CEP Specialist Training
Contents
1. for deposit only and account number Destroyed checks that are signed must have identifiable name amount check number remnants to be replaced Dual payee checks will only be replaced when 1 The payee has stated the unendorsed check has been lost destroyed or stolen or 2 The payee has endorsed on the check given it to the second party and the second party endorsed the check and it was lost destroyed or stolen In this case the second party must complete the DHS 138A and sign a statement stating that if the original check comes in cashed he she holds the client harmless and will reimburse the state if the original check is negotiated In this situation the replacement check can be issued to the second party only no dual payee is needed Checks that have been paid should not be replaced prior to receiving a front and back copy of the check so that the payee may examine the signature if upon viewing the check the payee states that it was not endorsed by them they must complete the forgery packet It is important because then you can make a preliminary determination whether or not the payee negotiated the original check before a replacement is issued Five postal service working days from the date the original check was issued shall be allowed for delivery before a replacement check is issued In addition 49 an effort should be made by the branch to locate the original check through the local post office In cases wh2. 7 i H ER is 5 created Yu may TE in the next date a a a ee gt o sF EF Fr Trans T ych b Prim Id Prov Nmbr Prov Nans Service Auth Beg 09 11 04 Cat APD Contact Br 2011 Hr ly Hr ly Paid Leave Y N Live in UYN N Live in Leave hours 24 MHD DD Pers Care Prov Y N Mileage Y N Proc Description 00115 24 hr Relief gogogo Pres Tran Recip N un Tot Sve Units Err Code Msg QUES ADD YCHR TO FILE Y N PFa P lan _ File Edit Transfer Fonts oon Options Macro View oF FF FF Window In home Trans T ych Nabe Prim Id Prov Nmbr Service Auth Beg 09 11 05 Cat APD Contact Br 2011 Hr ly Hr ly Paid Leave Y N Live in BYN N Live in Leave hours 24 MHD DD Pers Care Prov Y N N Mileage Y N N Proc Description 00115 24 hr Relief Q 0000000_ Pres Tran Recip N Tot Sve Units Err Code Msg QUES ADD VCHR TO FILE Y N PF4 P lan Chg ct amp R In home Service Authorization Upd Date 00 00 0000 Upd RACF ANSW Uni ts Mi ANSW x PAL PAZ Pag ENT CLR O LE Not on file i City St PORTLAND OR Auth End 09 11 04 Lst Work 00 00 00 Auth Wkr Spousal Pay Y N Days work per wk Reg Live in Prov Nmbr E CIIS Y N Pub Trans Allowance Y N its Mil Rate Line Tot 24 00 7 2916 175 00 24 00 Auth Cim Err Stat 175 00 PRNT 59887 rs Chg MAIL BR Help S S R x Service Authorization Upd Date 00 00 0000 Upd RACF PAL PA PA3
3. Prt Pre pas ENT CLR o ae 7 eee Service Claim Detal Upd 03 09 coro nnmur SHANNAN L wkr Id MI Cre 11 02 2009 RACF I ANGELA Msg Hours reflect unpaid leave ych nmbr guteeeeeeeeenn Pres trans 99 msg IN READY TO PAY STAT REGULAR ych Xref 7 CHK DATE 00 00 00 CHK NMBR 80000000 RA Nmbr 0000000 ICN 00000OOOOOOOO Pay Ref 00 00 00 Ych Adj N EOB 650 f X Ref CICN 00000000000 BR 3515 Prnt 598B 09 11 02 Mail Br Prim Id pastalele Tatas Prov nmbra Recip t Prov Nam iu Auth Date wo tas UL Addr Syc Cat APD Prov Str HERRY BLOSSOM DR Prov City Si reniernND OR Compl Zip 97216 2827 Author ized Adjudicated Beg 09 11 01 End 09 11 15 Beg 09 11 01 End 09 11 15 Proc Desc Units Rate Total Units Rate Total 0C112 ADL Full Assist 60 00 10 2000 612 00 52 33 10 2000 533 0C112 Self Management 42 50 4 5500 193 38 37 06 4 5500 168 0C112 24hr Avai lability 79 50 4 5500 361 73 69 33 4 5500 315 F3 EXIT F7 PREY F8 NEXT F10 HSYC F11 HDTL F12 HINQ F2l AUTH F22 ADJ F23 d If an OC112 voucher has leave without pay it will display in the Msg area Hours reflect unpaid leave at the top of the screen 28 In home Service Claim List YCH PRCS PRIM RECIP PROV PROY SERY SERY CHK EFT NMBR TRANS ID NAME NMBR NAME BEG END DATE REJ j S46 ya m 9891201 091215 100303 36 091201 091215 991219 B27 A 091201 091215 100303 MSG 101 Top of display 3 EXIT F11 HINY F21 AUTH F22 ADJ F23 PAY
4. p RRY BLOSSOM Proy City ST PORTLAND OR Comp Zip 97216 2827 Adjudicated Beg 00 00 00 End 00 00 00 Units Rate 2717 0000 0 00 0000 0 00 0000 09 11 02 Cea DR Total 612 00 193 38 361 73 2000 5500 5500 fia 2 smh eboi File Edit Transfer Fonts Options Macro View Window Help oog QF Fr Bae a In home Service Aut Upd Date 03 09 2010 Upd RACF Trans Ty ych Nmbr Prim Id Prov Nmbr Service Cat 4 00000000 Prcs Tran Recip SCh Prov Name HA Auth Beg E Contact Br Hr ly Hrly Paid Leave Y N Live in Y N Live in Leave hours MHD DD Pers Care Prov Y N Mileage Y N Proc Description Tot Svc Units Err Code Uni ts Mi PAL PA2 PA3 ENT CLR O O orization Not on file HA City St PORTLAND OR Auth End Lst Work Auth wkr Spousal Pay Y N Days work per wk 7 B S 21 Reg Live in Prov Nmbr CIIS Y N Pub Trans Allowance Y N Rate Line Tot Auth Cim Msg P173 Must enter both Begin and End dates Need to put in begin and end dates Live In Leave hours and the Reg Live In Provider Number then press enter f File Edit Same Fonts Options Macro View Window Help ei sF F Fe amp ct ce R x pat PA PAs ENT CLR O In home Service Authorization 03 09 2010 Upd Date Qasaa snare ead DOCr Not on file vch Nbr oaacagag Pros Tran Prim Id Recip Prov Nmbrmecaue Prov Name frenes wens waritA City St PORTLAND OR Service Auth Beg 09 11 03
5. or payee Upon receipt of the forgery packet the local office will 1 Have the payee review a copy of the paid original check and acknowledge whether or not the endorsement on the check is his hers 2 Have the payee complete the AFS 980 a If the payee acknowledges the endorsement 50 1 Payee must so indicate on the AFS 980 and sign his her name in the signature area 2 Ifa replacement check has been issued complete an AFS 284 and forward it to Overpayment Recovery Unit A copy goes to Forgery Services with the packet 3 The balance of the forgery packet is not necessary b If the payee does not acknowledge the endorsement 1 Payee so indicates in the designated area on the AFS 980 and completes the entire forgery packet 2 Return the forgery packet to Forgery Services If the payee is no longer available to complete the forgery packet so indicate on the AFS 980 and return the packet to Forgery Services also note if the case has been closed and the date of closure On active cases where there is difficulty in getting the payee to come to the branch to complete the forgery packet a hold on the payee s next check is suggested This should result in the payee making an appearance in the branch office to review and complete the forgery packet SENIORS AND PEOPLE WITH DISABILITIES PROVIDER PAYMENT UNIT The following procedure is to be used when replacing lost stolen destroyed and not received
