Enterprise Program Integrity Control System (EPICS)

I. THIS CHAPTER PROVIDES INSTRUCTIONS AND INFORMATION FOR:

II. REFERRAL MENU

III. ADD A NEW REFERRAL

IV. REFERRAL LIST

V. REFERRAL DETAIL

VI. NOTEPAD

VI. UTILIZING F4

VII. NAME SEARCH

102 – REFERRALS

Change #1-2011

April 1, 2011

I. THIS CHAPTER PROVIDES INSTRUCTIONS AND INFORMATION FOR:

• The Referral Menu function keys;
• The Referral Detail 1 fields;
• The Referral Detail 1 functions keys;
• The Referral Detail 2 fields;
• The Referral Detail 2 function keys;
• Creating a referral;
• Creating a referral using Spin-off;
• The Referral List fields;
• The Referral List function keys;
• Displaying a list of unassigned referrals and view referral details;
• Assigning a referral;
• Displaying a referral list and view referral details by county;
• Displaying a referral list and view referral details by Investigator ID;
• Accepting a referral;
• Opening a referral;
• Displaying a referral using the Referral Detail option;
• Updating a referral;
• Closing a referral;
• Transferring a Referral Out of State;
• Reopening a Referral From Out of State Status;
• Creating a Referral from an Out of State source;
• The Notepad Summary function keys;
• The Notepad Detail function keys;
• Adding a note in Notepad;
• Displaying and updating a note in Notepad;
• Deleting a note in Notepad;
• Entering field details using F4 key;
• Searching for an individual ID (Name Search feature).

II. REFERRAL MENU

A referral is the origination point for a claim in EPICS. Referral information (e.g., an individual who may or may not be committing a fraudulent act) is obtained in Program Integrity from several sources such as phone calls or letters. The Referral function provides the Program Integrity Staff with a method of recording, viewing, and updating referral information. The Referral menu contains three options from which to choose:

Option	Description
1. Referral List	To display a list of existing referrals
2. Referral Detail	To display and update a known/specific referral
3. Create New Referral	To add a new referral

Referral Menu Function Keys

Key	Description
F1	To access EPICS on-line help
F3	To exit and return to Main Menu

III. ADD A NEW REFERRAL

Upon a receipt of a new referral, it is required that the Program Integrity Staff add the referral in EPICS with the appropriate information (e.g., Case ID, Referral Type, and Allegations). There are two screens that require data entry: REFERRAL DETAIL 1 and REFERRAL DETAIL 2. Each screen contains mandatory and optional fields, as well as specific function keys that execute tasks.

A separate referral must be entered for each claim. Also, if a claim has any crossover date periods (i.e., TANF) a separate referral must be entered for each one.

A. Referral Detail 1 Field Descriptions

Field	Description	Required	System Generated	Optional
REFERRAL ID	10 digit ID generated by the system upon creation of a referral		X
REFERRAL TYPE	1 character code identifying the type of referral	X
REFERRAL STATUS	2 character code identifying the status of the referral		X
NAME	Last Name (up to 20 characters), Suffix (up to 3 characters), First Name (up to 12 characters), and Middle Initial (1 character) of the case head payee		X
INDIVIDUAL ID	10 character number of the case head payee provided by CNDS	X
SSN	9 digit number for the case head payee’s social security number		X
DOB	10 character date of the case head payee’s date of birth		X
SEX	1 character code for the individual case head payee’s sex		X
ORIGINATING COUNTY	3 digit code between the values of 000 and 100; Represents the issuing county in which the suspected overpayment took place		X
OWNER	Used to show which county currently owns the referral; Defaults to originating county number unless the referral has been transferred		X
PROGRAM	Up to 4 characters; Code that identifies the benefits program to which the suspected overpayment applies	X

Field	Description	Required	System Generated	Optional
CASE ID	Up to 9 characters; Identifies the Program Case ID associated with the suspected overpayment	X
COUNTY CASE #	7 character county case number (Note: You must key slashes.)			X
REFERRAL DATE	10 character date (MM/DD/YYYY) the referral is received	X
REFERRING PERSON	Up to 45 characters; Name of the person reporting the referral (Note: anonymous and unknown are accepted.)	X
REFERRING PERSON PHONE	10 character (including area code) phone number of the Referring Person (Note: Hyphens not accepted.)			X
REFERRAL SOURCE	2 character code representing the source of the violation	X
NATURE OF REFERRAL	1 character code representing the nature of the violation	X
SUSPECTED AMOUNT	Up to 10 characters; dollar amount of the suspected overpayment			X
SUSPECTED OP/OI PERIOD (BEGINNING DATE)	10 character date, (MM/DD/YYYY); Suspected start date of the suspected overpayment			X
SUSPECTED OP/OI PERIOD (ENDING DATE)	10 character date, (MM/DD/YYYY); suspected end date of the suspected overpayment			X

