BENEFIT ACCURACY MEASUREMENT
STATE OPERATIONS HANDBOOK

 

 

TABLE OF CONTENTS

   
 
OVERVIEW
    Chapter I.
    1. Introduction
    2. Background
    3. Program Scope
    4. Handbook Organization
REQUIRED PROCEDURES

    Chapter II.
    1. Organization
    2. Authority
    3. Written Procedures
    4. BAM Software

    Chapter III.  Data Processing - SESA Mainframe Computer Operations and Interfaces with UI ADP System
    1. Introduction
    2. State UI Transactions File
    3. Control Record
    4. COBOL Population Edit and Sample Selection Programs
    5. Downloaded Files
        - Attachment "A" (UI BAM Population Edit and Sample Selection COBOL Program Specifications and Installation)
        - Attachment "B" (Record Format for rec1.dat File)
        - Attachment "C" (Record Format for sfsum.dat File)

    Chapter IV.  Data Collection
    1. Introduction
    2. Overview
    3. Data Elements and Descriptions

    Chapter V.  Classifying Propriety of Payments
    1. Introduction
    2. Coding Proper Payments
    3. Coding Improper Payments
    4. Key Week Error Summary Sheet
    5. Case Completion
    6. Reopening Cases

    Chapter VI.  Investigative Procedures
    1. Introduction
    2. Standard Forms
    3. Investigative Requirements
    4. Investigative Methodology
    5. Disqualifying/Deductible Income Verifications
    6. Dependency Eligibility Verifications
    7. UCFE
    8. UCX
    9. Interstate Requests
    10. Summary of Investigation
    11. Appeals
    12. Completion of Cases and Timely Data Entry
    13. Reopening Cases

    Chapter VII.  Records and Reporting
    1. Introduction
    2. Documentation
    3. Retention of Records
    4. Transmission of Data to the National Office
DENIED CLAIMS ACCURACY (DCA)
    Chapter VIII.
    1. Introduction
    2. Overview of DCA
    3. Investigative Requirements
    4. DCA Investigative Methodology
    5. Interstate Requests
    6. Other Verifications
    7. Completion of DCA Cases and Timely Data Entry

    Chapter VIII Attachment
      Data Collection Instrument (DCI) for DCA - This attachment includes database specifications for denials.
APPENDICES		 Page



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