6. 4 5500 168 62 69 33 4 5500 315 45 Proc Desc 00112 ADL Full Assist 00112 Self Management 0C112 24hr Avai lability F1 HSVC F11 HDTL F12 HINQ Fel On going live in provider s voucher has been recalculated for more leave without pay 1 DHR HEP DHRMF File Edit Transfer Fonts Options Macro View Window Help i eeu BsF F Fe amp a R x Prt Pre PAs ENT CLR O In home Service Payment 03 Trans Type C Upd Date 03 09 2010 Upd RACF HSMM SHAAN L vch Nnbr CD rcs Trans 30 EOB 650 Prime Proy Nmbr Recip Name Prov Name P Prov Str MERRY BLOSSOM Proy City ST PORTLAND OR Prov Zip 97216 2827 Authorized Adjudicated Lst work 00 00 00 Beg 09 11 01 End 09 11 15 Beg 09 11 01 End 09 11 15 Proc Desc Units Rate Total Units Rate Total 0C112 ADL Full Assist 60 00 10 2000 612 00 52 33 10 2000 533 7 00112 Self Management 42 50 4 5500 193 38 37 06 4 5500 168 62 00112 24hr Avai labili 79 50 4 5500 361 73 69 33 4 5500 315 45 Err Cd Tot Auth 1 167 11 Tot Clm 1 017 84 Msg Msg QUES CHANGE YOUCHER TO PAY Y N ANSW amp PRNT NEW 598B Y N F3 Exit 11 HINQ i When paying the voucher do not change the hours Put a y for change voucher to pay and y for print new 598B and press enter The next time period voucher will be created with the original authorized hours fil 1 DHR HEP DHRMF File Edit Transfer Fonts Options Macro View Window Help eeu E F F Fe amp cot ce R x
7. Ge El ph l Voucher in paid status that had leave without pay It au romatically adjusts the voucher and creates an overpayment fm 1 DHR HEP DHRMF Edit Transfer Fonts Options Macro View Window Help FF Fe amp cot c amp hk x PAL PR PAS ENT CLR O upd 03 02 2010 RACF js SHANNAN L wkr Id YR Cre 12 03 2009 RACF ANN W a vch nitbpee 0308010 Stee MSG VCHR IN PPa REGULAR vch xre CHK DATE 09 12 19 CHK NMBR GD NubrSSeeseene Irch bay Ref 00 00 00 vch Adj Y EOB 000 X Ref ICN 2220nnnnnnNnnnnN 20 0711 Prnt 5988 A0422 Mail Br N Prim Id Prov nmby Recip Name SIr IIa U Prov Nam TA A f Auth Date 09 12 01 Addr Recip Sign Date Y 09 12 15 Prov Str INDING STREET Prov Sign Date Y 09 12 15 Proy City Seinen e NDENCE OR Compl Zip 97351 0000 Authorized Adjudicated Beg 09 12 01 End 09 12 15 Beg 09 12 01 End 09 12 15 Proc Desc Units Rate Total Units Rate Total 0C112 ADL Full Assist 38 00 10 2000 387 60 38 00 10 2000 387 62 0C112 ADL Subst Assist 13 50 10 2000 137 70 13 50 10 2000 137 70 0C112 Self Management 34 50 4 5500 156 98 34 50 4 5500 156 99 00112 24hr Avai lability 62 50 4 5500 284 38 62 50 4 5500 284 35m F3 EXIT F7 PREV F8 NEXT F1O HSVC F11 HDTL F12 HINQ Fel AUTH Fee ADI Fe3 PA Original payment without the leave without pay File Edit Fes Fonts Options Macro View Window Help oo m om F Fe amp a Ie pat p
8. Homecare Workers Guide Safety Manuals Employer and HCW Frequently Asked Questions Provider Guides for Oregon ACCESS Forms listing amp link to forms server SPD Transmittals Oregon ACCESS Provider Maintenance Guide http www dhs state or us spd tools cm provguides main tenance pdf How to add a HCW provider record e Process Overview Provider Search Provider Overview Screen Provider Add Screen Provider Maintenance Overview Screen Provider Detail Screen Provider Credential Screen Oregon ACCESS Provider Maintenance Guide cont e Changing Provider Credentials Verification Financial Tax Screen Address Screen Maintaining an Existing HCW Provider Record Homecare Workers Procedures Manual http www dhs state or us spd tools cm homecare manu al index htm Found on the Case Management Tools website on the Homecare Worker page A few topics include Age Exceptions Criminal History Checks Direct Deposit Enrollment in the CEP Program Paid Leave Termination J amp e J e Orientation J J e Gloves and masks SPD Support Staff Assistance Manual http www dhs state or us spd tools additional ssam ind ex htm See Section III Provider Payment Systems A Criminal History Checks B CEP Payment System C Other Provider Payment Related Procedures Resources on DHS Criminal History Checks http www oregon gov DHS chc On this site you will find e Updated OAR s e Provi
9. Live in Leave hours 24 MHD DD Pers Care Prov Y N N Mileage Y N N Proc Description 00115 24 hr Relief Tot Svc Units Err Code Units Mi 24 00 24 00 Auth Cim PAL PA2 PAS ENT CLR O 03 tie el ACF Not on file A City St PORTLAND OR Hurn ena g9 11 07 Lst work 00 00 00 Auth wkr Spousal Pay Y N N Days work per wk Reg Live in Prov Nmbr CIIS Y N Pub Trans Allowance Y N N Rate Line Tot 7 2916 175 00 175 00 Err Stat Msg Requested time will result in unpaid leave QUES ADD YCHR TO FILE Y N ANSW PRNT 598B 1 PF4 P lan C PF5 Hours Chg MAIL BR Tr EE Fonts B File Edit eeu Options Macro View sF OCF FF Window ct cb R x PAL PR PAB ENT CLR OO ae In home Service Claim Detail Upd 03 09 2010 KHL na Tas SHANNAN L Wkr Id MI Cre 11 02 2009 RACF D ANGELA Msq Hours retlect unpaid leave ych nuor gt Pres trans sW Msg YCHR IN AUTHORIZATION STATUS ych xref CHK DATE 00 00 00 CHK NMBR 0000000 RA Nmbr 0000000 Help ICN 0000000000000 Pay Ref 00 00 00 ych Adj N X Ref ICN 0800000000000 BR 3515 Prnt 598B 09 11 02 Prim Id aa Prov Recip Name Prov Auth Date Addr Syc Cat APD Proy HERRY BLOSSOM Proy City S1i FUKILAND OR Comp zip 97216 2827 Adjudicated Beg 00 00 00 End 00 00 00 Units Rate Total 0 00 0000 8 080 0000 2717 0000 EOB 650 Mail Br N NN P vy L1 vL DR Authorized Beg 09 11 01 End 09 11 15 Units Rate Total 52 33 10 2000 533 77 37 06
