When a technician identifies a potential excess fee issue, the technician must first ensure that the excess fee is one for which we will pursue recovery and that the excess fee was paid to the representative.

For more information on the circumstances under which we will pursue recovery of an excess fee, see GN 03920.051B.

If the excess fee issue meets the criteria for pursuing recovery and the fee in question was paid to a representative, the technician will document the situation in a Report of contact (ROC) in the Registration, Appointment and Services for Representatives (RASR) report of contact screen.

The ROC should include the following information:

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  The representative(s) involved (identify representative(s) and date(s) of appointment);

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  The fee process involved (fee petition or fee agreement);

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  The past-due benefit period and amount (include amounts for claimant and any affected auxiliaries);

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  The date of fee authorization (for fee agreements use date of fee setting notice);

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  The date fee authorization was amended or reversed by decision maker or person with fee setting authority, if applicable;

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  An explanation of the incorrect fee payment, including the amount; and

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  An indication of whether we correctly paid the claimant and any affected auxiliaries.

Before requesting a refund of an incorrect fee payment, verify that the decision maker or person with fee setting authority sent the correct fee authorization or rescission notice. We must notify both the claimant and the representative of the correct fee.

For information on the proper authorities for authorizing fees or reviewing requests for administrative review, see:

GN 03930.015 and GN 03950.005 (fee petitions), and

GN 03940.002 and GN 03960.015 (fee agreements).

If the excess fee resulted from a reduction in the fee we authorized, ensure that notice of the revised fee action was sent to the claimant and representative.

For a fee petition case, the decision maker will have issued a corrected or revised fee authorization notice.

For a fee agreement case, the processing center (PC) (for Title II claims) or field office (FO) (for Title XVI claims) will have sent notice of the revised fee amount, which includes the fee authorization language specified in GN 03940.008B.

If the relevant instructions in GN 03920.051B direct us to issue a refund to the claimant, the technician will refund any erroneously withheld benefits to the claimant.

For information on refunding the excess fee withholding, see

SM 01901.005 and SM 01901.015 for Title XVI claims, and

SM 00848.330 for Title II claims.

Notify the representative of the amount they must refund to us within 30 days. For sample language, see GN 03970.025.

Technicians annotate the incorrect fee payment or debt owed to us in the Debt Management System (DMS) for T2 claims, per SM 00610.772B.7.

Manually control debts for T16 claims and debts owed to claimants, see GN 03920.052C.7.

Annotate a special message or remark regarding the incorrect payment to the Master Beneficiary Record (MBR) or Consolidated Claims Experience.

For more information regarding special messages and remarks, see SM 00510.075 for T2 and SM 01301.841 for T16.

Technicians will establish a 45-day diary to follow up on the refund request. PCs may establish an ATFEE EXCESS diary through the Processing Center Action Control System (PCACS). For additional information on establishing PCACS diaries, see MS 04909.002 Diary Request Menu (DRMN). FOs may establish an issue on the Development Worksheet page or on the MDW screen.

For additional information on establishing FO follow-ups, see:

MS 08122.004 Development Worksheet, and

MS 03901.002 Modernized Development Menu (MMEN).

When FO or PC technicians identify a potential excess fee issue, they must first ensure that the excess fee is one for which we will pursue recovery and that the excess fee was paid to the entity.

For more information on the circumstances under which we will pursue recovery of an excess fee, see GN 03920.051B.

If the excess fee issue meets the criteria for pursuing recovery and the fee in question was paid to an entity, the technician issues a Notification of Collection Action to Entity (MAO104). This notice can be created using the Document Processing System (DPS) or AURORA, and it should be addressed to the entity’s POC.

The technician then documents the situation in RASR by recording an ROC in the Appointment-Related Report of Contact (ROCD) screen for each appointment associated with the excess fee issue. In cases involving multiple representatives, technicians must ensure that an ROC is created for each representative associated with the excess fee payment, even if they all assigned direct payment to a single entity.

The ROC should include the following information:

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  The name and Employer Identification Number (EIN) of the entity involved;

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  The name and Rep ID of the entity’s POC;

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  The names and Rep IDs of any representatives involved, their dates of appointment, and the date(s) they assigned the right to direct payment of their fee to the entity, if applicable;

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  The amount of the excess fee payment;

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  The fee process involved (fee petition or fee agreement);

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  The past-due benefit period and amount (include amounts for the claimant and any affected auxiliaries);

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  The date of the fee authorization; and

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  A brief description of the excess fee issue.
  
  

The technician then establishes the excess fee in the appropriate system and sets a 30-day diary to follow up on the refund request. For more information on establishing an excess fee and setting a diary, see GN 03920.052.B.6. and GN 03920.052.B.7.