Field	Description	Required	System Generated	Optional
CASE WORKER ID	5 character number of the caseworker currently assigned to the case. Also known as the IM Worker / District #.			X
ASSIGN REFERRAL	1 character Indicator set to Y when the supervisor assigns the referral to an investigator	X
ASSIGNMENT DATE	10 character date (MM/DD/YYYY) the referral was assigned to an investigator		X
INVESTIGATOR ID	5 character ID that corresponds to the investigator assigned to this referral by the supervisor	X
ACCEPT REFERRAL	1 character indicator set to Y when the investigator accepts their referral	X
ACCEPTANCE DATE	10 character date (MM/DD/YYYY) the referral was accepted by the investigator		X
OPEN INVESTIGATION	1 character indicator set to Y when the investigator opens the referral	X
OPEN DATE	10 character date (MM/DD/YYYY) the referral was opened by the investigator		X
CLOSE REFERRAL	1 character indicator set to Y when the investigator closes the investigation	X
DATE CLOSED	10 character date (MM/DD/YYYY) the referral was closed by the investigator		X
REASON CLOSED	2 digit alpha code Description of the reason the referral was closed (i.e., paid off)	X

Field	Description	Required	System Generated	Optional
OVERRIDE USER ID STATE OFFICE PERSONNEL	RACF ID of the person implementing the override		X
OVERRIDE COUNTY	The county for which the override took place		X
OVERRIDE DATE	10 character (MM/DD/YYYY) date the override took place		X

B. Referral Detail 1 Function Keys

Key	Description
F1	To access EPICS on-line help
F2	To clear the screen
F3	To exit and return to the Main Menu
F4	To display a list
F5	To display the Notepad
F6	To add a referral (save)
F9	To update referral information
F10	To display the Referral Detail 2 screen
F11	To create a new referral with default data from the currently displayed referral
F12	To cancel and return to previous screen

C. Referral Detail 2 Field Descriptions

Field	Description	Required	System Generated	Optional
REFERRAL ID	10 digit number generated by the system upon creation of a referral		X
EIS/FSIS ADDRESS	Case head payee’s address currently residing in EIS / FSIS		X
ALIAS NAMES	One or more alternate names for the case head payee			X
EPICS ADDRESS TYPE	Case head payee’s address; Used when the EIS / FSIS address is incorrect. (Note: For EPICS, this address is stored in CNDS.)			X

Field	Description	Required	System Generated	Optional
ALIAS SOCIAL SECURITY NUMBERS	One or more alternative social security numbers for the case head payee			X
PHONE NUMBERS TYPE	Case head payee’s phone number(s) including area code			X
PHONE NUMBERS EXT	Case head payee’s phone extension			X
ALLEGATIONS	Up to 79 characters; Description of the alleged fraud	X

D. Referral Detail 2 Function Keys

Key	Description
F1	To access EPICS on-line help
F3	To exit and return to Main Menu
F4	To display a list
F6	To add a referral (save
F9	To update referral information
F12	To cancel and return to the previous screen

E. To Create a New Referral

1. From the MAIN MENU, key the number 2 in the Enter Option field and press Enter. The REFERRAL MENU displays.



2. In the ENTER OPTION field, key the number 3 and press Enter. The REFERRAL DETAIL 1 screen displays.

NOTE: If you do not know the code or value for a field, you can use the F4 key, which displays a list of codes or values for selection. This field attribute is only available for those fields that contain a + (plus sign) to the right of the field.

3. In the REFERRAL TYPE field, key the code for the type of referral.

Code	Value
F	Front End
O	Other
P	Project Recall
R	Regular
S	Suspected IPV

4. In the INDIVIDUAL ID field, key the case head payee’s ID.

5. In the PROGRAM field, key the code that identifies the program to which the suspected overpayment applies.

You may use the equal (=) key and F4 key to obtain the list of codes. From the list of codes, enter an ‘S’ under the SELECT column by the appropriate code. Press ENTER. The code selected is brought forward to the PROGRAM field.

