYMENT ERROR If a check has been issued and that check has a trans code 34 as displayed in EIS Check History the recoupment is not posted in EPICS nor does it appear on the FRD401 EIS Recoupment Error Report When an EIS Re
183. in which the money is collected Up to 9 characters amount of overcollection made to the payment generally a refund PAYOR NAME Up to 30 characters name of the debtor making the payment Defaults to the Case head payee on the referral unless changed PAYMENT AMOUNT Up to 9 characters amount of payment made against the claim AMT APPLIED Up to 9 characters amount of payment applied to claim CHECK NUMBER Up to 5 characters number of check if the client is paying by check ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 COLLECTIONS March 1 2005 FIELD DESCRIPTION REQUIRED SYSTEM OPTIONAL GENERATED DATE RECEIVED 10 character X MM DD YYYY date the payment was posted defaults to the current date RECEIPT 10 character X receipt number COLLECTOR County Worker X number of the person signed in posting the payment CREATE DATE 10 character X MM DD YYYY date the payment was actually entered into the system COMMENTS Up to 80 X characters textual description about the payment B Payment Function Keys KEY DESCRIPTION F2 To clear the screen F3 To exit and return to the Main Menu F4 To display a list F6 To add the payment save F7 To display a payment F8 To enter a payment correction F12 To cancel or return to the previous screen C Payment By Referral ID Or I
184. ing a claim State Level access only e Reactivating a claim e The Debtor Detail field descriptions e The Debtor Detail function keys e Adding a debtor to a claim e The Debtor Summary field descriptions e The Debtor Summary function keys e Displaying a list of debtors and view debtor details e Deleting a debtor State Level access only e The TOP Process Overview e Setting or Updating a TOP Intercept Indicator flag e Setting or Updating a TOP Appeal flag e The DOR Process Overview e The Maintain Client field description e The Maintain Client function keys e Adding a client e Updating a client e The Repayment Approach field descriptions e The Repayment Approach function keys ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CLAIMS July 1 2004 Adding Repayment Approach information Updating Repayment Approach data The EPICS History by Casehead field descriptions The EPICS History by Casehead function keys Viewing a list of referrals by individual ID for Casehead The EPICS History by Debtor field descriptions The EPICS History by Debtor function keys Viewing a list of referrals by individual ID for Debtor Entering field details using F4 key Searching for an individual ID Change 1 2004 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS CLAIMS MENU During the investigation of a referral the investigator may determine that a client owes a CLAIMS substantiated debt Once the i
185. ion displays ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 COLLECTIONS March 1 2005 D In the Receipt field key the number and press Enter The payment displays E Press the F8 function key The PAYMENT CORRECTIONS screen displays FR39 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 06 29 2004 FRD0391 PAYMENT CORRECTION 12 01 52 ORIGINAL RECEIPT DATE RECEIVED PAYMENT AMOUNT METHOD OF COLLECTION ___ PAYOR NAME CORRECTION METHOD OF COLLECTION ADJ RECEIPT 0000000000 PAYMENT AMOUNT CORRECTION DATE PAYMENT COMMENT PAYMENT CORRECTION FOR RECEIPT 0000406018 F3 EXIT F6 ADD F12 CANCEL F In the CORRECTION DATE field change the date if necessary G In the PAYMENT COMMENT field enter a description if necessary H To add save the payment press the F6 function key NOTE The Receipt is system generated The Comments field is system generated with the description Payment reversal for receipt the original receipt number To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays or To return to the PAYMENTS screen and apply a new payment press the F12 function key The PAYMENTS screen displays NOTE Prior to applying a new payment press the F2 function key to clear the screen V PAYMENT HISTORY BY REFERRAL You can view a list of historical payment information e g payment dates payment amounts and
186. is less that 181 days from the date the TOP INTERCEPT IND was set to A and the TOP INTERCEPT IND is currently H S L or X you may only change the indicator back to A or the following error message is displayed TOP INTERCEPT IND MUST BE A 6 If the ADDRESS REQ date is present and the date is 181 days for greater from the date the TOP INTERCEPT IND was set to A and the TOP INTERCEPT IND is currently H S L or X you may only change the indicator to space If an A is entered the following error message is displayed TOP INTERCEPT IND A NOT ALLOWED 7 If the criteria are met the system must request an address again Once the address is requested from TOP the ADDRESS REQ date is again populated and the TOP INTERCEPT IND is set from space to A E TOP returns the results to EPICS F EPICS sends a 60 Day Notice letter to the debtor s Debtor s TOP Intercept Indicator field is set to a B indicating the 60 Day Process has begun This is done by a nightly update job At this point H L S or X can not be entered by the county to block the intercept NOTE The county may enter an E code to stop the certification process from continuing If the debtor fails to make payments as agreed the code should be set back to a B code to continue with the certification process In this situation the debtor will not receive another 60 day notice
187. isplayed THE OP IS MORE THAN 12 MONTHS IN THE PAST ORDER A MEDICAID PROFILE NOW For example the current date is 3 3 03 The TO Date of the OP OI period is 2 28 2002 The calculated date is 2 28 2003 which has expired The indicator is not allowed when no overpayment period is displayed on the claim If the indicator is keyed with no OP OI displayed the following error message is displayed MEDICAID PROFILE INDICATOR NOT ALLOWED NO OP OI DISPLAYED The indicator may be changed from Y or N or vice versa when the calculated date has not expired a The OP OI period is 1 1 2002 06 30 2002 The current date is 3 3 03 The calculated date is 06 2003 The change from Y to N is allowed b The OP OI period is 1 1 2002 06 30 2002 The current date is 3 3 03 The calculated date is 06 2003 The change from N to Y is allowed The Medicaid Profile Indicator is reset from Y to space if the OP OI TO Date is changed The original calculated date is recalculated based on the new TO Date keyed If the new calculated date has not expired you may enter a Y if a follow up profile is needed If the new calculated date has expired you may not enter a Y a The original TO Date was 5 31 02 The calculated date was 05 2003 A Y had previously been keyed for the indicator The TO Date is changed to 3 31 02 The indicator is reset to space The new calculated date is 3 20
188. it and return to the MAIN MENU press the F3 function key The MAIN MENU displays i Change 1 2004 V ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS REFERRALS July 1 2004 REFERRAL DETAIL If you know the referral ID of the specific referral you want to display view or update you can use the Referral Detail option from the REFERRAL MENU A To Display a Referral 1 From the MAIN MENU key the number 2 in the Enter Option field and press Enter The REFERRAL MENU displays From the REFERRAL MENU key the number 2 in the Enter Option field and press Enter The REFERRAL DETAIL 1 screen displays In the REFERRAL ID field key the referral ID and press Enter The referral displays NOTE If you do not know the referral ID you can use the F4 key which displays the REFERRAL LIST screen View the referral details To view details on the REFERRAL DETAIL 2 screen press the F10 function key The REFERRAL DETAIL 2 screen displays To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays B To Update a Referral Detail Information 1 From the MAIN MENU key the number 2 in the Enter Option field and press Enter The REFERRAL MENU displays From the REFERRAL MENU key the number 2 in the Enter Option field and press Enter The REFERRAL MENU displays In the REFERRAL ID field key the referral ID you need to update and press Enter The referral displays NOTE If you do not k
189. l not proceed to REFERRAL DETAIL 2 screen until you provide the fields with the appropriate data For auditing and reviewing purposes you must maintain all supporting documentation that warrants the override 14 In the ALLEGATIONS field key a description of the alleged fraud i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 15 16 17 REFERRALS July 1 2004 If applicable enter data in the optional fields NOTE To determine which fields are optional see page 11 Referral Detail 2 Field Descriptions To add data in the optional fields key the appropriate code in the S column To add save the referral press the F6 function key To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays F Spin off Function After creating a new referral you may determine that more than one benefit program is involved EPICS provides a feature called Spin off to help save time with data entry in this process Since only one program can be associated with a referral at a time using Spin off function F11 key allows you to add a new referral based on the current referral displayed on the REFERRAL DETAIL 1 screen This feature uses the currently displayed information as default data With this information you make the necessary modifications to the data i e change the program code case number referring person To add a referral using the spin off feature 1 Cre
190. l s list of referrals This screen is Read Only A EPICS History By Debtor Field Descriptions Field Description Required System Generated Optional Individual ID Unique ID associated to the debtor of the referral X Name Last name first name and middle initial of the debtor SSN Debtor s social security number DOB Debtor s date of birth Sex Debtor s sex S The selection field for viewing the details for a specified referral Referral ID 10 digit number generated by the system upon creation of a referral ST The current status of the referral 52 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CLAIMS JULY 1 2004 Field Description Required System Optional Generated Date Date the referral X was received Prog Benefit program X that the individual is currently receiving benefits OP Amount Actual amount of X overpayment against the claim Op Period Actual beginning X from date of the overpayment Op Period To Actual ending date X of the overpayment Balance Current balance of X the claim CAT Code indicating the X claim type B History By Debtor Function Keys Function Key Description F1 To access EPICS on line help F3 To exit and return to the Main Menu F4 To display a list F7 To display the previous screen Page Dow