REMINDER: When following the instructions in GN 03920.052.B.7. to set a diary for entity-related fee issues, technicians must set a 30-day diary, not a 45-day one.

Once the initial 30-day diary has expired, the technician queries RASR and any other relevant system (e.g., DMS, MBR, MDW, PCACS) to determine whether the entity has refunded the entire excess fee.

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  If the entity has refunded the entire excess fee payment, the technician creates a new ROC in RASR for each related representative to reflect that full payment of the excess fee has been received.

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  If the entity has not refunded the entire excess fee payment, the technician proceeds to step 4.

If the entity has not refunded the full excess fee payment by the expiration of the first 30-day diary, the technician issues a second, final recovery notice, Final Notification of Collection Action to Entity (MAO105). This notice can be created using DPS or AURORA, and it should be addressed to the entity’s POC.

The technician then creates a new ROC in RASR for each related representative and sets a new 30-day diary to follow-up on the refund request. The technician reviews the prior ROC and ensures that the information listed in GN 03920.052C.2. was included in that ROC. If any information is absent, or if there is no prior ROC, the technician will include that information in the new ROC.

In addition, the technician adds the following information:

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  The amount of the excess fee payment that has been refunded, if applicable;

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  The amount that has not yet been remitted.

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  The date the initial notification of collection action was issued; and

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  Any other relevant information related to the fee recovery process, including whether the entity’s POC has contacted us.

Once the final 30-day diary has expired, the technician queries RASR and any other relevant system (e.g., DMS, MBR, MDW, PCACS) to determine whether the entity has refunded the entire excess fee.

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  If the entity has refunded the entire excess fee payment and RASR already contains ROCs documenting this for each related representative, the technician clears any pending diaries and takes no further action.

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  If the entity has refunded the entire excess fee payment, but RASR does not contain ROCs for each related representative documenting this, the technician creates an ROC for each related representative to reflect that the full payment of the excess fee has been received. The technician then clears any pending diaries.

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  If the entity has not refunded the entire excess fee payment, or has refunded only part of it, the technician proceeds to step 6.

If the entity does not refund the full excess fee by the expiration of the second diary, the FO or PC technician should consult their manager for a potential referral to the IDPE Coordinator Group.

The manager will confirm that:

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  We issued to the entity's POC both the "Notification Action to the Entity" and the "Final Notification of Collection Action to the Entity";

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  At least 30 days have passed since we issued the "Final Notification of Collection Action to the Entity"; and

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  We have not received a full refund of the excess fee.

If the conditions above are met and the manager approves, the manager will:

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  Refers the entity to the IDPE Coordinator Group by sending an email to the IDPE Coordinator Group Mailbox. See the example email below.

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  Creates an ROC in RASR for each related representative with the following message “IDPE Referral made on [insert date].”

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  Closes any open diaries.

The subject line of the referral email should be “IDPE Referral for [Entity name and EIN].

The body of the email may be formatted as follows:

Re: [Claimant Name and SSN]

Good [Morning/Afternoon],

We are referring [Entity Name, EIN] for potential action by the IDPE Coordinator Group. An excess fee of [Full Excess Fee] was paid to this entity on [Fee Payment Date]. Based on the criteria in [Cite the applicable recoverable excess fee provision in GN 03920.051B, we identified this payment as an excess fee requiring recovery.

We sent collection notices to the entity’s POC on [Date of First Collection Notice] and [Date of Final Collection Notice], but as of today, [Remaining Excess Fee] remains unremitted. Please see the information below for more details.

[Include any information that is relevant to recovering the excess fee. This includes but is not limited to:

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  The claimant’s SSN and name;

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  The name and EIN of the entity involved;

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  An explanation of the excess fee payment;

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  The dates of the first and final notice collections notice; and

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  Any information that should have been documented in RASR ROCs, but was not. For more information, see subsection GN 03920.052C.2 and GN 03920.052C.4., above.

Once the referral has been submitted, the IDPE Coordinator Group will not generally provide updates to the referring office. However, the IDPE Coordinator Group may contact the referring office as needed to resolve any question related to the referral.

If an FO or PC technician receives an inquiry from an entity’s POC about an issue that relates to the IDPE list or other excess fee-related matters, the technician may access the IDPE list in RASR for information on an entity’s status and any unresolved fee issues.

Technicians may provide any necessary information needed to resolve the excess fee matter, including but not limited to:

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  Claimants’ SSN;

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  IDPE status;

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  Ineligibility Start or End Date; and

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  Amount Owed.