TN 15 (09-17)
HI 03050.045 Manual Correction Process for the Extra Help Application
A. Description of the manual correction process
Medicare Application Processing System (MAPS) users in the field office (FO) or subsidy appeals unit (SAU) may determine that an error on a MAPS application or redetermination affects the subsidy determination and cannot be corrected using normal procedures. The error(s) could be caused by scanning, keying, or incorrect information from the applicant. The manual correction process permits users in the FO and SAU to correct problems without using a work around. FOs and SAU users can use this process to correct an applicant's Social Security Number (SSN).
NOTE: MAPS must process a case to an award or a denial in order to use the manual correction process. Identified errors should be corrected within 60 days of the initial determination or hearing decision.
1. When to use the manual correction process
These instructions apply only to cases where a technician identifies an error. They do not supersede instructions for the exception and verification processes. If the beneficiary contacts Social Security Administration and disagrees with the determination, advise the beneficiary to file an appeal.
2. Effective date of a manual correction input
Any change resulting from a manual correction input will be effective the month after the month of report because the manual corrections use the same determination process as almost all of the subsidy-changing events (SCEs). The only SCE that uses a different determination process is “beneficiary’s living-with spouse dies,” but only in those cases that fall under the special situation described in HI 03050.025C.5. In cases where the Extra Help will increase because of the change, users must over key the “Report Date” field on the Manual Correction Process Portal (MCOR) screen. This ensures that the effective date of the correction is equal to the first month of Extra Help entitlement.
NOTE: Before keying in a manual correction, review the Determination Data section in MAPS. If the determination date does not equal the current date, process the manual correction action. If the determination date is equal to the current date, process the manual correction action on the next business day.
IMPORTANT: Do not process more than one manual correction action per day for the same SSN.
B. Making corrections prior to submitting a case for a subsidy determination
When you identify an error prior to subsidy determination, access the appropriate MAPS screen and make the correction via the “Edit Application” button. Make sure you submit the new data to the Subsidy Determination process.
REMINDER: Unlike a manual correction, prior to subsidy determination you can process more than one edit action for the same SSN. Each time you process an edit action, submit the case to subsidy determination.
Example of correcting an error before submitting the case to Subsidy Determination:
The pension amount shown on Carol Montoya's application is incorrect. The claims representative (CR) notices the error before the application goes through the Subsidy Determination process. Therefore, the CR can correct the error via MAPS. The CR selects the ”Edit Application” button on the Development Worksheet screen (DWMP), accesses the unearned income (ATUI) screen and enters the correct pension amount. For additional DWMP MAPS instructions, see MS INTRANETMAPS 006.002 and For additional ATUI MAPS instructions see MS INTRANETMAPS 005.006.
C. Making corrections after an initial award or denial determination, or favorable or unfavorable hearing decision
To correct an error within 60 days after an initial award, denial, or fully favorable or unfavorable hearing decision, take the following actions:
Access the beneficiary's DWMP screen in MAPS. (or detailed information on the DWMP screen see MS INTRANETMAPS 006.002.
Select Manual Correction - From the Development Worksheet, select the “Manual Correction “button. The user then goes to the MCOR screen and completes this screen. (For additional MCOR MAPS instructions see MSOM INTRANETMAPS 004.004.)
Make corrections - the system will create a new application by propagating all data from the prior application. Data may be over keyed as appropriate. If you change the SSN, some data will not propagate.
Over-key the “Report Date” field with a date equal to the month before the month of the effective date for the subsidy determination, if the correction will result in an increase in the subsidy amount,
Return to the DWMP screen. Review the determination effective date and ensure the date is equal to the first month of Extra Help entitlement. If the date is incorrect, use the “Edit” button.
Input the proper date in the “Report Date” field on the SCE/Manual Applications (DEDS) screen. See MSOM INTRANETMAPS 006.022 for additional information regarding the DEDS screen.
Save the changes.
Submit corrected information to the Subsidy Determination process.
The new application stays in pending status until it goes through the Subsidy Determination process.
NOTE: MAPS processes manual corrections cases as new applications. As a result, the system will request updated IRS data, which may create new verification issues and delay processing. To avoid this, show income and resources as verified. For additional MAPS instructions see MS INTRANETMAPS 006.006.
EXAMPLE 1: Effective date of a manual correction
Saul Jones' application was approved. He receives a 75 percent subsidy, effective January 1, 2014. In February 2014, a CR realizes that because of a scanning error, a large pension was not included in the income calculation. Mr. Jones should be receiving a lower subsidy amount. The CR accesses the MCOR screen via DWMP screen and completes the screen(s) using the correct income information. The “Report Date” is equal to the date of the input, and then the CR submits the corrected application for Subsidy Determination.
The 75 percent subsidy will terminate on February 28. The new subsidy amount of 50 percent will be effective on March 1. The system will issue a Notice of Planned Action to Mr. Jones.
NOTE: When using the manual correction process, a change to a lower subsidy amount is effective with the month after the month shown in the “Event Report Date” field of the MCOR.
EXAMPLE 2: Effective date of a manual correction
Mary Martin's application was approved and she receives a 25 percent subsidy, effective March 1, 2014. In April 2014, the CR realizes that she entered earned income on the application in error. The CR accesses the MCOR screen via the DWMP screen, inputs February 1, 2014, in “Report Date” field selects “Continue” and updates the screens using the correct income information. After reviewing the DWMP screen to ensure that the determination effective date is equal to March 1, 2014, the CR submits the new data to Subsidy Determination.
Mary Martin will receive a Notice of Change and her subsidy amount will increase to 75 percent effective March 2014.
NOTE: When using the manual correction process, an increase in the subsidy amount must be effective with the first month of Extra Help eligibility. Be sure that the “Report Date” field on the MCOR screen is equal to the month prior to first month of Extra Help eligibility.
EXAMPLE 3: A manual correction for a change to income information
Lolly Williams' application for Extra Help was denied effective January 1, 2014. On February 5, 2014, the CR recognizes that a scanning error has posted the same income as earned and unearned income, resulting in the denial. Mrs. Williams has not filed an appeal.
The CR accesses the MCOR screen via the Development Worksheet, enters December 1, 2013, in the “Report Date” field, and checks the DWMP screen to ensure that the determination effective date is equal to January 1, 2014. The CR then enters the correct information, saves the application, and submits the case to Subsidy Determination. MAPS will issue a notice to Mrs. Williams, informing her that she will receive a subsidy.
EXAMPLE 4: A manual correction for a change to resource information
Sherry Williams applied for Medicare Part D Extra Help and was denied effective November 2013 because of excess resources. She filed an appeal.
After denying the appeal, the Subsidy Determination Reviewer (SDR) realizes that the resource information is incorrect. In MAPS, the SDR accesses the Development Worksheet and selects the MCOR screen. The SDR keys November 1, 2013, in the “Report Date” field, corrects the erroneous information, and submits the application for Subsidy Determination.
MAPS will issue a Notice of Award to the beneficiary.
GN 02602.000 Continuing Eligibility
HI 03040.000 Appeal of Medicare Part D Subsidy Determination
HI 03050.020 Redetermination of Eligibility for Medicare Part D Extra Help (Low-Income Subsidy)
SM 03005.170 Change of Address
SI 02306.010 Change of Address or Residence
MS INTRANETMAPS 006.014 MAPS Changing Event (DWCE)
MS INTRANETMAPS 006.002 MAPS Development Worksheet Main (DWMP)
MS INTRANETMAPS 004.004 Manual Correction Process Portal (MCOR)
MS INTRANETMAPS 006.022 MAPS Edit Determination Dates – SCE/Manual Application (DEDS)