191. lays In the ENTER OPTION field key the number 4 and press Enter The NC FR45 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 08 24 2004 FRD0450 NC DEBT SETOFF PENDING INTERCEPTS 11 39 03 MORE SSN NAME _ IND ID _ DOB SEX _ APL CURRENT AMOUNT INTERCEPT NOTICE S IND PGM REFERRAL EST DATE CNTY BALANCE INTERCPTD DATE DATE PF1 HELP PF3 EXIT PF4 LIST PF5 CLAIM DTL PF6 DEBTOR DTL PF7 PREV PF8 NEXT PF9 UPDATE PF10 PYMT INDV PF11 PYMT REFERRAL PF12 CANCEL 26 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 COLLECTIONS March 1 2005 3 In the SSN field key the SSN of the debtor and press Enter The referrals eligible for appeal or pending referrals that have been appealed will appear 4 In the S column key an S beside the referral that requires an appeal to be set or the appeal that needs to be updated NOTE There may be multiple screens to view If necessary press the F8 function key to view the next screen of individuals and press the F7 function key to view the previous screen of individuals 5 In the APL IND field key the code for the type of appeal the debtor is requesting or the updated status of the appeal The F4 function may be used 6 To save and update the screen press the F9 function key NOTE If you have multiple appeal flags to set repeat steps 3 5 7 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays D Set Or
192. lds F11 To display the Maintain Client screen F12 To return to the previous screen B Search An Individual ID Using The Name Search Function 1 In the INDIVIDUAL ID field key and press F4 The NAME SEARCH screen displays Select a search method and key the appropriate information in the field s To initiate the search press Enter The Name List screen displays with all records that match your search criteria In the Sel column key an S in the field next to the appropriate individual and press Enter The previous screen displays with the data from the search Continue entering or updating the screen details 56 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 COLLECTIONS March 1 2005 104 COLLECTIONS Change 1 2005 March 1 2005 l THIS CHAPTER PROVIDES INSTRUCTIONS AND INFORMATION FOR e The Collections Menu function options e The Collections Menu function keys e The Payments field descriptions e The Payments function keys e Adding a payment by referral ID e Adding a payment by individual ID e Displaying a payment e Entering a Compromised Amount FS Only e Undoing a Compromised Amount FS Only e Increasing the Current Balance e Decreasing the Current Balance e Applying a payment adjustment e The Payment History By Referral field description e The Payment History By Referral function keys e Displaying a list of payment history by referral e Viewing payment details Payment
193. leted at the state level ACTION REQUIRED For review purposes REPORT SCHEDULE Runs on a monthly basis REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is available in XPTR RETENTION PERIOD Three Years i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 FRD416 FIELD DESCRIPTIONS FIELD DESCRIPTION COUNTY Three character code uniquely identifying the county and its name REFERRAL ID 10 digit ID generated by the system upon creation of a referral COUNTY CASE ID 7 character county case number INVESTIGATOR ID 5 character ID that corresponds to the investigator assigned to the claim NAME The full name of the debtor Last Name First Name Middle Initial CAT Code that specifies the type of overpayment claim DATE ESTAB The date the claim was established BEG CLAIM AMOUNT 8 digit number identifying the amount of overpayments of benefits PAYMENT DATE The date the payment was actually entered in the system PAY TYPE The payment method type CURRENT PAYMENTS The amount of the current payment TOTAL ALL PAYMENTS The sum total of all payments made on the claim BALANCE 8 digit field that identifies the current claim balance 8 FRD 452 CLAIMS EXEMPT FROM TOP REPORT REPORT PURPOSE This report shows Food Stamp claims that are e
194. ly with the correction To correct multiple ID numbers the DSS 8128 process may be used if all conditions in EIS are met Contact the EIS worker to determine if the 8128 process can be used The individual ID number that is present in EIS is the number that should be retained If the 8128 process cannot be used contact the DSS Automation Section REPORT SCHEDULE Runs on a weekly basis 33 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is available in NCXPTR only under the name DHRFRD FRD214 DOR DUPLICATE SSN RETENTION PERIOD Three years FRD214 FIELD DESCRIPTIONS FIELD DESCRIPTION COUNTY NAME Name of the county the report applies to INVESTIGATOR ID The 5 character ID of the investigator assigned to the claim CLIENT NAME Debtor Name SSN The social security number s of the debtor INDIVIDUAL ID The individual ID number s of the debtor PROGRAM The program associated with the referral claim MULTI COUNTY A Y is displayed if the debtor has affected claims in multiple counties CLAIM TYPE The claim type associated with the claim REFERRAL STATUS The status of the referral claim CLAIM BALANCE This is the claim balance for the claim not submitted to DOR This includes those claims with a status of CL SENT TO DO
195. m another state This is done by using the referral source code of OT LINE 2C 5 This line shows the dollar amount and the AJOT number of claims transferred out of state This can be done by changing the referral status from CO to OT LINE 2C 6 This line shows the dollar amount Current DELETED Balance at the time of the delete and the number of deleted claims All U and P claims that are deleted are included under the IHE column LINE 2C 7 This is the dollar amount Overpayment AJUP Amount for all closed U and or P claim LINE 2C 8 This line shows State Office Adjustments STATE OFFICE ADJUSTMENT LINE 2D This line is used to show the total dollar KEYING ARITHMETIC amount and number of corrections and ADJUSTMENT 2D INCLUDES 2C 1 adjustments made during the given quarter for THRU 2C 8 each heading IPV Fraud IHE Non Fraud AE Non Fraud The number and or dollar amount is derived from claims that have an AJCI AJCD AJUC claims with a referral status of OT U and P claims that are closed out and deleted claims This is the total of Lines 2C 1 through 2C 8 Dollar Amount Formula Line 2C 1 AJCI Line 2C 2 AJCD Line 2C 3 AJUC Line 2C 4 AJIT Line 2C 5 AJOT Line 2C 6 Deleted Line 2C 7 AJUP 14 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 FIELD DESCRIPTION LINE 2D CONT D KEYING ARITHMETIC ADJUSTMENT 2D INCLUDES 2C 1 THRU 2
196. m the MAIN MENU key the number 4 in the Enter Option field and press Enter The COLLECTIONS MENU displays 2 In the ENTER OPTION field key the number 1 and press Enter The PAYMENTS screen displays 3 In the REFERRAL ID field key the ID and press Enter The referral displays 4 In the METHOD OF COLLECTION field key the code AJCD Adjustment Decrease Current Balance 5 In the PAYOR NAME field verify payor s name If necessary select a different payor NOTE The PAYOR NAME field defaults to the case head payee name 6 In the PAYMENT AMOUNT field key the dollar amount of the decrease to be made to the current balance NOTE The overpayment field can never be less than the current balance field If this occurs you must adjust the overpayment field prior to adjusting the current balance field ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 COLLECTIONS March 1 2005 7 In the DATE RECEIVED field key the date of the decrease NOTE The DATE RECEIVED field defaults to today s date unless changed 8 In the PAYMENTS COMMENTS field enter a description of the decrease if necessary 9 To add save the decrease press the F6 function key 10 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays PAYMENT ADJUSTMENTS Corrections to payments that were entered in error are known as PAYMENT ADJUSTMENTS The DOR REVERSALS are corrections mandated by DOR due to an
197. mounts FS ONLY 1 To enter a Compromised Amount FS Only There are times when the overpayment and current balance originally entered into EPICS on the Claim Detail screen is different due to a negotiation or judgement and needs to be adjusted Entering a compromised amount does this When you enter a compromised amount the current balance will subtract the amount entered to reflect the change i e original overpayment and current balance was 250 00 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 COLLECTIONS March 1 2005 You enter a compromised amount of 100 00 Your Current Balance field now reflects a balance of 150 00 providing no payments have been made The Overpayment Amount field automatically changes This field is unprotected and can be changed by the end user a From the MAIN MENU key the number 4 in the Enter Option field and press Enter The COLLECTIONS MENU displays In the ENTER OPTION field key the number 1 and press Enter The PAYMENTS screen displays In the REFERRAL ID field key the ID and press Enter The referral displays In the METHOD OF COLLECTION field key the code AJCA Adjustment Compromised Amount In the PAYOR NAME field verify payor s name If necessary select a different payor NOTE The PAYOR NAME field defaults to the case head payee name In the PAYMENT AMOUNT field key the dollar amount of the compromise In the DATE RECEIVED field
198. multiple individuals associated to the SSN a message displays ENTERED SSN HAS MULTIPLE CLIENTS INVOKE SEARCH 3 From the DISQUALIFICATION LIST key an S in the selection column of the disqualification you wish to display and press Enter The DISQUALFICATION DETAIL screen displays 4 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays H Update A Disqualification You can only update disqualifications in the state of North Carolina 1 From the MAIN MENU key the number 5 in the ENTER OPTION field and press Enter The DISQUALIFICATION INQUIRY screen displays NOTE If you do not know the code or value for a field you can use the F4 key which displays a list of codes or values for selection This field attribute is only available for those fields that contain a plus sign to the right of the field 2 Key the SSN of the individual and press ENTER The disqualification list displays NOTE If there are multiple individuals associated to the SSN a message displays ENTERED SSN HAS MULTIPLE CLIENTS INVOKE SEARCH 3 Key an S in the selection column of the disqualification you wish to display and press Enter The DISQUALFICATION DETAIL screen displays 4 Update the DQ Investigator DQ County Case DQ Method DQ Period DQ Start Date and DQ End Date fields as necessary 5 To save the update press the F9 function key NOTE When updating a disqualification the LAST ACTIVITY field will
