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GN 02270.003: Claims Folder Information for Personal Conferences

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  • Effective Dates: 04/21/2016 - Present
  • Effective Dates: 01/09/2018 - Present
  • TN 10 (11-09)
  • GN 02270.003 Claims Folder Information for Personal Conferences
  • In most overpayment waiver situations created after 2000, the field office (FO) or program service center (PSC) does not need to request a paper claims folder for any documents used to calculate the overpayment. Most of these documents can be found in either Paperless, NDRed, or the electronic folder (EF).
  • Use the following steps to gather pertinent documents used to calculate the overpayment to use for the folder review and personal conference.
  • A. Query CFRMS
  • A. Query CFUI
  • Since we are becoming more of a paperless environment it is possible there is no paper claims folder to review. Therefore, use the Claims File Records Management System (CFRMS) to view documents stored in NDRed using instructions found in SM 08001.005 Record Retrieval. If there is a certified electronic folder (CEF) use eView to view the documents. For further instructions, see DI 81001.005 Certified Electronic Folder.
  • Since we are becoming more of a paperless environment it is possible there is no paper claims folder to review. Therefore, use the Claims File User Interface (CFUI) to view documents stored in NDRed using instructions found in SM 08001.005 Record Retrieval. If there is a certified electronic folder (CEF) use eView to view the documents. For further instructions, see DI 81001.005 Certified Electronic Folder.
  • Print the pertinent information used to calculate the overpayment so it is available to the debtor for the folder review (review (i.e. paid vs payable charts, notices, etc.).
  • B. Query PCACS and Paperless
  • Query the Processing Center Action Control System (PCACS) or the Paperless Read Only Query System (PPL ROQS) to see what other actions are pending or not pending, which may be relevant to the overpayment.
  • If a Paperless record exists (Image on File) and you are in the FO, contact the PSC that has jurisdiction to request any pertinent documents faxed to you.
  • NOTE: If waiver requests are pending at multiple FOs, have the documents faxed to NDRed where everyone can access them.
  • C. Information needed from the paper folder
  • If a paper folder exists and Paperless does not have all of the documents needed, contact the appropriate Information Retrieval Group (IRG) if the folder is located in the National Records Center or the Office of Central Operations (OCO’s) Megasite. For more detailed instructions, see GN 01070.600 Retrieving Information and Documents from Stored Folders.
  • D. Requesting the paper folder
  • If you are unable to locate the pertinent overpayment documents in CFRMS, Paperless, or from the IRG; request the paper folder using instructions in GN 03340.010B.1.
  • If you are unable to locate the pertinent overpayment documents in CFUI, Paperless, or from the IRG; request the paper folder using instructions in GN 03340.010B.1.
  • E. No overpayment documents found
  • If you are still unable to obtain any pertinent overpayment documents from the claims folder and you cannot gather them the Online Retrieval System (ORS), Paperless, NDRed or other electronic means, the FO is legally bound to assume the debtor is without fault and approve the waiver request.
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