You will be able to process some of the AFNB DE claims through EC using the Future MOE AI process. However, if the
future MOE is earlier than MOE on the established MBR, you will continue to receive
the BENDPOINTS processing limitation.
On those AFNB DE claims that qualify as Future MOE cases, you do not have to hold
the claims until EC updates with the 2024 bendpoints unless both DE claims are AFNB
claims. After you trigger the case as Future MOE AI claims, the system holds the DE
AFNB claims for future processing.
AFNB DE claims triggered as Future MOE claims process during the Future MOE AI run
for the calendar month that is equal to the MOE for the claim.
The earliest Future MOE AI run for AFNB DE claims is in January 2024. A DE AFNB claim
with a MOE of 01/24 will process by the system on 01/02/24. The MBR updates on 01/03/24.
DUAL ENTITLEMENT (DE) AFNB Processing Steps:
Process dual-entitlement cases when ONE claim is an advance file claim as follows
(for example, an A-B-A claim when the A-B account is AFNB and the other A account
Trigger the non-AFNB claim as a single entitlement;
Remember: Include the MCS paragraph CLOR05 on the Notice 3 (NOT3) screen to alert the claimant
about the pending entitlement to the other benefits.
Wait until the MBR establishes for this claim;
Trigger the AFNB DE claim using the Future MOE process, if the alert on DRMK screen
tells you it qualifies as a Future MOE case (“TRIGGER CLAIM AS FUTURE MOE THROUGH
When BOTH dual-entitlement claims are advance file cases; (for example, an A-B-A case
where all claims are AFNB)
Hold the claims until the bendpoints are available in EC (11/17/23);
Change the MATERIAL FILE DATE on the FDDS screen to 11/17/23 and
Trigger the claims as dual-entitlement through EC.
NOTE: If you attempt to run ANY DE claim with an established MBR after the COM change but before the MBR BRI update, EC generates the following processing
limitation: "POSSIBLE PRE-BRI MBR FOR DUAL-ENTITLEMENT EXISTS -- HOLD FOR PROCESSING
IN DECEMBER COM". Hold the claim until after the MBRs update with the BRI. Change
the MATERIAL FILE DATE on the FDDS screen to the date you trigger the claim before
processing these cases.