10. steps in this procedure are Local Office Verify that an original check was issued Verify the payee name check number amount and date of the check Have payee complete an Affidavit Concerning Lost Check DHS138A Must be notarized Do not alter after payee has signed except for 5 and 6 below Research the paid check file RCIQ to determine if the check is paid or outstanding Call Forgery Services and give them the information required on the Payment Alert DHS 435A Forgery Services will assign a payment alert number to be written in the designated area of the 138A Write payment alert number on the DHS 138A Forward the original of the DHS 138A to the Forgery Services If a replacement check is issued through Revolving Fund write the replacement check number on the DHS 138A If the original check is returned cancel it If it is negotiated you will receive a copy front and back of the check if the payee says it s not their signature a forgery packet will sent to the branch REPLACEMENT CHECK A replacement check may be issued upon completion of the payment alert and the DHS 138A if the original check is still outstanding If the original check has been negotiated and the payee claims it was stolen the payee must show proof of having filed a Police Report before replacement can be issued Checks that are lost or stolen after they have been endorsed are not replaced unless the check was signed by the payee
11. union member for fair share You access this screen through SVDM SPRQ Provider This screen shows recoupments when an adjustment has been done because a provider is overpaid SHHW Provider This screen shows the number of hours worked each month for health insurance Client Service Eligibility SELG Prime This is the CAPS service eligibility inquiry screen This screen will tell you if a client is service eligible Mobius Reports View Direct RD2 F2 Print F3 End F7 Up F8 Down F10 Left F11 Right If the message 100000 lines searched appears enter F5 until the right HCW is found Name Social Security Number Discrepancy SJ M0210R B Greater than 90 days Terminated Providers SJ M0305R B This report lists the providers whose credentials have expired after the two year time frame Providers Due for Review in 1 Month SJ MO315R A Providers Due for Review in 2 Months SJ M0315R B Providers Due for Review in 3 Months SJ M0315R C These reports show when the credentials are due to expire if action is not taken Provider Credentials Ended Not Working in the Past Year SJ M0320U A Client Employed Service Authorization Report SJ H2220R A shows outstanding vouchers more than 30 days old Remittance Advice SJ H1415R A On mobius select the day prior to the check date listed on HINQ Example If check date is 3 3 09 on HINQ you would select 3 2 09 on mobius Payment Voucher Report SJ H1155D
12. Auth End Q9 11 03 Lst Work 00 00 00 Cat APD Contact Br 2011 Auth wkr Hr ly Hr ly Paid Leave Y N N Spousal Pay Y N N Live in OYAN N Days work per wk ee 1 Live in Leave hours 24 Reg Live in Prov Nmbr CD SUSAN MHD DD Pers Care Prov Y N N CIIS Y N Mi leage Y N N Pub Trans Allowance Y N N Proc Description Units Mil Rate Line Tot 00115 24 hr Relief 24 00 7 2916 175 00 Tot Sve Units 24 00 Auth Cim 175 00 Err Code Err Stat Msg QUES ADD YCHR TO FILE Y N ANSW PRNT 598B MAIL BR a Chg PFS Hours Chg 112 m L L1 07 11 3 2009 TES for relief provider Once you put in all the information needed put a y in the add vchr to file and put a y in the print 598B press enter h Fie Edit TRA Fonts Options Macro View Window Help eeu 3 sF F F cot cot R xX PAL PA2 PAS ENT CLR O Co o O O in home Service Authorization Trans Typ Upd Date 03 09 2010 Upd RACF D HA HHA ych Nmbr Prcs Tran 30 Prim Id Recip Proy Nmbr Proy Name A City St PORTLAND OR Service Auth Beg MULI cra Lst Work Cat 4 Contact Br Auth Wkr Hr ly Hr ly Paid Leave Y N Spousal Pay Y N Live in UYAN Days work per wk 7 e121 Live in Leave Chours Reg Live in Prov Nmbr TD SUSAN MHD DD Pers Care Proy Y N CIIS Y N Mi leage Y N Pub Trans Allowance Y N Proc Description Uni ts Mi Rate Line Tot 0C115 24 hr Relief 24 00 7 2916 175 00 Tot Svc Units 24 00 Auth Cim 175 00 Err Code Msg 83 Vchr record D c e d ya i
13. CEP Specialist Training Provider Payments Unit amp In Home Services Seniors amp People with Disabilities qui Some of the materials in this training packet contain client information Please keep in mind the confidential nature of the information and please do not share the packet outside your immediate work area Thank you Staff Listing Staff Listing Provider Payment Unit Seniors amp People with Disabilities Manager Patty Hall 903 945 6453 Employment verifications Forcing creating vouchers Overpayments underpayments Corrections to W 2 s Returned provider checks Janice Castle 503 947 5346 Provider enrollment Kerry Mandero 503 945 5820 Direct Deposits Send direct deposit requests to SPD Direct Deposit Unit P O Box 14960 Salem OR 97309 5045 503 947 1141 Garnishments Send garnishment requests to DHS Office of Financial Services Accounts Receivable Unit 500 Summer St NE E 79 Salem OR 97301 1 866 631 0745 In Home Services Unit Manager Angela Munkers 903 945 6985 Client Employed Provider Program Jenny Cokeley 503 945 5799 Unemployment Claims Gayle Holderby 503 945 6408 Gayle s Fax 503 945 7029 Fax 903 947 4245 Oregon Home Care Commission Executive Director Cheryl Miller 503 378 2733 Registry amp Referral System Nancy J anes 903 378 4050 Workers Compensation Coordinator Kelly Rosenau 503 378 3099 Workers Compensation Claims Assistance f
14. ENT CLR O Not on file City St PORTLAND OR Auth End 09 11 05 Lst Work 00 00 00 Auth wkr Spousal Pay Y N N Days work per wk Reg Live in Prov Nmbr TA CIIS Y N N Pub Trans Allowance Y N N Rate Line Tot 24 00 7 2916 175 00 24 00 Auth Cim Err Stat 175 00 PRNT 59887 PF5 Hours Chg MAIL BR 11 5 2009 voucher for relief provider Ssh FR IS Trans Ty ych Nmbr Prim Id Prov Nmbr Prov Name Tus Service Auth Beg 09 11 06 Cat APD Contact Br 2011 Hr ly Hrly Paid Leave Y N N Live in Y N N Live in Leave hours 24 MHD DD Pers Care Prov Y N N Mi leage Y N N Proc Description 00115 24 hr Relief AAAAAAAA Pres Tran Recip Tot Svc Units Err Code cat ce R x PAL PA2 PAR ENT CLR O In home Service Authorization Upd Date 00 00 0000 Upd RACF Uni ts Mi 09 2010 Not on file City St PORTLAND OR Auth End 09 11 06 Auth Wkr Spousal Pay Y N N Days work per wk 1 Reg Live in Prov nor a SUSAN CIIS Y N Pub Trans Allowance Y N N Rate Line Tot 7 2916 175 00 Lst Work 00 00 00 24 00 24 00 Auth Cim Err Stat 175 00 Msg Requested time will result in unpaid leave QUES ADD YCHR TO FILE Y N j PF4 P lan Chg ANSW PRNT 59887 PFS Hours Chg MAIL BR 11 6 09 voucher for relief provider On going live in provider i is going to have leave without pay Ba F oF F TG PA