6. In the CASE ID field, key the individual’s Case ID. If the case ID/program cannot be validated, the following error message is displayed:

CASE ID IS NOT FOUND. REVIEW CASE OR CALL EPICS AUTOMATION.

The override function can only be completed by State Staff Program Integrity Staff when applicable.

a. Food and Nutrition Services

(1) For R, O, P and S referral types, the CASE ID entered on the screen must exist in the FSIS Active Master file or the FSIS Inactive Master file. Any transaction code type is acceptable.

(2) For F referral types, the Case ID entered on the screen must exist in the FSIS Active Master file and must have a transaction code of 1.

b. AFDC/TANF

(1) For R, O, and P referral types, benefits must have been issued for the Case ID and Program entered on the screen.

(2) For F referral types, the Case ID and Program entered on the screen must currently exist in the EIS pending application database.

NOTE: Front-end referral with a program code of AFDC can not be entered in EPICS.

c. Medicaid

(1) For R, O, and P referral types, benefits must have been issued for at least one individual associated with the Case ID and Program entered on the screen.

(2) For F referral types, the Case ID and Program entered on the screen must currently exist in the EIS pending application database.

7. In the REFERRAL DATE field, key the date the referral was received using the 10-character date format: MM/DD/YYYY.

8. In the DATE OF DISCOVERY field, key the date of discovery. This is a required field and must be in MM/DD/CCYY format.

a. This date cannot be greater than the REFERRAL DATE.

b. This date cannot be greater than the current date.

c. This date can be prior to or the same as the REFERRAL DATE.

d. This date can be changed if the referral status is not CL, TE, or OT.

9. In the REFERRAL PERSON field, key the name of the person who provided the referral information.

10. In the REFERRAL SOURCE field, key the code that represents the source of violation. You may use the equal (=) key and F4 key to obtain the list of codes. From the list of codes, enter an ‘S’ under the SELECT column by the appropriate code. Press ENTER. The code selected is brought forward to the REFERRAL SOURCE field.

11. In the NATURE OF REFERRAL field, key the code that represents the nature of violation. You may use the equal (=) key and F4 key to obtain the list of codes. From the list of codes, enter an ‘S’ under the SELECT column by the appropriate code. Press ENTER. The code selected is brought forward to the NATURE OF REFERRAL field.

Code	Value
E	Earned Income
O	Other
R	Reserve
U	Unearned Income

12. If applicable, enter data in the optional fields.

NOTE: To determine which fields are optional, see Referral Detail 1 Field Descriptions.

13. To add/save the data on the REFERRAL DETAIL 1 screen and continue entering required data on REFERRAL DETAIL 2 screen, press the F6 function key. The REFERRAL DETAIL 2 screen displays.

NOTE: EPICS attempts to validate the data, ensuring all required fields are populated. If not, the system informs you of the fields that require details and will not proceed to REFERRAL DETAIL 2 screen until you provide the fields with the appropriate data.

For auditing and reviewing purposes, you must maintain all supporting documentation that warrants the override.

14. In the ALLEGATIONS field, key a description of the alleged fraud.

15. If applicable, enter data in the optional fields.

NOTE: To determine which fields are optional, see page 11, Referral Detail 2 Field Descriptions.

To add data in the optional fields, key the appropriate code in the S column.

16. To add/save the referral, press the F6 function key.

17. To exit and return to the MAIN MENU, press the F3 function key. The MAIN MENU displays.

F. Spin-off Function

After creating a new referral, you may determine that more than one benefit program is involved. EPICS provides a feature called Spin-off to help save time with data entry in this process. Since only one program can be associated with a referral at a time, using Spin-off (function F11 key) allows you to add a new referral based on the current referral displayed on the REFERRAL DETAIL 1 screen. This feature uses the currently displayed information as default data.

With this information, you make the necessary modifications to the data (i.e., change the program code, case number, referring person).

To add a referral using the spin-off feature:

1. Create a referral.

After the referral is created, return to the REFERRAL DETAIL 1 screen to access SPIN-OFF. If the REFERRAL DETAIL 2 screen is displayed, press the F12 function key.

2. From the REFERRAL DETAIL 1 screen, press the F11 function key.

NOTE: The spin-off function clears the REFERRAL ID, REFERRAL STATUS, PROGRAM ID, CASE ID, COUNTY CASE #, SUSPECTED AMOUNT, SUSPECTED OP/OI PERIOD fields. It also clears the ALLEGATIONS field on the REFERRAL DETAIL 2 screen.

