Page 15

FOOD AND NUTRITION SERVICES CERTIFICATION CLAIMS Agency Error (AE) Claims

15 Section 810 Change #3 2017 September 20, 2017 B. Request an adjustment closure of claim when:

1. All debtors are deceased at least six months and the local agency has verified their estate is exhausted or they do not have an estate.

2. All debtors filed bankruptcy, and the bankruptcy court has discharged the debt:

3. The system will not allow deletion as in 810.08, A, 4: or

4. All debtors are in a nursing home, and it is unlikely they will ever pay on the debt.

C. The request for deletion or closure must include:

1. Claim Name 2. PDC Number 3. EPICS Referral ID Number 4. Individual ID Number 5. Category of Claim 6. Date Established 7. Reason for deletion 8. Name, Title, and Telephone Number of individual submitting claim for deletion 9. Current balance as shown in EPICS. 10. Investigator’s signature 11. Program Integrity Supervisor’s signature 12. The date of death, if applicable. 13. Justification for the request. Justification includes, but is not limited to: copy of death certificate, copy of bankruptcy order, etc.

Mail or fax the request to:

North Carolina Division of Social Services Economic and Family Services/Program Integrity 820 S. Boylan Ave. Raleigh, NC 27603

2420 Mail Service Center Raleigh, NC 27699-2420 Fax: (919) 334-1265

810.09 CLAIMS RECORD RETENTION

A. Follow policy in Section 135 regarding retention of claims, with the following exception. Use the date of the last payment that paid the claim in full as the last transaction date.

B. Records for AE claims may be maintained electronically.