199. n F8 To display the next screen Page Up F12 To cancel or return to the previous screen C View List Of Referrals For A Debtor By Individual ID 1 From the MAIN MENU key the number 3 in the ENTER OPTION field and press Enter The CLAIMS MENU displays 2 From the CLAIMS MENU key the number 2 in the ENTER OPTION field and press Enter The EPICS HISTORY by Debtor screen displays 53 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CLAIMS SEPTEMBER 13 2004 FR33 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 08 24 2004 FRD0330 EPICS HISTORY 11 27 10 BY DEBTOR More INDIVIDUAL ID _ NAME SSN DOB SEX REFERRAL OF a OP PERIOD S ID ST DATE PROG AMOUNT FROM TO BALANCE CAT F1 HELP F3 EXIT F4 LIST F7 PREV F8 NEXT F12 CANCEL 3 In the INDIVIDUAL ID field key the ID and press Enter The referral information displays 4 View the list of information NOTE You may need to view multiple screens of referral history To view the next screen of referral history press the F8 function key Press the F7 function key to display the previous screen of referral history 5 Key an S in the selection field to the left of the Referral ID to view the Claim Detail screen of a particular referral Press the F12 function key to return back to the EPICS History by Debtor screen 6 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays 54 ENTERPRISE PROGRA
200. ndividual ID A collector can add a payment by applying it to a specific referral There may be multiple debtors assigned to a particular referral Always ensure you are posting the payment to the correct debtor If multiple debtors i e husband and wife are paying on a specific referral they should be posted by Referral ID versus Debtor Individual ID This ensures the entire payment s is credited on a specific referral i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 COLLECTIONS March 1 2005 1 To add a payment by referral ID a From the MAIN MENU key the number 4 in the Enter Option field and press Enter The COLLECTIONS MENU displays b In the ENTER OPTION field key the number 1 and press Enter The PAYMENTS screen displays FR39 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 02 24 2004 FRDO390 PAYMENTS 10 46 54 REFERRAL ID DEBTOR INDIVIDUAL ID _ NAME SSN DOB SEX _ COUNTY ___ PROGRAM CASE ID COUNTY CASE TYPE OF CLAIM OVER OP OI BALANCE COLLECTION OVERPAYMENT PERIOD METHOD OF COLLECTION __ CYCLE NUM 00 00 0000 00 00 0000 PAYOR NAME 00 00 0000 00 00 0000 PAYMENT AMOUNT AMT APPLIED 00 00 0000 00 00 0000 CHECK NUMBER 00 00 0000 00 00 0000 DATE RECEIVED RECEIPT COLLECTOR CREATE DATE PAYMENT COMMENT F2 CLEAR F3 EXIT F4 LIST F6 ADD F7 DISPLAY F8 CORRECTION F12 CANCEL NOTE If you do not know the code or value for
201. now the referral ID you can use the F4 key which displays the REFERRAL LIST screen Update the necessary fields To save the updates press the F9 function key To make updates to the REFERRAL DETAIL 2 screen press the F10 function key The REFERRAL DETAIL 2 screen displays i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 7 REFERRALS July 1 2004 Update the necessary fields NOTE To update the ALIAS NAMES EPICS ADDRESS and PHONE NUMBER fields type a U in the S column To update an ALIAS SSN edit the number To delete an ALIAS SSN key a D in the S column To save the updates press the F9 function key To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays C To Close a Referral If the entire investigation on a referral is completed i e unsubstantiated it is required that the investigator close the referral The investigator must still complete the Claim Detail screen prior to closing a referral Referrals that have been paid off do not require this process The REFERRAL STATUS automatically populates to CL closed when the current balance on the CLAIM DETAIL screen is set to 0 and sets the CLOSE REFERRAL field to Y 1 From the MAIN MENU key the number 2 in the Enter Option field and press Enter The REFERRAL MENU displays From the REFERRAL MENU key the number 2 in the Enter Option field and press Enter The REFERRAL DETAIL 1 screen display
202. nt claim Suspected Claim Agency Error Intentional Program Violation etc See Appendix B CLIENT NAME Name of the client who is Head of Household or Case Head Payee CLOSED A Y or N value used to close a referral COLLECTION A referral status indicating that payments can be applied to the claim COLLECTION FLAG A Y or N value indicating whether a claim is currently being collected upon ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 COLLECTOR The caseworker number of the person currently responsible for collecting the funds as a result of an overpayment COMMENTS The text field used to record comments relating to the claim CONTACT NAME The first and last name of the authorized user designated to handle disqualification verifications for the specified county CONTACT TITLE A text field containing the Official job title of the authorized user COUNTY CASE NUMBER The county case number associated with the referral COUNTY CODE A code used to uniquely identify the county See Appendix E COUNTY TRANSFER The process of transferring ownership of established claims Claims can be transferred to another county due to the relocation of the person on the referral claim COUNTY WORKER NUMBER The county worker IMC ID number CRIMINAL JUDGEMENT DATE Date MM DD YYYY that indicates when a criminal judgement was entered against the debtor CURRENT BALANCE T
203. nt screen F12 To return to the previous screen B Search Individual ID Using Name Search Function 1 In the INDIVIDUAL ID field key and press F4 The NAME SEARCH screen displays 2 Select a search method and key the appropriate information in the field s xI ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 COLLECTIONS March 1 2005 3 To initiate the search press Enter The Name List screen displays with all records that match your search criteria 4 In the Sel column key a S in the field next to the appropriate individual and press Enter The previous screen displays with the data from the search 5 Continue entering or updating the screen details EIS RECOUPMENT PROCESS A EIS drives the recoupment process The worker enters the recoupment amount into EIS If the amount entered is greater than 99 the case is displayed on the FRD401 Error Report with the message RECOUPMENT AMOUNT EXCEEDS 99 EIS sends EPICS the case ID s that contain recoupment data EPICS searches CNDS for all individual ID numbers that are included on the EIS case If client is not found the case is displayed on the FRD401 EIS Recoupment Error Report with the message CNDS CONTAINS NO PERSON FOR THIS CASE The program searches to determine the persons included on the EIS case and determines if the dependent indicator is or P CNDS Using the information in C above the program determines which persons are debtors
204. nvestigation on a referral is complete and proved to warrant a claim an established overpayment subject to collection process it is necessary for specific information to be recorded in EPICS on the claim before collections is initiated The claim is then used to track the debtor s and all payments made by the debtor s to repay the overpayment The CLAIMS MENU contains four options from which to choose Claims Menu Option Description 1 EPICS History by Case Head To view the history of referrals for a case head by individual ID 2 EPICS History by Debtor To view the history of referrals for a debtor by individual ID 3 Claim Detail To record required information about the claim in preparation for collections It contains the following screens Claim Detail Debtor Summary Debtor Detail and Repayment Approach Summary 4 Repayment Approach Summary To record repayment agreement information against the debtor s Claim Menu Function Keys Function Key Description F1 To access EPICS on line help F3 To exit and return to the Main Menu July 1 2004 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CLAIM DETAIL CLAIMS SEPTEMBER 13 2004 When you create a new referral in EPICS the shell of a claim is also created for the referral The initial and required steps for recording claim information e g claim type Overpaym
205. o access EPICS on line help F3 To exit and return to the Main Menu C County Detail The County Detail screen is designed to enable the user to display contact information for a county in the state of North Carolina This information is also used for the Contact Information located on the Disqualification Detail screen All users with inquiry access to EPICS may view this screen However only Program Integrity Supervisors have update capabilities Whenever the county address or telephone number changes this information must be updated If these fields are not updated the screen displays incorrect contact data on the Disqualification Detail screen This data is accessed by other states D County Detail Field Descriptions Field Description COUNTY Three character code used to identify the county TEAM NUMBER Code used to identify the Team Number within the state where the county number resides COUNTY NUMBER The county s name COUNTY ADDRESS The full mailing address for the county including the street address city state and zip code COUNTY TELEPHONE The local area code and phone number used by the county COUNTY EXTENSION The extension of the phone number used by the county COUNTY FAX NUMBER The 10 digit County Fax Number COMMENTS Free form text and allows up to 42 alpha numeric characters ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 ADMINISTRATION