15. L PA2 PA3 ENT CLR 0 Jno hame Service Ciaim Upd 03 09 2010 RACF HSSLW Q i Cre 11 02 2270 bere HSADLOO a ych nmbr ych xref v ICN 0OAAAAAAOOOQO Prim Id Recip Name Auth Date Syc Cat APD VyY 11 V1 Authorized Beg 09 11 01 End 09 11 15 Units 56 33 39 90 74 63 Proc Desc 0C112 ADL Full Assist 0C112 Self Management 0C112 24hr Avai lability F3 EXIT On going live in provider S OC112 e has been A et the leave without pay Pres Trans wy n gt y CHK DATE 20 00 00 CHK NMBR 00000000 Pay Ref 00 00 00 Ych Adj N X Ref CICN 0000000000000 BR 3515 PHANNAN L Wkr Id MI ANGELA Msg Hours reflect unpaid leave YCHR IN AUTHORIZATION STATUS RA Nmbr 0000000 EOB 650 Prnt 5988 09 11 02 Mail Br N Proy nmbr Prov Name Addr Proy Str HERRY BLOSSOM Prov City ST PORTLAND OR Comp Zip 97216 2827 Adjudicated Beg 00 00 00 End 00 00 00 Units Rate Total 2717 0000 0 00 2717 0000 0 00 0 80 0000 0 00 N P DR Total 574 57 181 55 339 57 Rate 10 2000 4 5580 4 5500 FISaHOvE F11 HDTL F1l2 HINQ qt F22 ADJ po File Edit Transfer Fonts Options Macro View Window 0 amp sF F Fr Help Sager In home Service Authorization AA EA AAAI Trans tyr ych Nmbr Prim Id Upd Date 00000000 Prcs Traj em a Recip Prov Nib Prov Nami Service Hutn Beg 09 11 W7 Cat APD Contact Br 2011 Hr ly Hr Paid Leave Y N NWN Live in Y N N
16. P can be used to reprint vouchers Helpful Hint When you are looking for a specific individual at the command prompt enter F space Provider enter Section 4 Issuing Paid Leave Hourly HCW leave accrual screen SHLQ provider Home Care Worker Leave Inquiry TU111 02 01 2009 01 31 2010 00 02 07 09 SJH2695 TU111 02 01 2008 01 31 2009 16 00 a 02 03 09 SJH3010 TU111 07 01 2007 06 30 2009 16 00 02 03 88 SIH3012 A future date indicates this leave is available A later date indicates the benefit is no longer available SHLQ D Home Care Worker Leave Inquiry Prov Name GERD Ronrca Proc Lve Beg Lye End Lye Earn Lye Use Lye Rem Updated Updated Date Date Hours Hours Date RACF TU111 02 01 2007 06 30 2007 16 00 88 16 00 02 03 07 SJH2699 Live in leave accrual HRSP provider TRANS TYPE WKR ID USE SEC PROV NMBR 777079 PROV NAME OSB SERY BEG SERV END HOUR RESP 144 0 2006 05 04 2009 05 31 1993 06 01 2004 03 06 52 8 HOUR RESP CURRENT HRS AVAILABLE MSG A1 No more records for Provider on file MSG MSG Paid Leave for Hourly Homecare Workers Paid leave for hourly HCWs are issued on a separate voucher using the TU111 procedure code Example If a HCW is authorized 80 hours per month and they want to take 8 hours of paid leave the regular hours worked will be issued on one voucher for 72 hours and the paid leave voucher using the TU111 procedure code will be for the ot
17. der Crime List updated 1 09 e Record Retention Schedule U S Citizenship amp Immigration Services http www ucis gov On this site you will find e Form I 9 Employment Eligibility Verification e Publication M 274 Handbook for Employers Instructions for Completing Form I 9 Section 3 Screens Frequently Used Mainframe Screens Providers SPVF This screen allows you to search for a provider by name or social security number when you do not have the provider number Once you select a provider it will take you to PRV8 PRV8 provider view only This screen is the Provider File Information screen It will list Name Provider Type Date of Birth SSN TIN Physical and Mailing Address Telephone Number Branch Credential Enrollment Status Date of Original Application Issue amp Pay Vouchers HATH Prime Provider OATH Prime Provider OPI only These screens are used for the online entry of authorization to generate a voucher HATH Voucher This screen is used to inquire about a particular voucher HPAY Voucher OPAY Voucher OPI only These screens allow you to pay a provider Issue amp Pay Vouchers cont HRDY Branch This screen displays all vouchers by branch in ready to pay status It will also allow you to print voucher information at a local printer if desired Payment History HINQ P Provider This screen displays the payment history for pro
18. e multiple changes but please make sure that you put in all the procedure codes that need to be changed If they don t need to be changed you don t need to enter them on the request Example The provider was underpaid in 2 out of the 4 procedures that he was paid for Paid Full Assist 45 hours Min Assist 34 hours Self Management 10 hours 24 hour Avail 79 hours Should have been paid Full Assist 65 hours Self Management 15 hours The only 2 lines that need to be put on the form are Full Assist and Self Management Procedure Code and _ Units Correct 44 Begin Date End Date Description Paid Units MM DD YY MM DD YY For each voucher _ hours hours choose all that apply pT 7 OCM2U Self Management 10 15 a ee ee po ed Section 8 Replacement of Lost or Stolen Checks amp Forgery Procedure Replacement of Stolen Checks POLICY It is agency policy to issue replacement checks in compliance with ORS 293 475 and the procedures contained in this manual Forgery Services in General Accounting Unit has been charged with the responsibility for replacement procedures Any procedural questions should be referred to Forgery Services Unit at 503 945 5640 DEFINITIONS Payment Alert A Payment Alert is the method used to notify Forgery Services that a check has been lost stolen destroyed or not received A Payment Alert DHS 435A does not stop payment on a check It i
