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MS 0830 (1) Volume 1 – General Administration MS 0830 – R. 7/1/21 – OMTL-580 [Responsibilities for Claims] A. [Field Staff are to take the following actions: 1. Enter a change to a case and run eligibility which prompts the Discrepancy Overpayment screen. 2. Enter the Discrepancy Overpayment detail, which creates a task for the Regional Claims Worker (RCW) to begin the claims process. 3. Manually process disqualifications that are not automatically imposed on the Integrated Eligibility and Enrollment System (IEES) (i.e. Employment & Training (E&T) disqualifications). 4. Create manual claim referrals as appropriate. See MS 0820. 5. Identifying and referring suspicious case situations prior to approval to the Determining Eligibility Through Extensive Review (DETER) program where it is operational. Refer to MS 0900. B. RCWs are responsible for the following: 1. Processing automatic claims. 2. Processing Supplemental Nutrition Assistance Program (SNAP) and Child Care Assistance Program (CCAP) individual-only disqualifications for Intentional Program Violations (IPV). 3. Determining whether to validate and establish or No Claim the referral and update the status in the system. 4. Determining the claim type and verifying the claim amount. 5. Establishing a Manual Claim. 6. Initiating Fraud Referrals to the Office of Inspector General (OIG). 7. Submitting requests for claim adjustments. 8. Contacting the household to determine and discuss the reason for a claim and to explain the computation of the claim amount. 9. Scanning all claim-related documents to the associated claim(s) electronic case files. 10. Screening claims for suspected fraud and taking the following action: a. Referring the claim(s) meeting criteria to the OIG for further investigation and possible prosecution. See MS 0910; or