206. obtain the list of codes From the list of codes enter an S under the SELECT column by the appropriate code Press ENTER The code selected is brought forward to the SERVICE CODE field Code Value 01 Inpatient Hospital Claim Types S X 02 Outpatient Hospital Claim Types M W 03 Dental Claim Type K 04 Drugs Claim Type D 05 Physician Claim Types J L O P 06 Home Health Hospice PCS Claim Type Q 09 Medicare Part A or Part B Premium 11 Nursing Home PCS In ACH Claim Type T 67 NC Health Choice Premium 71 Medicaid Transportation e In the CLAIM TYPE field key the claim type You may use the equal key and F4 key to obtain the list of codes From the list of codes enter an S under the SELECT column by the appropriate code Press ENTER The code selected is brought forward to the CLAIM TYPE field Code Value AE Agency Error IHE Inadvertent Household Error Client Error IPV Intentional Program Violation Fraud P Undetermined Pending Criminal Court S Suspected Claim SIE State Issuance Error Food Stamps Only U Undetermined Pending ADH US Unsubstantiated 1 Medicaid Do not enter Agency Error as a claim type The system generates an error message if attempted 2 Food Stamps and Workfirst If you select AGENCY ERROR it is required that you enter the agency error type in the AGENCY ERROR TYPE field a Food Stamps Agency Error Code The county can enter C County and S State o EN
207. ociated with the case head payee supplied by CNDS SSN Case head payee s X social security number DOB Case head payee s Xx date of birth Sex Case head payee s X Sex 29 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CLAIMS SEPTEMBER 13 2004 Field Description Required System Optional Generated County 3 digit number with xX the value from 000 100 representing the issuing county in which the overpayment took place Program Code that identifies X the benefits program to which the referral applies Case ID Program Case ID X associated with referral County Case County case X number associated with the referral Referral Date Date the referral X was received Investigator ID ID number of the X investigator assigned to the referral List of Debtor s social X Debtors SSN security number List of Unique ID X Debtors Ind associated with the ID Debtor supplied by CNDS List of Debtor s full name X Debtors Name first name last name and middle initial 30 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CLAIMS SEPTEMBER 13 2004 B Debtor Summary Function Keys Function Key Description F1 To access EPICS on line help F3 To exit and return to the Main Menu F4 To display a list F7 To display the previous screen page up F8 To display the next screen page down F9
208. ode or value for a field you can use the F4 key which will display a list of codes or values for selection This field attribute is not available for all fields but only those fields that contain a plus sign to the right of the field For claim code information see APPENDIX B 47 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CLAIMS JULY 1 2004 3 In the INDIVIDUAL ID field key the debtor ID and press Enter The repayment approach agreement information displays 4 Make the necessary modifications 5 To save the updates press the F9 function key 6 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays 4s ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 X CLAIMS EPICS HISTORY BY CASE HEAD SEPTEMBER 13 2004 The EPICS HISTORY by Case Head feature provides you with a means of viewing all referrals associated with a specific individual ID for a particular Case Head Utilizing this feature enables you to quickly access and verify an individual s list of referrals This screen is Read Only A EPICS History By Case Head Field Descriptions Field Description Required System Generated Optional Individual ID Unique ID associated to the case head payee of the referral X Name Last name first name and middle initial of the case head payee SSN Case head payee s social security number DOB
209. ort month NUMBER OF TIMELY This is the timely U P Claims REFERRALS Established Claims and Unsubstantiated Claims for the report month s ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS FIELD DESCRIPTION NUMBER OF TIMELY REFERRALS CONT D U P Claims This is the number of referrals claims in the report month with a Claim Category of U or P a Creation Date is present the status is UN AC PE IN or CO no Establishment Date is present and the U P Creation Date is six 6 months or less from the Date of Discovery Established Claims This is the number of claims in the report month with a Claim Category of IPV IHE AE or SIE the status is CO CL TE or OT and the Establishment Date is six 6 months or less from the Date of Discovery Unsubstantiated Claims This is the number of claims in the report month with a Claim Category of S US U or P the status is CL or TE and the Establishment Date is six 6 months or less from the Date of Discovery Total Timely This is the total number of timely U P Claims Established Claims and Unsubstantiated Claims Percentage Completed This is the percentage of Timely Referrals Claims completed for the report month The Total Timely is divided by the NUMBER OF REFERRALS FOR REPORT MONTH NUMBER OF UNTIMELY REFERRALS This is the total number of untimely Pending Referrals U P Claims Establis
210. ort shows the total claims by source code for all IPV IHE and AE claims ACTION REQUIRED Evaluate the report data to determine trends in referral sources Use the information to review problem areas in order to prevent errors and referrals REPORT SCHEDULE Runs quarterly on the first of the month of a quarter REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is available in XPTR RETENTION PERIOD Three Years ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 FRD503 FIELD DESCRIPTIONS FIELD DESCRIPTION SRC Code representing the source of the error IPV NUMBER The total number of IPV claims entered for the quarter sorted by source code Claims determined for the quarter are by the Referral Date IPV AMOUNT The total dollar amount of IPV claims entered for the quarter sorted by source code IPV COLLECTION The total dollar amount collected on IPV claims entered for the quarter sorted by source code IHE NUMBER The total number of IHE claims entered for the quarter sorted by source code Claims determined for the quarter are by the Referral Date IHE AMOUNT The total dollar amount of IHE claims entered for the quarter sorted by source code IHE COLLECTION The total dollar amount collected on IHE claims entered for the quarter sorted by source code AE NUMBER The total number o
211. otential payments from all programs to be refunded back to the client debtor ACTION REQUIRED Review for accuracy and refund any amount over collected to the claim debtor If the overcollection is due to recoupment a supplement should be issued if the overcollection is due to a cash payment then a cash refund should be issued REPORT SCHEDULE Runs on a daily basis Change 1 2005 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS APPENDIX F REPORTS March 1 2005 REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is mailed and is available in XPTR RETENTION PERIOD Three Years FRD104 FIELD DESCRIPTIONS FIELD DESCRIPTION COUNTY The name of the county the report applies to DEBTOR The full name of the debtor the overcollection occurred on Last First Middle Initial PROGRAM Identifies the Program Type the debtor is due a refund in CASE ID Up to 9 characters Identifies the Program Case ID associated with the error INDIVIDUAL ID OF DEBTOR 10 character number of the debtor SSN 9 digit social security number for the debtor METHOD OFCOLLECTION RECOUPMENT COLLECTION AMOUNT DATE OF COLLECTION The date in which the payment was made The method by which the payment was received Cash recoupment etc The total dollar amount of recoupments collected on AFDC claims for the quarter CASH COLLECTION AMOUNT Th
212. ounty the referral s will disappear from the screen the next time the Apply Payment batch job is run by EPICS NC DEBT SETOFF Pending Intercepts Field Descriptions If the appeal FIELD DESCRIPTION REQUIRED SYSTEM GENERATED OPTIONAL SSN 9 digit number for the debtor s social security number X NAME Last name up to 20 characters First Name up to 12 characters and Middle Initial 4 character of the debtor INDIVIDUAL ID 10 character number of the case head payee provided by CNDS DOB 10 character date of the case head payee s date of birth SEX 1 character code for the individual debtor s sex 1 character code used to select a referral for viewing APL IND Set by the county when a debtor request an appeal that suspends tax intercept until the outcome of the hearing or waives an appeal 24 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS COLLECTIONS Change 1 2005 March 1 2005 FIELD DESCRIPTION REQUIRED SYSTEM GENERATED OPTIONAL PGM Code that identifies the benefits program to which the referral applies X REFERRAL 10 digit number generated by the system upon creation of a referral Est DATE CNTY 10 character date in which the claim goes into CO status by entering the Claim Type as AE SIE IHE or IPV 3 digit number from 000 100 representing the issuing county
213. ourt Action H Administrative Disqualification Hearing ADH S Superior Court Action W Waiver of ADH j If applicable enter data in the optional fields k Press the F9 function key NOTE Validation is initiated against the benefit distribution eligibility on the EIS Check History EIS Individual database and the FSIS Issuance System based on the program code If the overpayment periods can not be validated against these systems for reasons other than OP Ol criteria described EPICS prompts you to press F9 again to override these edits or press Enter to modify the OP Ol dates as necessary If the dates are correct and you choose to override the dates you must have the proper supporting documentation The ESTABLISHMENT DATE field is system generated with today s date if the claim type entered is AE SIE IHE or IPV Once the information is validated the referral status is updated to CO collections Exception If the Claim Type is US or S it maintains the status of the referral status AND the Establishment date is not populated If the Claim Type is U or P it maintains the status of the referral and the U P Creation date is populated the Establishment Date is not populated at this time Once the Claim Type is updated to IHE IPV AE or SIE the status will change to CO and the Establishment date will be populated 14 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CLAIMS JULY