19. e to the applicant photocopies of documents cannot be accepted Completed I 9 s must be retained for either three years after the date of hire or for one year after employment is terminated whichever is later The form must be available for inspection by the Department of Homeland Security Department of Labor and or Office of Special Counsel The initials DHS on employment documents refers to the Department of Homeland Security and not the Department of Human Services W 4 Employees Withholding Allowance Certificate Homecare Workers must complete a new W 4 each year if they would like claim exempt status If a Homecare Worker does not submit a new W 4 by the deadline SPD must change his her tax status to single with zero withholdings The local office must update OACCESS by the deadline if a new W 4 is received Copies of W 4 s must be retained for four years Date stamp W 4 s when they are received and enter them into OACCESS as soon as possible Employment Verifications Make sure there is a current release of information signed by the HCW within the last 3 months of the request for the verification The local office can sign as the employer in this case Direct Deposit The HCW must complete DHS 7262H Request for Direct Deposit if they would like the check automatically deposited into their checking account it cannot be a form that the bank provides The form must be completely filled out A voided check mu
20. en 7 calendar days from the proper submission and processing of the prior pay period s voucher e A newly hired Homecare Workers should receive written confirmation of the date they are authorized to begin providing services SDS 4105 and receive their vouchers within seven 7 days from the date services began Relief workers should receive their voucher prior to beginning services but no later than seven 7 days from the date relief services began If a Homecare Worker has submitted a properly completed voucher signed by the client and worker and legibly documents the number of hours worked his her payment cannot be held at the local office e Faxed copies of vouchers cannot be accepted There is never a check run on the last working day of the month Checks will always go out on the second working day of the month Form I 9 Employment Eligibility Verification Use Form I 9 with the revision date of February 2 2009 Make sure applicants receive Form I 9 instructions with the form Only unexpired documents listed on the List of Acceptable Documents can be accepted Applicants can choose which documents to present from the List of Acceptable Documents and local office cannot request a specific document such as a green card Local office staff must complete Section 2 Employer Review and Verification by viewing original or certified documents and signing the form certifying the documents appear to be genuine and relat
21. er Fan Options Macro View Window Help oo hk ik eeu 5 sF FOF PROV NMBR CHD SERY BEG 2004 12 20 HOUR RESP CURRENT HRS AVAILABLE PAL PA2 PA3 ENT CLR O TRANS TYPE WKR ID PROV NAME C SERY END 2010 02 28 HOUR RESP 33 85 33 85 AL No more records for Provider on file On going live in is taking 12 hours of paid leave But Natural Supports is providing the relief care File Edit Teka Fonts Options Macro View Window Help ct ce R Ix In home Service Authorization Upd Date 03 09 2010 Upd RACF F Fr Trans Typ ych Nmbr Prim Id Prov Nmbr Service Pres Tran nuit Beg 10 03 13 Contact Br 2011 Hr ly Hr ly Paid Leave Y N Live in Y N Live in Leave hours 12 MHD DD Pers Care Prov Y N 4 Mi leage Y N Proc Description 0C115 4 12 Hr Relief Tot Sve Units Err Code Msg QUES ADD YCHR TO FILE Y N PF4 P lan Recip a Proy Name Surrunio FRUYLUCK uni ts Mji 12 00 12 00 Auth Cim ANSW PAL PA2 PA3 ENT CLR O 09 2010 Not on file NHTURA City St SALEM OR Auth End 10 03 13 Lst Work 20 00 00 Auth wkr Spousal Pay Y N N Days work per wk e382 2 Reg Live in Prov Nmbr cai e CIIS Y N Pub Trans Allowance Y N N Rate Line Tot 10 2000 122 40 122 40 Err Stat PRNT 598B7 MAIL BR PF5 Hours Chg Relief voucher with Natural Supports provider number of 723118 This will not generate a voucher or payment to a natural support natura
22. ere the unendorsed original check has been lost or destroyed after receipt the waiting period may be eliminated There is no waiting period when replacing a destroyed lost or stolen check However if an original check has been stolen the check will not be replaced unless a police report is filed For OS Check Have payee sign DHS138A must be notarized and send it to Forgery Services Complete payment alert procedure Complete Authorization for Special Cash Payment AFS 437 using code 03 see the reverse side of AFS 437 The computer will generate a check and it will be mailed to the client or in cases where dire need exists a replacement check may be issued via Revolving Fund Write the replacement check number on the AFS 437 and the DHS 138A Send the 437 and the load sheet to General Accounting Unit Revolving Fund Clerk FORGERY PACKET The forgery packet is provided to the branch by Forgery Services when the original check is returned from the State Treasury as a paid instrument after the payee has viewed the check and stated that the signature is not theirs The forgery packet must be completed and returned to the Forgery Services as soon as possible If forgery packets are not returned to Forgery Services within 20 days of their receipt by the branch Forgery Services will return the original check to the State Treasurer pursuant to ORS 293 475 This action in many cases will result in legal proceedings against the agency and
23. f voucher the same way as if they have the leave available Upon issuance a message will come up that warns you the on going live in will have leave without pay The on going live ins voucher will be automatically adjusted for the leave without pay The calculation figures out the average hours worked in a day Please do not change the authorized hours to accommodate the leave without pay since the system will do it for you now If the on going live in voucher is in authorization status the authorized hours will be reduced to reflect the live in leave If the on going live in voucher is in paid status an overpayment will be generated and we will collect at 100 of what is owed for the leave without pay If an OC115 relief voucher is deleted it will add the leave hours back to the HRSP screen for the on going live in If the OC112 voucher for 21 the on going live in was reduced due to leave without pay the hours will be put back to what the hours were originally If a HCW wants to take time off and natural supports are providing the relief care use the Natural Supports provider number 723118 to create the relief voucher This number should be used for all local offices statewide The voucher is created the same way as the other relief vouchers but that number is used instead of another HCW provider number When the Natural Supports provider number is used it will reduce the HRSP screen by however many hours the On going HCW is goi
