TN 31 (09-12)

The overpaid person may still have questions about his or her overpayment and request an explanation, despite the information he or she receives in the initial overpayment notice. We must stop recovery efforts until we provide the overpaid person an explanation, and give him or her an opportunity to decide how to respond to the explanation.

A. Overpaid person contacts the field office (FO) for an explanation of the overpayment

When an overpaid person contacts the FO either in person or by telephone, provide an explanation of the overpayment immediately (if possible) using the following sources:

• the Master Beneficiary Record (MBR),

• Recovery of Overpayments Accounting and Reporting (ROAR),

• Payment History Update System (PHUS),

• payment history and worksheets,

• Overpayment Wizard (OPWIZ) on the personal communications, Office of Quality Assurance (PCOM OQA) toolbar,

• Claims File User Interface (CFUI),

• Paperless, or

• Online Retrieval System (ORS) for any notices we sent to the overpaid person regarding the overpayment, etc.

1. Overpaid person’s response to the overpayment explanation

Once the overpaid person is satisfied with the explanation, he or she may decide to continue with plans to pay the overpayment, as stated in the notice, or request:

• Waiver of recovery of the overpayment, follow instructions in GN 02201.021 Waiver of Recovery – FO Action;

• Reconsideration only or reconsideration and waiver of the overpayment, follow instructions in GN 02201.025 Title II Overpayment Reconsideration Request; or

• Lesser rate of withholding, follow instructions in GN 02210.030 Considering Different Rate of Adjustment.

2. Documenting the response and next steps

Annotate the Debt Management System’s (DMS) remarks screen with:

• a detailed description of the explanation that you gave,

• the date you gave it,

• your office code,

• your name (or unit code), and

• the overpaid person’s decision.

Then do one of the following:

• Process any refund following instructions in GN 02403.001, Overview of Field Office Remittance Process; or

• Resume collection (if we stopped collection) using the Establish Offset (Debtor) (DROA) screen in the debt management system (DMS) (MSOM DMS 006.015) if the person is in current pay or deferred pay status; or

• Resume billing (if we stopped collection) using the Record Installment Agreement (DRIN) screen in DMS (MSOM DMS 006.014) if the person is in suspense or terminated status per GN 02210.180 and SM 00610.735; or

• Code the desired appeal, when appropriate, using the Protest/Stop Recovery Request (FO) (DRPF) screen in DMS (MSOM DMS 006.019).

B. FO responds to the overpaid person in writing

If you are unable to respond to the overpaid person verbally or the overpaid person requests a written response, provide a written explanation of the overpayment. You may need to stop the collection process depending on how long it takes to send the notice following instructions in GN 02201.017C.

IMPORTANT: Do not include any appeal rights in the explanation notice. The original overpayment notice contained appeal rights.

After sending the explanation notice, use DMS (DROA screen) to resume collection in the current operating month (COM) plus 2 months (if applicable) and annotate DMS Remarks.

C. More detailed explanation needed from the Program Service Center (PSC)

When the FO or teleservice center (TSC) cannot provide a more detailed explanation of the overpayment and the overpayment telephone contact (OPTEL) per GN 01070.240 is not responding, do the following:

• Send a modernized development worksheet (MDW) to the PSC requesting a written explanation of the overpayment;

• Input the explanation protest reason using the Protest/Stop Recovery (FO) (DRPF) screen in DMS to suspend collection activity and annotate DMS remarks; and

• Transfer the workload management system (WMS) jurisdiction for the explanation protest request to the servicing PSC using the WMS Debt Management Function Selection (DMFS) screen in DMS (MSOM DMSWMS 002.003).

There are also instances when the overpaid person sends a direct request to the PSC for an explanation.

D. PSC instructions

If the PSC receives a direct request from the overpaid person or a request from the FO, stop recovery (if applicable) via Protest/Stop Recovery Request (PC) (DRPR) screen in DMS (MSOM DMS 006.003) using the “explanation” protest reason. Check ORS for any notices we previously sent to the overpaid person regarding the overpayment then take the following actions to provide the explanation and resume recovery:

• Provide a thorough written explanation of the overpayment using the MBR/ROAR/PHUS, documentation located in Paperless, or OPWIZ on the PCOM OQA Toolbar.

• Follow the notice standards located in GN 02201.009B.1.

• Do not include any appeal rights in the explanation notice.

• Use DMS or MACADE to resume collection in COM plus 2 months.

• Annotate DMS remarks to say that you have provided an explanation of the overpayment and you are resuming collection. Include the date you sent the notice, your office code, and your name (or unit code).

• Clear the MDW (if applicable).

E. 800 Number instructions

National 800 Number agents should follow the instructions in TC 26001.020 Request For Explanation Of An Overpayment.