MANAGER'S ANNUAL MANAGEMENT REVIEW
PERIOD THRU
REVIEW SEPARATION OF DUTIES
A negative answer to any of the following questions indicates a need for corrective
action.
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YES
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NO
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1.
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Do you maintain separation of duties with remittance clerks and Third Party Draft
Cashier responsibilities?
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If NO, have you requested a waiver from CSI?
If YES, to filing a waiver, is a copy of the approved waiver in the office Security Action
Plan (SAP)?
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2.
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Do you ensure that the remittance supervisor does not serve as the remittance clerk?
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REVIEW THE PHYSICAL SECURITY OF YOUR RECORDS
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YES
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NO
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3.
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Are receipt books, Master Control Roster and associated receipt book logs stored in
a safe or locked container? GN 02403.100B.)
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REVIEW THE FO DAILY RECEIPT LISTINGS FOR ONE WEEK OF THE YEAR, ANSWER THE FOLLOWING:
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YES
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NO
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4.
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Does the remittance supervisor sign each FODRL? (GN 02403.021)
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REVIEW MAIL HANDLING/RECEPTION DESK PRACTICES
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YES
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NO
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5.
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Is mail always opened in the presence of two employees? (GN 02403.004B.)
If NO, have you requested a waiver from CSI?
If YES, to filing a waiver, is a copy of the approved waiver in the office Security Action
Plan (SAP)?
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6.
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Does the office maintain a mailroom and reception area log or require that all incoming
remittances are immediately stamped to render them nonnegotiable? (GN 02403.004C.)
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7.
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Does management do a daily review of mailroom and reception area logs to ensure logged
items have entered the remittance process? (GN 02403.006B., GN 02405.010D., GN 02405.100B.)
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REVIEW THE SECURITY OF REMITTANCES
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YES
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NO
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8.
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Are refunds and returned checks awaiting disposition maintained in a locked cash box
by the remittance clerk?
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9.
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Do all remittance clerks have their own cash boxes, with keys kept in a secure area?
(NOTE: Keys kept in unlocked desk drawers are not considered secure.)
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10.
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Are all remittances, fees, returned benefit checks mailed daily to the appropriate
addresses or if unable to be mailed the same day are they secured and mailed the next
business day? (GN 02403.006B.)
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11.
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Has the FO documented its efforts to resolve unverified remittances by following GN 02403.050C. and GN 02403.050D.?
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12.
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Are all personal checks, money orders, or endorsed returned benefit checks stamped
“For Deposit Only, SSA?” (GN 02403.006A.)
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13.
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Are all returned unendorsed benefit checks stamped “Not Negotiable?” (GN 02405.010B.1.)
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14.
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Are all Medicare premium remittances stamped “For Deposit Only, CMS?” (GN 02403.030A.1.)
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15.
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Is a cash log entry completed for all cash remittances? (GN 02403.010A. and GN 02403.010B.)
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16.
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If cash is not converted to a money order on the day cash is received in the FO, is
the FO remittance transmittal or FO daily receipt listing annotated accordingly, and
the cash remittance held in a secure location overnight? (GN 02403.009C.)
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REVIEW PHYSICAL SECURITY, DOCUMENTATION AND WORKFLOW
If you have not used or received a receipt book in the last year, skip to Question
28.
Reviewing the Master Control Roster, answer the following:
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YES
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NO
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17.
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Does the the packing slip or outside label of the receipt book(s) match the list of
receipt books on the Master Control Roster? (GN 02403.090B.2. and GN 02403.095A)
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18.
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Are the receipt books returned to the issuer when the users no longer need them?
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19.
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Can the SSA-1395 Receipt Book(s) be accounted for? (GN 02403.095F)
If NO, has the Master Control Roster been annotated with the date it was discovered
missing and is an explanation of the recovery attached?
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20.
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Does the Receipt Book Log show the date of issuance and return for each receipt book
in use? (GN 02403.100 and GN 02403.105C.)
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21.
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Are the numbers of the receipts used and the date the receipt book was returned to
the issuer entered into the receipt book log? (GN 02403.105C.)
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22.
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Are the inside covers of receipt books completed, dated, and signed by the issuer?
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23.
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Do out-of-office representatives notify management if the remittance clerk or issuer
has left for the day, so refunds and receipts can be kept overnight in a secure location?
(GN 02403.008B.)
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24.
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Are all SSA-1395-BK's present in the completed receipt books? (GN 02403.135)
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25.
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Are the original and all three copies of voided receipts accounted for in the receipt
books? (GN 02403.135B.1.)
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26.
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Do all completed SSA-1395-BK's have cross-referred automated systems receipts attached?
Appropriate cross-reference numbers should be on both forms. (GN 02403.130B.)
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27.
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Is the receipt book issuer at or above the Operations Supervisor/Management Support
Specialist level?
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If you have not completed an SSA-414 in the last year, skip to Action Items.
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YES
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NO
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28.
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For SSA-414-U3's, are blocks completed for the Social Security Number, Name of Remitter,
Amount, Receipt Number, and is the FO return address clearly shown? (GN 02403.013)
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29.
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Do all SSA-414-U3's bear the signatures of the remittance clerk and remittance supervisor?
(GN 02403.013D.)
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30.
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If any unverified SSA-414-U3 is more than 45 days old (for fees sent to OF), or 60
days old for fees sent to OEO, has the remittance supervisor begun the follow-up procedure?
(GN 02403.012B. and GN 02403.012C.)
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| 31. |
Has the FO documented its efforts to resolve unverified fee remittances by contacting
OF/OEO? (GN 02403.055C.)
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Action Items:
Evaluation Completed By:
Date:
Retention Period: 3 Years (Do not take the review with you if you leave the field
office or retire.)