24. her 8 hours If the HCW has multiple clients the voucher will be issued under the name of the client the HCW would otherwise be working for that day If the HCW normally provides services to more than one client on the same day the leave will be attributed to the day and shift in which they are taking their paid leave To issue paid leave vouchers e Cancel the original voucher with the OC111 procedure code ex 80 hours e Reissue the voucher with the OC111 procedure code with the hours worked for the correct number of hours ex 72 hours e Issue the paid leave voucher with the TU111 procedure code ex 8 hours The hours paid on this voucher will be subtracted from the SHLQ screen If the HCW chooses not to use their paid leave and ends up working the maximum hours indicated on the original voucher Cancel the paid leave voucher with the TU111 procedure code since the leave was not taken Cancel the voucher that was issued with the fewer hours with the OC111 code Issue a new voucher with the full maximum monthly hours indicated on the original voucher If the HCW is paid twice per month and is taking leave the first half of the month Cancel the voucher for the first half of the month ex 40 hours Reissue a new voucher using the OC111 procedure code for the first half of the month with few hours ex 32 hours Issue the paid leave voucher using the TU111 procedure code ex 8 hours The voucher for the second half of
25. l supports are unpaid informal providers fd 1 DHRHEP DHRMF j File Edit Transfer Fonts Options Macro View Window Help aM F Fe amp ct a R x Pat Pr Pas enT cR o A1 No more records for Provider on file g2 HRSP screen was automatically reduced by 12 hours using the Natural Supports provider number for the relief voucher Voucher Issuance Codes Hourly Live In Live In Relief Fill In Mileage Transportation Spousal Pay Hourly Paid Leave OPI Hourly OPI Mileage In Home Agency Personal Care In Home Agency Home Care Home Delivered Meals Voucher Processing Codes Voucher authorization voided deleted Voucher payment voided deleted Voucher credit ready to pay Voucher credit Voucher in authorization status Voucher in ready to pay status Voucher in paid status regular Adjustment approved to pay Voucher adjustment paid Voucher adjustment zero paid Voucher Error Messages A86 Invalid combo proc med pgm svc pgm This edit appears when there are several mismatches between the SVC Category SSEQ SLO01 the Service Category Case Description and the Medical Program perc information A87 proc cli asmt invalid w ELGR svc c d This edit appears when the Service Category Case Descriptor that is displayed on ELGR for the service period is not valid with the Procedure Code or the Service Category SSEQ SL01 information A88 Med pgm invalid w proc code svc pgm This edit appea
26. mittal Medicaid Fraud SDS 0727 Medicaid Fraud Referral Form Miscellaneous SDS 7263 Request to Cancel Direct Deposit SDS 0598B Payment Voucher not available on the web DHS 0300 Notice of Fitness Determination SDS 2310 Emergency Payment for Accrued Paid Leave for Live in Homecare Workers Section 7 Important Things to Remember Homecare Worker Enrollment A Homecare Worker cannot be approved to work until e Form I 9 Employment Eligibility Verification has been completed and the applicant has presented acceptable documents which have been viewed by staff The Provider Enrollment form SDS 736 has been signed Provider Payments Unit has issued a provider number A preliminary fitness determination has been made related to criminal history check We cannot back date enrollment before the determination has been made and vouchers cannot be issued prior to this date Important information about OACCESS The Homecare Worker s tax name and social security number must match if they do not match it affects his her work credits and wage information and we will be fined Please look at the SSA Verified box on OACCESS detail screen A tax name must be entered on the Financial Tax info screen in OACCESS even if it is the same name listed on the Detail screen Vouchers e A properly submitted voucher must be processed in the payment system within two 2 working days e Vouchers need to be issued no later than sev
27. ng to take off If they do not have enough leave available it could result in leave without pay The local office will no longer be required to email Janice Castle in central office to have the hours removed from the HRSP screen manually Screen Samples below File Edit Transfer Fonts Options Macro View Window Help 0 0 amp amp B sF F Fe Bch a R fe Pat Pre pas en OR O a TRANS TYPE C WKR ID USE SEC AEGEE PROV NANE HILL qa SEL SERV BEG SERV END HOUR RESP 2008 11 16 2009 10 31 73 00 HOUR RESP CURRENT HRS AVAILABLE 73 08 MSG A3 RESPITE HOUR record changed MSG On going live in mr 73 S available and wants to ae off TE 3 11 7 2009 in 24 hours blocks each day Fonts indow wi ce ce R Ix Options Macro View Bis FR amp Help D Upd 11 02 2009 KHLr Hogi Cre 11 02 2009 RACF H In home Serv PAL PA2 PAI ENT CLR O ice Claim Detail re D Wkr Id MI Msg Cie Senec Miami Cem a eam lel Aa ee ew ych xref ICN G8Q0000000000 X Ref ICN 8808880000000 BR 3515 Prim Id o Recip Name Auth Date Svc Cat APD MDA J vy 11 01 Authorized Beg 09 11 01 End 09 11 15 Rate 620 00 10 4 4 Proc Desc 0C112 ADL Full Assist 0C112 Self Management 0c112 24hr Avai labi lity Units 42 50 79 50 2 CHK DATE 00 00 00 CHK NMBR 88000000 Pay Ref 00 00 00 Ych Adj N RA Nmbr 0000000 EOB 000 Prnt 598B Mail Br N Prov nmbr Prov Name HILL qa Addr APT 85 Proy Str fe