214. plays at the bottom of the screen Action completed successfully and an appears beside the case s you selected in the S column To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 IV CASE MAINTENANCE CASE REASSIGNMENT July 1 2004 To effectively manage the workload assigned to the various investigators within the same county there must be a mechanism for reassigning one or more cases from one investigator to another This reassignment may be due to various reasons including workload balancing adjustments or conflict of interest The Case Reassignment screen allows the supervisors and managers to perform this function Once you reassign a case it does not show up on the new investigator s list until the actual effective date of the transfer When you reassign a case in the future to an investigator the current investigator continues to have access and control of the case until the effective date of transfer You cannot reverse the reassignment until the new investigator has received it NOTE You must reassign referrals before access to EPICS is terminated You cannot reassign cases for a worker whose access has been terminated A Case Reassignment Field Definitions FIELD DESCRIPTION REQUIRED SYSTEM OPTIONAL GENERATED CURRENT A unique number X INVESTIGATOR assigned by the county to id
215. press the F3 function key The MAIN MENU displays J Transfer A Disqualification You can only transfer a disqualification in the state of North Carolina 1 From the MAIN MENU key the number 5 in the ENTER OPTION field and press Enter The DISQUALIFICATION INQUIRY screen displays NOTE If you do not know the code or value for a field you can use the F4 function key which displays a list of codes or values for selection This field attribute is only available for those fields that contain a plus sign to the right of the field 2 Key the SSN of the individual and press ENTER The DISQUALIFICATION LIST displays NOTE If there are multiple individuals associated to the SSN a message displays ENTERED SSN HAS MULTIPLE CLIENTS INVOKE SEARCH 3 Key an S in the selection column of the disqualification you wish to display and press Enter The DISQUALFICATION DETAIL screen displays ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 4 DISQUALIFICATIONS July 1 2004 In the XFER DQ COUNTY field key the county code for the county where the disqualification is being transferred To transfer the disqualification press the F5 function key NOTE The Last Activity field will automatically populate with Transfer and the Current Date To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays K Delete A Disqualification STATE LEVEL ONLY You can only delete
216. procedures select a MAIN MENU option to add update or view data in EPICS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 GETTING STARTED July 1 2004 1 Logon to EPICS The MAIN MENU displays FRO1 NCDHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 02 02 2000 Frd0010 MAIN MENU 10 58 18 1 Administration Menu 4 Collections Menu 2 Referral Menu 5 Disqualifications 3 Claims Menu 6 Maintenance Menu Enter Option F1 HELP F12 CICS CLEAR SCREEN 2 In the Enter Option field key the number of the MAIN MENU option and press Enter A menu displays with a list of options from which to choose 3 Proceed with adding updating or viewing data Change 1 2004 IV ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS GETTING STARTED July 1 2004 EXITING EPICS When exiting EPICS you must logoff properly from the session If you neglect to do so you may have difficulty logging back into EPICS or the system may lock Ensure all work has been added and updated successfully before you logoff A To Exit EPICS Via a Terminal 1 To return to the MAIN MENU press the F3 function key The MAIN MENU displays NOTE From any screen in EPICS you can press the F3 function key to return to the MAIN MENU To exit EPICS press the F12 function key A PIE menu displays Press the F3 function key A blank CICS screen displays Key logoff and press Enter The STATE BANNER screen display
217. qualification This value may be different from the County Case NOTE If you do not enter data in this field the system automatically populates the County Case under Referral Information once F6 is pressed 7 Key the number of disqualification offense in the DQ NUMBER field 8 Key the type of offense in the DQ OFFENSE CODE field if the program is FS This field is required if the PROGRAM CODE is FS a If the PROGRAM CODE is FS and no entry is made during the ADD function or the field is blank for the CHANGE function the following error message is displayed ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 DISQUALIFICATIONS July 1 2004 MANDATORY FIELD DATA IS MISSING b If the PROGRAM CODE is not FS and an entry is made in the DQ OFFENSE CODE field the following error message is displayed DQ OFF CODE IS NOT ALLOWED INVALID PROGRAM C If an invalid DQ OFFENSE CODE is entered the following error message is displayed INVALID DQ OFFENSE CODE d The valid values for the DQ OFFENSE CODE field are DQ OFFENSE CODE DEFINITION A Drug Trafficking Conviction Involving Less Than 500 B Any Trafficking Conviction including drugs Involving 500 or More C Firearms Trafficking Conviction Any Amount D Trafficking Administrative Finding E Duplicate participation F Application Fraud Including Non Report of Changes Z Other Intentional Program Violation
218. ram Integrity Staff add the referral in EPICS with the appropriate information e g Case ID Referral Type and Allegations There are two screens that require data entry REFERRAL DETAIL 1 and REFERRAL DETAIL 2 Each screen contains mandatory and optional fields as well as specific function keys that execute tasks A separate referral must be entered for each claim Also if a claim has any crossover date periods i e TANF a separate referral must be entered for each one A Referral Detail 1 Field Descriptions Field Description Required System Optional Generated Referral ID 10 digit ID generated X by the system upon creation of a referral Referral Type 1 character code X identifying the type of referral Referral Status 2 character code x identifying the status of the referral Name Last name up to 20 Xx characters First Name up to 12 characters and Middle Initial 1 character of the case head payee Individual ID 10 character number of X the case head payee provided by CNDS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS September 13 2004 Change 2 2004 REFERRALS Field Description Required System Generated Optional SSN 9 digit number for the case head payee s social security number X DOB 10 character date of the case head payee s date of birth SEX 1 character code for the individual case head payee s sex
219. rch 1 2005 FIELD DESCRIPTION COUNTY NAME The name of the county the report applies to INVESTIGATOR ID ID that corresponds to the investigator assigned to the referral NAME The full name of the casehead on the referral Last Name First Name Middle Initial PROGRAM Identifies the Program associated with the referral SSN 9 digit social security number for the debtor INDIVIDUAL ID 10 character number of the claim debtor REF ID 10 digit ID generated by EPICS upon creation of a referral PROGRAM CASE ID Up to 9 characters Identifies the Program Case ID associated with the referral NC DEBT APPEAL The value entered in the NC Debt Appeal Indicator INDICATOR field this value will always equal O CLAIM AMOUNT The current balance of the claim INTERCEPT AMOUNT The amount that was intercepted from the debtor 5 FRD 204 UNASSIGNED CASES REPORT REPORT PURPOSE This report is a workload management tool for supervisors and managers to show all cases not yet assigned to an investigator ACTION REQUIRED Review this report and use it as a management tool for Supervisory and investigative staff REPORT SCHEDULE Runs on a weekly basis REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is available in XPTR RETENTION PERIOD Three Years ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 20
220. rch 1 2005 FIELD DESCRIPTION LINE 3 CONT D If a claim is compromised to 0 00 and closes out OR a claim is paid out by an expungement these claims are included in the Number Amount on Line 17 This will prohibit double counting LINE 4 NEW CLAIMS ESTABLISHED This line is used to show the total dollar amount and number of new claims established for the given quarter for each heading IPV Fraud IHE Non Fraud AE Non Fraud U and P claim types appear in the IHE Non Fraud column For U and P claims we look at the U P Creation Date The dollar amount is captured from the overpayment amount for all newly established claims These entries are identified with an AJNE code LINE 5 TRANSFERS BETWEEN A B C BALANCES This line is used to show all claims that have been transferred from one category to another This includes court ordered and non court ordered category changes within the same quarter or a subsequent quarter Note A court order category change is a hearing or court determination claim for any U or P claim that has changed to another category OR any claim that is changed from one category to an IPV A non court ordered category change is defined as IPV changing to any other category IHE to SIE AE and SIE AE to IHE LINE 6 SUBTOTAL This line is used to show the total dollar amount and number of claims transferred between categories IPV Fraud IHE Non Fraud AE Non Fraud during th
221. rrent balance of the claim P PAYMENT AMOUNT The debtor s monthly payment PAYMENT METHOD Method the debtor is expected to use to make payment See Appendix B PAYOR NAME The Last Name First Name and Middle Initial of the person making the payment PENDING One of the codes used for Referral Status PHONE NUMBER The client s or debtor s phone number PHONE TYPE The type of phone number the client uses e g home See Appendix A PROGRAM CODE The benefit program associated with the referral See Appendix A PROJECT RECALL REFERRAL A code used for the Type of Referral R RACE The race of the client or debtor See Appendix B REASON CLOSED The text field used to describe the reason the referral was closed ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 RECEIPT NUMBER The payment receipt number REFERRAL The origination point for a claim in EPICS REFERRAL DATE The date MM DD YYYY the referral was initiated REFERRAL DETAIL Screen used to display update or add referrals to the EPICS system REFERRAL ID A system generated ID number that is assigned to a referral claim throughout the EPICS process REFERRAL LIST A list of referrals assigned to a specific investigator within a specific county or unassigned within a specific county REFERRAL SOURCE The two digit code that represents the source of the violation See Appendix A REFERRAL STATUS
