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body of the case note will state only the date the Incorrect Payment Preliminary Review Form CC17;

b. Submit theIncorrect Payment Preliminary Review Form CC17 to the CCPO and any corrective action taken to prevent the IP from continuing; and

c. Retain the Incorrect Payment Preliminary Review Form CC17in a file other than the family’s or provider’s case file until a determination is issued by the CCPO at which time the Incorrect Payment Preliminary Review Form CC17 is shredded.

2. Overpayment of $99.99 or Less If an overpayment occurred and the amount overpaid is a total of $99.99 or less, for all the months included in the error, the Incorrect Payment Preliminary Review Form CC17 is completed and submitted to the CCPO for documentation purposes. The Designee or CCPO will document the details in a case note in the family’s or provider’s case in ICCIS to include the month the IP occurred and all months reviewed; the cause of the error; a recalculation of the provider’s payment or if applicable, a re-calculation of the family’s benefit; and any corrective action taken to prevent the IP from continuing.

3. Overpayment of $100.00 or More Regardless of the cause, if an overpayment occurs and the amount overpaid is a total of $100.00 or more, for all the months included in the error, supporting documents relevant to the overpayment, including: a copy of the family’s application applicable for the timeframe the error occurred; income verification used if it was an income error, and copy of the Request for Payment CC78, if applicable are to be sent with the Incorrect Payment Preliminary Review Form CC17.

The Designee or CCPO will: a. Document the details in a case note in the family’sor provider’s case in ICCIS using subject heading: CCAP Overpayment. The body of the case note will state only the date the Incorrect Payment Preliminary Review Form CC17 was submitted to the CCPO and any corrective action taken to prevent the IP from continuing; and

b. Retain the Incorrect Payment Preliminary Review Form CC17in a file other than the family’s or provider’s case file until a