28. nstructs the computer to send out a message when the check in question is paid The state treasurer still pays the check Paid Check A paid check is a check that has been negotiated and returned to the state treasurer for payment Outstanding Check A check that has not been paid is still outstanding Either it has not been negotiated or it has been negotiated but has not yet been submitted to the treasurer for payment Original Check The original check is the first check issued to the payee for a specific payment Replacement Check A replacement check is a check issued in lieu of an original check for the same obligation same amount and same payee as an original check 47 Payee A payee is the person to whom a check is made payable In the case of dual payee both persons named on the face of the check are payees Forgery Packet The Forgery Packet information is used to determine the validity of the request for a replacement check when the original check is cashed and to facilitate recovery actions by the state when a fraud or forgery determination is made A forgery packet includes DHS 980 Interoffice Memo DHS 597 Handwriting Exemplar DHS 163 Affidavit Claimant s Endorsement Forged Photostat copy of the original paid check front and back Postal Lost Check Report Signature page PAYMENT ALERT When a payee reports that a check is lost stolen destroyed or not received payment alert procedures begin The
29. or HCWs 888 365 0001 Union Related SEIU Service Employees International Union Local 503 OPEU Salem resource line 800 452 2146 Salem local 503 581 1505 Portland 800 427 9374 Portland local 503 408 4090 HUBB Homecare Union Benefits Board LLC P O Box 12159 Salem OR 97309 0159 www hubbinsurance org info hubbinsurance org Local Salem 503 364 4822 Toll Free 866 364 4822 Background Check Unit Manager J eff Akin 903 378 3356 Status of Outstanding Applications 503 378 5470 888 272 5545 Choose 4 Hearings amp Policy Analyst Kelly Myrick Duckett 503 378 5628 Main Line 903 378 5470 Toll Free 888 272 5545 Send appeals to DHS BCU P O Box 14870 Salem OR 97309 5066 Distribution Services Questions about ordering publications forms brochures on FBOS Monty Beam 503 373 1342 DHS Accounting DHS Forgery Services 503 945 5640 Office of Information Systems Service Desk 503 945 5623 On Groupwise as SERVICEDESK Resources SPD Case Management Tools Website http www dhs state or us spd tools cm index htm On the main page you will find links to rules tools guides and manuals Under the Homecare Worker section you will find e Chapter 411 Division 031rules for the CEP Program Collective Bargaining Agreement Homecare Workers Procedure Manual HCW Termination web page Link to the Registry amp Referral System RRS RRS User Manual for Staff CEP Employers Guide
30. provider checks 1 Local office has provider complete an Affidavit Concerning Lost Check DHS 138A Local office telephones DHS Forgery Services at 503 945 5640 indicates that an affidavit has been completed by the provider and requests that a payment alert be done Forgery Services E Mails the Provider Payment Unit indicating it is okay to start the replacement paperwork for a particular provider 51 SPD Provider Payment Unit staff complete a Department of Human Services Provider Check request Form DHS 1479 The form along with supporting documentation is routed to Disbursement s Unit In completing the above documents the requesting party shall not sign as the authorizing individual The authorizing individual is normally the unit manager General Accounting Unit completes the necessary data entry to initiate a Replacement check Warrant through Department of Administrative Services The check is mailed by DAS to the provider Provider checks are not replaced in the branch
31. re prs jen cir In home Service Cla Upd 03 02 2010 gt SHANNAN L Wkr Id YR Cre 12 03 2009 RACF Py ANN W Msg Hours reflect unpaid leave vch nu QQ Pros Trans 46 Msg VOUCHER ADJUSTMENT PAID ych xref CHK DATE 10 03 03 CHK NMBR 0000 0 RA Nmbr 0053209 ICN 47 Poy aes vch Adj N EOB 650 X Ref ICN D Prnt 598B 09 12 03 Mail Br N Prim Id Prov nmb Recip Name i MR Prov Nan ITA A Auth Date 09 12 01 Addr Recip Sign Date Y 09 12 15 Aia Str ANDING STREET Prov Sign Date Y 09 12 15 v City ST INDEPENDENCE OR Comp Zip 97351 0000 Author ized Adjudicated Beg 09 12 01 End 09 12 15 Beg 09 12 01 End 09 12 15 Proc Desc Units Rate Total Units Rate 0C112 ADL Full Assist 38 00 10 2000 387 60 24 24 10 2000 0C112 ADL Subst Assist 13 50 10 2000 137 70 8 61 10 2000 0C112 Self Management 34 50 4 5500 156 98 22 01 4 5500 00112 24hr Avai lability 62 50 4 5500 284 38 39 87 4 5500 F3 EXIT NEXT FLO HSVC F11 HDTL F12 HINQ F21 AUTH F22 ADJ F23 File Edit To Fonts Options Macro View Window Help Bs sF F Fr amp coe c amp R x Pat pre PAs ENT CLR O O Provider Recoupment List Nnbr SP prov Nance oo a soap Orig ych Nmbr ICN Beg D Typ P Adjust Cur Bal Cc O 80 00 6000 RSP too 281 53 278 40 F10 SPRE F11 SPRU This dicats how much the EE is due to the leave w without pay We will collect the overpayment amount at 100 from their next paycheck due to it being leave without pay File Edit Transf
32. rs when the Medical Program Code perc that is displayed on the ELGR screen for the service period is not valid with the Procedure Code or Service Category SSEQ SLO1 associated with the client for the service period A89 No service eligibility SSEQ or SLOD This edit appears when there is no valid Service Eligibility record on SSEQ or SL01 for the service period 002 Recipient Ineligible on Date of Service The recipient is not eligible for the entire period of authorization 006 Provider Ineligible on Date of Service The provider is ineligible for the period of authorization 41 Case Ineligible on Date of Service The case was not eligible on the dates of service authorized 013 Service Hours Exceed Allowed Hours Hours authorized exceed the maximum allowed hours SELG Codes To issue vouchers without an error the service category should be In Home Services or State Plan Personal Care PC 20 or Oregon Project Independence the reason code can be Administrative change Reassessment that overlaps assessment periods Hearing pending or decision Initial assessment the voucher authorization dates should be within the service category begin date and service category end date If the service category code is NFC nursing facility you will not be able to issue a voucher You will not be able to issue a voucher if the reason code is NLV No longer valid The Case Manager will need to take action in order for you to iss