222. ruptcy then debtor comes out of bankruptcy set Fed Tax Indicator to a space ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 REPORT SCHEDULE Runs on the 2 to the last Thursday of each month for the period February November REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is available in XPTR RETENTION PERIOD Three Years FRD406 3 FIELD DESCRIPTIONS FIELD DESCRIPTION COUNTY NAME Name of the county INVESTIGATOR ID 5 character ID of the investigator assigned to the claim NAME The full name of the claim debtor listed on the report Last Name First Name Middle Initial PROGRAM Identifies the Program associated with the referral SSN The social security number of the claim debtor INDIVIDUAL 10 character number of the claim debtor REFERRAL 10 digit ID generated by the system upon creation of a referral of the claim debtor PROGRAM CASE ID Up to 9 characters Identifies the Program Case ID associated with the claim CLAIM CAT Code that specifies the type of claim FED TAX INT Code that indicates the stage of the Federal Tax intercept of a claim debtor FED TAX APPEAL The federal tax appeal indicator code for a claim debtor CLAIM EST DATE The date the claim is established CLAIM BALANCE The current claim balance owed 6 FRD410 CLAIMS TRACKING AND EXCEPTIONS
223. s 9 Key the method by which the disqualification was established in the DQ METHOD field NOTE You can not create a Disqualification if the Claim Type located on the Claim Detail Screen is any value other than US or IPV If the Claim Type located on the Claim Detail Screen is US the DQ Method can equal any valid value If the Claim Type located on the Claim Detail Screen is IPV the Claim Substantiation Method also located on the Claim Detail Screen and the DQ Method must match Also if the Program is TANF AFDC the claim must be 100 or greater 10 Key the length of the disqualification in the DQ PERIOD field 11 Key the date the disqualification decision was made in the DQ DECISION DATE field i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 DISQUALIFICATIONS July 1 2004 12 Key the beginning date of the disqualification n the DQ START DATE field 13 The REFERRAL INFORMATION displayed is based on the referral ID number entered 14 The CONTACT INFORMATION is displayed based on the information from the County Detail Scree or an out of state disqualification 15 Press the F6 function key to add the disqualification A confirmation message displays at the bottom of the screen Action completed successfully NOTE When adding a disqualification the LAST ACTIVITY field automatically populates with Add and the Current date The END DATE field is system generated
224. s In the REFERRAL ID field key the referral ID you need to close and press Enter The referral displays NOTE If you do not know the referral ID you can use the F4 key which displays the REFERRAL LIST screen In the CLOSE REFERRAL field key an Y to close the referral In the REASON CLOSED field key the reason the referral is closed To save the changes press the F9 function key NOTE The DATE CLOSED field is system generated with today s date Also the REFERRAL STATUS field automatically populates to CL closed when the claim balance on the CLAIM DETAIL screen is 0 TE terminated when the claim balance on the CLAIM DETAIL screen is greater than 0 i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 REFERRALS September 13 2004 Exception Work First Only and is displayed as TE Claims that have a balance greater than 0 Claim Type AE Agency Error and Agency Error Type C County are considered County Responsible Overpayment CROP 7 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays D To Transfer a Referral Out of State Food Stamps Only If a client moves out of state it may be necessary to transfer the claim out of state Only those claims in CO collection status are eligible for Out of State transfers 1 From the MAIN MENU key the number 2 in the Enter Option field and press Enter The REFERRAL MENU displays 2 From the REFERRAL ME
225. s or Enter another transaction B To Exit EPICS Via a Personal Computer PC 1 To return to the MAIN MENU press the F3 function key The MAIN MENU displays NOTE From any screen in EPICS you can press the F3 function key to return to the MAIN MENU To exit EPICS press the F12 function key A PIE menu displays Press the F3 function key A blank CICS screen displays Key logoff and press Enter The STATE BANNER screen displays or Enter another transaction ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 GETTING STARTED May 1 2004 101 GETTING STARTED Change 1 2003 May 1 2004 l THIS CHAPTER e Describes how to access EPICS e Describes Main Menu options e Describes Main Menu function keys e Describes how to access a Main Menu option and e Describes how to exit EPICS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 GETTING STARTED May 1 2004 ll ACCESSING EPICS You can access EPICS via a terminal or personal computer A To Access EPICS Via a Terminal 1 Open the Mainframe State Banner screen 2 From the State Banner screen key CICSSCC4 and press Enter 3 In the Userid field key your RACF ID 4 Press Tab 5 In the bill cde field key FRP DHR 6 Press Tab 7 In the Password field key your password 8 Press Enter A blank CICS screen displays 9 Key FRO1 and press Enter The EPICS MAIN MENU displays NOTE The O in FRO1 is a number value B
226. s the day after the Date of Discovery with the Establishment Date being the last day included For those claims in AC PE and IN this is the number of days that pended from the Date of Discovery to the Run Date of the report Day one is the day after the Date of Discovery with the Run Date being the last day included BEGINNING BALANCE The beginning overpayment amount due on the claim AMOUNT DUE Current balance due on the claim 13 FRD 421 CASELOAD STATISTICS INVESTIGATOR ID REPORT PURPOSE This report shows the monthly summary caseload information sorted by the investigator ID ACTION REQUIRED Used as a management tool for Supervisory and Investigative staff REPORT SCHEDULE This report is scheduled to run on the first of the month REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is available in XPTR RETENTION PERIOD Three Years i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 FRD421 FIELD DESCRIPTIONS FIELD DESCRIPTION COUNTY CODE Three character code identifying the county INVESTIGATOR ID ID that corresponds to the investigator assigned to the referral NO ASSIGNED CASES The total number of referrals assigned PE status to the investigator during the month NO ACCEPTED CASES The total number of referrals accepted AC sta
227. signed to the claim INDIVIDUAL ID 10 character number of the claim debtor NAME The full name of the claim debtor listed on the report Last Name First Name Middle Initial OVERPAYMENT DATES The dates the overpayment overissuance occurred BEGINNING CLAIM BALANCE The beginning dollar amount of the overpayment CURRENT BALANCE The current dollar amount owed on the overpayment TOTAL FOR COUNTY The total dollar amount for CROP claims 3 FRD 506 QUARTERLY REPORT OF OVERPAYMENTS IN AFDC AND TANF REPORT PURPOSE This report shows the number of AFDC and TANF claims and the amount collected It is divided into two sections AFDC Claims with Overpayment Months prior to 1 1 97 and TANF Claims with Overpayment Months After 1 1 97 This report takes the place of the SSA 4972 report ACTION REQUIRED Review for accuracy If there are discrepancies the appropriate State Office should be contacted REPORT SCHEDULE The report is scheduled to run in the first month of the quarter for the previous quarter REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is available in XPTR RETENTION PERIOD Three Years ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 FRD506 FIELD DESCRIPTIONS FIELD DESCRIPTION COUNTY NAME Name of the county COUNTY CODE Three character code identifying the county CL
228. splays 4 Press the F5 function key 22 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CLAIMS SEPTEMBER 13 2004 FR35 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 08 24 2004 FRDO350 DEBTOR DETAIL 10 11 08 REFERRAL ID REFERRAL TYPE _ REFERRAL STATUS __ NAME IND ID SSN DOB SEX COUNTY PROGRAM CASE ID COUNTY CASE REFERRAL DATE INVESTIGATOR ID LOI DATE 00 00 0000 60 DAY NOTICE 00 00 0000 DEBTOR INFO POST HEARING NOTICE 00 00 0000 INDIVIDUAL ID 000000000_ SSN SEX _ DOB RACE ETHNICITY LANGUAGE PHONE NUMBER EXT NAME ADDRESS NC DEBT SETOFF _ DELETE REASON CODE TOP INTERCEPT IND _ TOP INTERCEPT APPEAL IND _ ADDRESS REQ 00 00 0000 FS APPEAL IND _ F1 HELP F3 EXIT F4 LIST F5 REPAY F6 ADD F9 UPD F10 DELETE F11 CLIENT F12 CANCEL FRDDDOS ACTION COMPLETED SUCCESSFULLY NOTE If no debtors have been previously added to the claim the DEBTOR DETAIL screen displays If one or more debtors have been previously added to the claim a list of debtors displays on the DEBTOR SUMMARY screen Press the F9 function key from the Debtor Summary screen 5 Inthe INDIVIDUAL ID field under Debtor Info key the individual ID of the person being added as a debtor and press Enter The individual s demographic information displays If you do not know the debtor s ID press the equal sign and F4 key The Name Search screen displays You may search in
229. status of the referral CLAIM The Program type of the claim IHE IPV SIE AE the date the claim was established and the current balance of the claim FED TAX INFO The current stage for TOP Processing and the date it began NC TAX INFO The current stage for DOR Processing and the date it began PERSON LAST UPDATED The RACF ID of the person who last changed the person information in CNDS date the change was made and the program that made the change s ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 10 APPENDIX F REPORTS March 1 2005 FRD 407 DATE OF DISCOVERY TIMELINESS REFERRAL REPORT FOR THE REPORT MONTH OF MONTH CCYY REPORT PURPOSE This is a statistical report Referrals are identified based on the Date of Discovery and that date being the 7 month prior to the run date of the report ACTION REQUIRED Statistics REPORT SCHEDULE The report runs the last workday of each month REPORT SECURITY LEVEL The report is county specific REPORT DISTRIBUTION The report is available in NCXPTR only under the name DHRFRD FRD407 TIMELINESS RPT RETENTION PERIOD Three years FRD407 FIELD DESCRIPTIONS FIELD DESCRIPTION COUNTY Name of the county the report applies to NUMBER OF REFERRALS FOR This is the total number of REPORT MONTH referrals claims in UN AC PE IN CL CO TE and OT status that have not been deleted and contains a Date of Discovery in the rep
