TN 5 (03-03)

GN 00506.002 Definitions – Fee for Service

A. DEFINITIONS

The following terms are used in this subchapter and are defined for the purpose of this subchapter only:

  1. Authorized Fee-The amount of money an organization can legally collect from a beneficiary for representative payee services.

  2. Authorized Organization— An organization that has applied to, and received written permission from SSA, to collect from beneficiaries a fee for representative payee services.

  3. Beneficiary— A person receiving a benefit administered by SSA.

  4. Benefit— Includes a Title II, a Title XVI, and a Title VIII benefit. The term “benefit” also includes a federally administered state supplementary payment (SSP) and state recognition payment where applicable.

  5. Charitable Organization— An organization that provides assistance to the elderly, the needy or the disabled.

  6. Conserved Funds— Money belonging to a beneficiary, which has been saved from SSA benefit payments. Conserved funds can be in various forms - such as cash-on-hand, money in a checking or savings account, U.S. savings or treasury bonds, etc.

  7. Creditor— An organization is a creditor of the beneficiary if it provides goods or services and requires monetary compensation from that beneficiary.

  8. DAA Condition— A medically determinable substance abuse disorder that is posted as a secondary diagnosis (for example a SDIG code of 3030 or 3040). P.L. 104-121 enacted March 29, 1996 states that DAA (Alcoholism and/or drug addiction) should no longer be material to the disability determination.

  9. Government Agency— A subordinate entity of a State or local government created to carry out a government function or to implement a statute or statutes.

  10. Organization— Any agency that applies to become a representative payee and may become authorized by SSA to collect a fee for payee services. Examples include a corporation, society, church, foundation, civic league, association, domestic fraternal order, or other agency. The term includes certain state and local government agencies.

  11. Out of Pocket Expenses— They are actual expenses for food, shelter, medical items, clothing, transportation, and personal needs items incurred on behalf of a particular beneficiary. Be aware that Fee for Service organizations are not authorized to be reimbursed for any expenses that are considered “overhead”, such as postage, office equipment and supplies, photocopying, etc. These are already included in the fee for representative payee services.

  12. Personal Needs Allowance— Money that is set aside each month for the individual needs of institutionalized beneficiaries.

  13. Qualified Organization— An organization that meets the criteria specified in the Act, but that has not yet been authorized to collect a fee for representative payee services.

  14. Religious Organization— An organization that is operated by, affiliated with or adhering to the principles of, a specific faith or religious order.

  15. Reviewing Official— The SSA field office management official who initially reviews and decides upon an organization's request to collect fees for representative payee services.

  16. Social Welfare Organization— An organization that addresses the economic or social needs of the general public or a certain group of people.

B. REFERENCES

GN 00603.001 Conservation of Benefits

SM 05905.058 Secondary Diagnostic Codes (SDIG)

GN 00502.020A.4 DAA Condition


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0200506002
GN 00506.002 - Definitions - Fee for Service - 01/23/2006
Batch run: 01/27/2009
Rev:01/23/2006