33. st be attached to the original form The HCW should mail the form to the Direct Deposit Unit address on the form It takes approx 15 30 days to process the request It takes 3 banking days M F excluding holidays to get from DHS to the HCW s account Provider payments are required to go through a clearinghouse at the State Treasury before they can be sent electronically to the HCW s bank or credit union e Ifa HCW has direct deposit instead of CHK DATE on HINQ there will be EFT DATE e Ifa HCW no longer wants direct deposit it is preferred that that he she fills out SDS 7263 Request to Cancel Direct Deposit However the HCW can hand write the desire to cancel with his her name provider number date and signature and fax to 503 947 5357 If you know a provider will no longer be working ask if he she has a direct deposit account If so make sure the account is cancelled Otherwise when they begin working again in the future the checks will be sent to this account which may be closed When they start working again look in OACCESS to see what his her payment method is CEP Adjustment Requests 287A underpayment 287B overpayment 287E forced payment e When filling out adjustment requests you can add more than one voucher on the form if it is for the same provider and client When entering the voucher number and date you only need to put it down once for each voucher that is being corrected even if there ar
34. the month would be issued with the hours as normal ex 40 hours If the HCW is paid twice per month and is taking leave the second half of the month e The first half of the month will be paid as usual ex 40 hours e Cancel the voucher for the second half of the month if it was already issued e Reissue the voucher using the OC111 procedure code with few hours ex 32 hours e Issue the paid leave voucher using the TU111 procedure code ex 8 hours Paid Leave for Live In Providers Live In HCW time off per the Collective Bargaining Agreement must be taken in hourly increments of 4 12 hours or in 24 hour block of time In order to issue the relief voucher there has to be an OC112 voucher for the on going live in for the time period the live in wants to take off Example On going live in wants to take 3 13 2010 off there has to be an OC112 voucher for the on going live in For example 3 1 3 15 2010 or 3 1 3 31 2010 Relief vouchers are issued for 1 day only no matter how many days they want to take off in a row Example On going live in wants to take 3 13 2010 off the voucher would be 3 13 2010 to 3 13 2010 More than one day cannot be put on the relief voucher so if they wanted to take 3 13 3 15 2010 off the vouchers would be 3 13 2010 to 3 13 2010 3 14 2010 to 3 14 2010 and 3 15 2010 to 3 15 2010 If the on going live in does not have the leave available and wants to take leave without pay issue the relie
35. ue a voucher Section 6 SDS 0355 SDS 0355A SDS 0736 DHS 301AD SDS 0356 Form I 9 Form W 4 DHS 7262H HCW Enrollment Packets Available on the Forms Server Homecare Worker Application Form Workers Compensation Brochure Client Employed In Home Provider Enrollment Criminal History Request Client Employer s Right to Confidentiality Employment Eligibility Verification available at www uscis gov Employee s Withholding Allowance Certificate available at www irs gov Request for Direct Deposit The above highlighted forms must be witnessed in the local office Underpayments Overpayments Forced Payments Available on the Forms Server interactive amp submit on line SDS 287A SDS 287B SDS 287E SDS 0287G SDS 0287H SDS 02871 SDS 4105 SDS 4105L SDS 0613 SDS 0613c SDS 0613d SDS 06131 CEP Underpayment Request Form CEP Overpayment Request Form CEP Forced Payment Request Form OPI Underpayment Request OPI Overpayment Request OPI Forced Payment Request Homecare Worker Notices Available on the Forms Server Homecare Worker Notice of Change in Hours Delayed Voucher Processing Letter Notice of Termination of Provider Enrollment Notice of Termination based on Criminal History Notice of Denial of Homecare Provider Enrollment Notice of Inactivation of Homecare Provider Enrollment Lost Stolen Not Received Checks DHS 138A Affidavit Concerning Lost Check DHS 297 Cancelled Check Trans
36. vider HINQ V Voucher This screen displays the information about a particular voucher HINQ R Prime This screen displays all of the vouchers for a particular client Title XIX and OPI HADJ Voucher This screen shows adjustments made to a particular voucher These adjustments are made by the SPD Provider Payment Unit HPAD Branch YYMMDD This screen displays all vouchers for the branch that have been paid It will also allow you to print voucher information at a local printer if desired RCIQ This is the check status screen You can look up information by e Check Number will show you when the check was issued amp paid Payee ID Number will show all the payments for this provider Payee Name partial Payee Name exact spelling ce Payment Histo cont HFIQ Provider This screen shows provider tax information by quarter and year This screen can be used for employment verifications For a specific year HFIQ provider 9 year Paid Leave Available HRSP Provider This screen shows the paid leave hours earned for live in providers SHLQ Provider This screen shows the paid leave hours earned for hourly providers Recoupments Deductions amp Garnishments SLIA P Provider This screen shows if a provider has had recoupments garnishments voluntary deductions etc SUDI Provider This screen provides information about SEIU dues deductions amp whether a HCW is a
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