230. t and return to the Main Menu F4 To display a list F5 To transfer the disqualification to a new county F6 To add a new disqualification save F9 To update a disqualification F10 To delete a disqualification State Level only F11 To enter a key change F12 To cancel or return to the previous screen ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 DISQUALIFICATIONS July 1 2004 E Create A New Disqualification T From the MAIN MENU key the number 5 in the ENTER OPTION field and press Enter The DISQUALIFICATION INQUIRY screen displays FR13 NC DHHS ENTERPRISE PROGRAM INTERGITY CONTROL SYSTEM 06 29 2004 FRD0130 DISQUALIFICATION INQUIRY 11 24 41 More SOCIAL SECURITY NUMBER SELECTION STATE DQ NUMBER PROGRAM F1 HELP F2 CLEAR F3 EXIT F4 LIST F6 ADD F7 PREV F8 NEXT F12 CANCEL 2 Key the SSN in the SOCIAL SECURITY NUMBER field of the individual being disqualified and press Enter NOTE If no previous disqualification s is associated with this Social Security Number a message displays NO DISQUALIFICATION RECORD EXISTS If there are multiple individuals associated to this social security number a message displays ENTERED SSN HAS MULTIPLE CLIENTS INVOKE SEARCH 3 Press the F6 function key The DISQUALIFICATION DETAIL screen displays ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 DISQUALIFICATIONS July 1 2004 FR15 NC DHHS ENTERPRISE PROGRAM INTERGITY CONTRO
231. t contain a plus sign to the right of the field FR39 NC DHHS ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM 02 24 2004 FRD0390 PAYMENTS 10 46 54 REFERRAL ID DEBTOR INDIVIDUAL ID at NAME SSN DOB SEX _ COUNTY ____ PROGRAM CASE ID COUNTY CASE TYPE OF CLAIM OVER OP OI BALANCE COLLECTION OVERPAYMENT PERIOD METHOD OF COLLECTION CYCLE NUM 00 00 0000 00 00 0000 PAYOR NAME 00 00 0000 00 00 0000 PAYMENT AMOUNT AMT APPLIED 00 00 0000 00 00 0000 CHECK NUMBER 00 00 0000 00 00 0000 DATE RECEIVED RECEIPT COLLECTOR CREATE DATE PAYMENT COMMENT F2 CLEAR F3 EXIT F4 LIST F8 ADD F7 DISPLAY F8 CORRECTION F12 CANCEL NOTE If you do not know the code or value for a field you can use the and F4 keys to display a list of codes or values for the selection This field attribute is only available on those fields that contain a plus sign to the right of the field In the DEBTOR INDIVIDUAL ID field key the debtor ID and press Enter The debtor information displays In the METHOD OF COLLECTION field key the collection method You may use the equal key and F4 key to obtain the list of codes From the list of codes enteran S under the SELECT column by the appropriate code Press ENTER The code selected is brought forward to the METHOD OF COLLECTION field NOTE Ifthe payment is a cash payment or recoupment and all open claims in CO status are associated to the same program the payment is applied
232. tem Generated Optional Substantiation Method 1 character code Required if the claim type is set to IPV indicating the method by which the claim is substantiated X Compromised Amount Up to 9 characters Used when the overpayment amount is different from what was originally entered FS Only This value must be entered from the Payments screen Delete Reason 1 character code required when a claim is being deleted State Office Only Establishment Date 10 character date in which the claim goes into CO status by entering the Claim Type as AE SIE IHE or IPV U P Creation Date 10 character date in which the claim type was entered as UorP ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 CLAIMS SEPTEMBER 13 2004 B Claim Detail Function Keys Key Description F1 To access EPICS on line help F2 To clear the screen F3 To exit and return to the Main Menu F4 To display a list F5 To display debtor information F9 To update the claim information F10 To delete a claim State Level only F12 To cancel or return to the previous screen 1 To Display and Update a Claim a From the MAIN MENU key the number 3 in the ENTER OPTION field and press Enter The CLAIMS MENU displays b From the CLAIMS MENU key the number 3 in the ENTER OPTION field and press Enter The CLAIM DETAIL screen
233. ter The referral details display Press the F5 function key The NOTEPAD SUMMARY screen displays In the S solumn key an S next to the note that you need to display and press Enter The NOTEPAD DETAIL screen displays To delete the note entry press the F10 function key To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays s ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 REFERRALS September 13 2004 Vi UTILIZING F4 If you do not know the code or value for a field you can use the F4 function key which displays a list of codes or values for selection This field attribute is only available for those fields that contain a plus sign to the right of the field To enter field details using F4 A In the field that contains a plus sign to the right of the field key equal sign and press the F4 function key The specific code list screen displays B To select a code or value table to the appropriate code value in the S column and key an S C Press Enter The previous screen displays with the field populated with the selected code or value D Continue entering or updated the screen details i Vil ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 NAME SEARCH REFERRALS September 13 2004 When you are working with referrals and are uncertain of the individual ID use the Name Search function This searching method provides
234. ter 1 20 Disaster 2 21 Disaster 3 22 Issuance Error 23 Third Party Query TPQY 24 State On line Query SOLQ 25 Department of Correction 26 SSA Death Match FS Only 27 Prisoner Match FS Only 28 Interstate Match Pennsylvania Dept of Labor 99 Other or Unknown E NATURE OF REFERRALS NATURE DESCRIPTION E Earned Income O Other R Reserve U Unearned Income ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 APPENDIX A REFERRAL CODES July 1 2004 F ADDRESS TYPES TYPES DESCRIPTION Bill Billing Intc Intercept Mail Mailing Phys Physical G PHONE TYPES TYPES DESCRIPTION Bus Business Phone Home Home Phone Other Other Phone H SELECTION CODES CODES DESCRIPTION A Add Alias Name EPICS Address Phone Number amp Alias Social Security Number D Delete Social Security Number Only U Update Address amp Phone Number ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 APPENDIX B CLAIM CODES July 1 2004 2100 APPENDIX B CLAIM CODES Change 2 2004 September 13 2004 A MEDICAID SERVICE CODES CODE DESCRIPTION 01 Inpatient Hospital Claim Types S X 02 Outpatient Hospital Claim Types M W 03 Dental Claim Type K 04 Drugs Claim Type D 05 Physician Claim Types J L O P 06 Home Health Hosp
235. ter code Required when the program is Medicaid goes in CO status indicating the type of medical services provided during the overpayment period Claim Type Up to 3 characters Code that specifies the type of overpayment claim ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS JULY 1 2004 Change 1 2004 CLAIMS Field Description Required System Generated Optional Type Agency Error 1 character Required if the claim type is AE indicating if the error is State or County X Civil Date Judgement Date indicating if the claim was reduced to a civil judgement providing an unlimited time in which the county can attempt to seek collection Criminal Date Judgement Date indicating if the claim was reduced to a criminal judgement providing an unlimited time in which the county can attempt to seek collection OP OI Begin Date from 10 character date MM DD YYYY of the start date for the overpayment To OP OI End Date 10 character date MM DD YYYY of the end date for the overpayment IND MED PROFILE This 1 character field indicates if a Medicaid Profile is needed amount Overpayment Up to 9 characters Amount due from the overpayment ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CLAIMS JULY 1 2004 Field Description Required Sys
236. the oldest establishment date and referral ID The recoupment amount is divided equally among all debtors who are in the active Food Stamp case from which the recoupment came It is possible that a recoupment may come from a Food Stamp case in County A to pay on aclaim in County B This could occur when a debtor on a referral is owned by one county is receiving Food Stamp benefits in another county i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 DISQUALIFICATIONS July 1 2004 105 DISQUALIFICATIONS Change 2 2004 September 13 2004 I THIS CHAPTER PROVIDES INSTRUCTIONS AND INFORMATION FOR e The Disqualification Inquiry fields e The Disqualification Inquiry function keys e The Disqualification Detail Fields e Displaying Disqualification Detail function keys e Creating a Disqualification e Displaying a Disqualification List e Displaying a Disqualification e Updating a Disqualification e Entering a Key change e Transferring a Disqualification e Deleting a Disqualification e Entering field details using F4 key e Searching for an individual ID ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 DISQUALIFICATIONS September 13 2004 OVERVIEW FOOD STAMPS amp TANF ONLY A disqualification is a penalty invoked for a person convicted of an Intentional Program Violation It will restrict a person from receiving benefits for a period of time depending upon the number of disqual
237. tus by the investigator during the month NO CASES UNDER The total number of referrals under investigation In INVESTIGATION status by the investigator during the month NO CASES COMPLETED The total number of referrals completed by the investigator during the month NO CASES IN COLLECTION The total number of claims in collections CO status by the investigator during the month TOTAL AMOUNT COLLECTED The total dollar amount of funds collected by the investigator collector for the month 14 FRD 425 INVESTIGATOR S MAINTENANCE REPORT DELINQUENCY REPORT PURPOSE This report shows all claim debtors that are delinquent Delinquency is defined as a payment that has not been made within the last 60 calendar days NOTE AE and SIE errors are included in the Claim category A ACTION REQUIRED Use this report to send additional demand letters to delinquent claim debtors REPORT SCHEDULE Runs on the first of the month REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is mailed and available in XPTR RETENTION PERIOD Three Years i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 FRD425 FIELD DESCRIPTIONS FIELD DESCRIPTION COUNTY Three character code identifying the county INVESTIGATOR ID ID that corresponds to the investigator assigned to the referral R
238. ud during the given quarter TOP payments CT TOP Payment Prior To June 1 T TOP Payment LINE 7D DOR This line is used to show all DOR payments made for each heading IPV Fraud and IHE Non Fraud during the given quarter AE SIE Claims are not submitted for DOR DOR payments N DOR payment i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 APPENDIX F REPORTS March 1 2005 FIELD DESCRIPTION LINE 7E This line is used to show the total amount of TOTAL CASH COLLECTED cash collected for each heading IPV Fraud IHE Non Fraud AE Non Fraud during the given quarter Dollar Amount Formula Line 7a Cash Check M O Line 7c TOP Intercept Line 7d DOR LINE 8 COUPONS This line is used to show the total amount of coupons and EBT benefits collected for each heading IPV Fraud IHE Non Fraud AE Non Fraud during the given quarter S Stamps EB EBT LINE 9 RECOUPMENTS This line is used to show all recoupments taken during the given quarter for each heading IPV Fraud IHE Non Fraud AE Non Fraud R Regular recoupments LR Local recoupments LINE 10 OFFSETS This line is used to show all offset amounts made during the given quarter for each heading IPV Fraud IHE Non Fraud AE Non Fraud O Offset payments LINE 11 TOTAL COLLECTED This line is used to show the total dollar amount collected for each heading IPV Fraud IHE Non Fraud
239. uld have to be done through the legacy system however you may update the debtor s address and phone number You may access Maintain Client via Debtor detail screen or name list screen You cannot delete maintain client information Only authorized personnel who have deletion rights may do so Therefore ensure accurate information is entered A Maintain Client Field Descriptions Field Description Required System Optional Generated Individual ID Unique ID assigned X by EPICS for the new individual This information is transferred and stored in CNDS Name Individual s name X SSN Individual s social X security number even if zeroes DOB Individual s date of X birth Sex Individual s sex X Race Individual s race X may be up to 5 codes Ethnicity Debtor s Ethnicity X Language Debtor s Language X Preference Address Individual s address X 38 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CLAIMS JULY 1 2004 Field Description Required System Optional Generated Type Code indicating the X individual s address type County Code 3 digit number with X the values from 000 100 indicating which county the individual resides Phone Number Individual s phone X number Ext Individual s phone X extension Type Code indicating the Xx individual s phone type
240. unty ACTION REQUIRED Review for accuracy REPORT SCHEDULE Runs quarterly on the first of the month in a quarter REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is available in XPTR RETENTION PERIOD Three Years j ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 FRD501 FIELD DESCRIPTIONS APPENDIX F REPORTS March 1 2005 FIELD DESCRIPTION COUNTY CODE Three character code identifying the county and its name PROGRAM Identifies the Program associated with the referral CASEHEAD NAME The full name of the case head listed on the referral Last Name First Name Middle Initial PROGRAM CASE ID Up to 9 characters Identifies the Program Case ID associated with the claim REF ID 10 digit ID generated by the system upon creation of a referral CLAIM EST DATE The date the claim was established CO status ORIGINAL BALANCE 8 digit number identifying the amount of overpayment overissuance QTR BEG BALANCE Current balance of the claim at the beginning of the quarter PAYMENTS The total dollar amount of payments that have been applied to the claim REFUND The amount that was overcollected on the claim CURRENT BALANCE The current balance due on the claim CAT Up to 3 characters code that specifies the type of claim 21 FRD 503 CLAIMS BY SOURCE CODE REPORT PURPOSE This rep
241. vestigator assigned to the referral NAME The full name of the debtor Last Name First Name Middle Initial PROGRAM Identifies the Program associated with the referral SSN The social security number of the debtor INDIVIDUAL ID The 10 character number associated with the debtor REFERRAL ID 10 digit ID generated by EPICS upon the creation of a referral PGM CASE ID Up to 9 characters Identifies the Program Case ID associated with the claim NC DEBT SETOFF The code entered in for exemption NC TAX APPEAL If applicable the code used for appealing the intercept 17 FRD 431 NC DEBT SETOFF 30 DAY NOTICE REPORT REPORT PURPOSE This report is used to show all claim debtors that were sent the 30 day notice Five extra days are given for mailing purposes ACTION REQUIRED No action is required unless the debtor requests an appeal If an appeal is requested within the notice period the county should put in an R in the appeal indicator The counties can use this report to calculate when the 35 day appeal period will end for the claim debtor for review purposes REPORT SCHEDULE Runs bi weekly REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is only available in XPTR RETENTION PERIOD Three Years Change 1 2005 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS FRD431 FIELD DESCRIPTIONS APPENDIX F REPORTS March 1 2005 FIELD DESCRIPTI
242. vious screen of history if necessary 5 Press Enter The PAYMENTS screen displays 6 View the payment details NOTE The PAYMENTS screen is read only Thus you cannot make edits updates If you decide a payment needs to be adjusted return back to the COLLECTIONS MENU and select option 1 7 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays VII NC DEBT SETOFF PENDING INTERCEPTS The NC DEBT SETOFF PENDING INTECEPTS function allows you to view a list of NC DOR intercepts that have been received by EPICS These intercepts are waiting for the 30 day appeal process to be completed before funds can be applied to claim balances This screen is designed to only show referrals in the PENDING stage of the DOR process If payments or refunds have been applied to the referral s they will not appear on this screen a ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS COLLECTIONS Change 1 2005 March 1 2005 From the NC DEBT SETOFF PENDING INTERCEPTS screen you can set and identify those intercepts for which the debtor requests an appeal Additionally you can identify those intercepts which will be applied to the claim balances due to the 30 day timeframe expiring without a response from the debtor If the debtor waives their right to the funds it will immediately be removed from this screen and payment and or refund will be applied to the referral s decision ruling is in the favor of the c
243. xempt from TOP process ACTION REQUIRED Review for accuracy If Federal Tax Intercept Indicator or the Federal Tax Appeal Indicator is incorrect then investigator should make appropriate changes to the field s REPORT SCHEDULE Runs on a monthly basis REPORT SECURITY LEVEL This report is viewable at the owner county level REPORT DISTRIBUTION This report is available in XPTR RETENTION PERIOD Three Years ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2005 FRD452 FIELD DESCRIPTIONS APPENDIX F REPORTS March 1 2005 FIELD DESCRIPTION COUNTY NAME Name of the county INVESTIGATOR ID 5 character ID of the investigator assigned to the claim NAME The full name of the claim debtor listed on the report Last Name First Name Middle Initial PROGRAM Code that identifies the overpayment program SSN The social security number of the claim debtor INDIVIDUAL 10 character number of the claim debtor REFERRAL 10 digit ID generated by the system upon creation of a referral of the claim debtor REFERRAL STATUS 2 letter code indicating the current status of the referral PROGRAM CASE ID Up to 9 characters Identifies the Program case ID associated with the disqualification FED TAX INT Code that indicates the stage of the Federal Tax intercept of a claim debtor FED TAX APPEAL The federal tax appeal indicator code for a claim debtor 9 FRD 505
244. y the number 2 in the Enter Option field and press Enter The REFERRAL MENU displays 2 From the REFERRAL MENU key the number 2 in the Enter Option field The REFERRAL DETAIL 1 screen displays 3 In the REFERRAL ID field key the referral ID of the referral that you need to update the note and press Enter The referral displays 4 Press the F5 function key The NOTEPAD SUMMARY screen displays 5 In the S column key an S next to the note that you need to display and press Enter The NOTEPAD DETAIL screen displays 6 View the note details and if needed modify the title description and or note details 7 To save the changes press the F9 function key NOTE The DATE LAST UPDATED field is system generated with the current date 8 To exit and return to the MAIN MENU press the F3 function key The MAIN MENU displays i ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 2 2004 REFERRALS September 13 2004 If the note entry is no longer applicable to the referral you can delete the entry This delete is not reversible To delete a note from Notepad a From the MAIN MENU key the number 2 in the Enter Option field and press Enter The REFERRAL MENU displays From the REFERRAL MENU key the number 2 in the Enter Option field The REFERRAL DETAIL 1 screen displays In the REFERRAL ID field key the referral ID of the referral that you need to delete the note from and press En
245. you with the capability to search CNDS for an individual ID number There are 4 search criteria You can only select one search method Name Sex Date of Birth only SSN social security number only Individual ID only Case ID only A Name Search Function Key Descriptions Key Description F1 To access EPICS on line help F3 To exit and return to the Main Menu F4 To clear the search criteria fields F11 To display the Maintain Client screen F12 To return to the previous screen B To Search an Individual ID Using the Name Search Function 1 In the INDIVIDUAL ID field key and press F4 The NAME SEARCH screen displays 2 Select a search method and key the appropriate information in the field s 3 To initiate the search press Enter The Name List screen displays with all records that match your search criteria 4 In the Sel column key an S in the field next to the appropriate individual and press Enter The previous screen displays with the data from the search 5 Continue entering or updating the screen details 38 ENTERPRISE PROGRAM INTEGRITY CONTROL SYSTEM EPICS Change 1 2004 CLAIMS July 1 2004 103 CLAIMS Change 2 2004 September 13 2004 l THIS CHAPTER PROVIDES INSTRUCTIONS AND INFORMATION FOR e The Claims Menu options e The Claims Menu function keys e The Claim Detail field descriptions e The Claim Detail function keys e Displaying and updating a claim e Delet

EPICS - NC DHHS Online Publications

Contents

Download Pdf Manuals

Related Search

Related Contents