3. In the PROGRAM field, key the code the identifies the benefits program to which the suspected overpayment applies.

4. In the CASE ID field, key the individual’s Case ID.

5. In the REFERRAL DATE field, change the date, if necessary.

6. In the DATE OF DISCOVERY field, change the date if needed.

7. In the REFERRAL PERSON field, change the name of the person who provided the referral information, if necessary.

8. In the REFERRAL SOURCE field, change the code that represents the source of violation, if necessary.

9. In the NATURE OF REFERRAL field, change the code that represents the nature of violation, if necessary.

10. If applicable, enter/modify data in all optional fields on REFERRAL DETAIL 1 screen.

11. To add/save the referral details, press the F6 function key. The REFERRAL DETAIL 2 screen displays.

12. In the ALLEGATIONS field, key a description of the alleged fraud.

13. If applicable, enter/change data in all optional fields REFERRAL DETAIL 2 screen.

14. To add/save and the referral, press the F6 function key.

15. To exit and return to the MAIN MENU, press the F3 function key. The MAIN MENU displays.

IV. REFERRAL LIST

If you need to display and/or update (e.g., accept a referral or edit) referral information, but do not know the referral ID, use the Referral List option. The Referral List provides several query options. The County number is always required to be a part of the search criteria:

County Only Search – This query option displays referrals for that county up to the 100 page limit.

Investigator ID and County Search – This query option displays referrals for that investigator and County up to the 100 page limit.

Investigator, County, and Referral Start Date Search – This query option displays referrals for that investigator, County, and referrals beginning with the Referral Start Date entered and greater up to the 100 page limit.

Investigator, County, Referral Start Date, and Status Search – This query option displays referrals for that investigator, county, status (UN, IN, CO, AC, TE, CL) beginning with the referral start date entered and greater up to the 100 page limit.

Investigator, County, Referral Start Date, Status, and Program Search – This query option displays referrals for that investigator, county status, program (FS, TANF, MAAN, etc.) beginning with the referral start date entered and greater up to the 100 page limit.

Or any of the above combinations of queries.

You may change your search criteria by entering and/or removing the option and pressing ENTER. Once ENTER is pressed, the referral information displays based on the new search criteria.

A. Referral List Field Descriptions

Field	Description	Required	System Generated	Optional
INVESTIGATOR ID	The Investigator ID for which to view referrals assigned.			X
COUNTY	3 character county code; Used to define which county’s list will display (Note: Defaults to the county of the person logged into the system)	X
REFERRAL START DATE	MM/DD/CCYY to Display Referrals from that date and greater.			X
STATUS	The Status of Referral			X
PROGRAM	Program Type			X
S	1 character field used to select and view a referral			X
TYPE	1 character code indicating the type of referral		X
STATUS	2 character code Status indicating the current status of the referral		X
START DATE	MM/DD/CCYY 10 character field indicating the referrals found based on the start date entered.		X
PROGRAM	Up to 4 characters; Code for the benefit program associated with the referral		X
NAME (LAST)	Case head payee’s last name (up to 30 characters)		X
NAME (FIRST)	Case head payee’s first name (up to 10 characters)		X
INDIVIDUAL ID	10 character numbers of the case head payee provided by CNDS		X

B. Referral List Function Keys

Key	Description
F1	To access EPICS on-line help
F3	To exit and return to Main Menu
F4	To display a list or just press ENTER to view a list of referrals based on criteria keyed.
F5	To display the Claim Detail for the selected referral
F6	To display a selected referral
F7	To display the previous screen (page down)
F8	To display the next screen (page up)
F9	To display the payment history for the selected referral
F12	To cancel or return to the previous screen

C. State Level and Supervisor Users

Supervisors (or designated person) must assign referrals to the investigators in their county. If the supervisor does not know the referral ID number of an unassigned referral, they can display a list of unassigned referrals for the county in which they are assigned.

1. To display a referral list of unassigned referrals and view referral details (Supervisor only):

a. From the MAIN MENU, key the number 2 in the Enter Option field and press Enter. The REFERRAL MENU displays.

b. From the REFERRAL MENU, key the number 1 in the Enter Option field. The REFERRAL LIST screen displays.

c. Do not enter a value in the INVESTIGATOR ID field.

d. Enter UN in the STATUS field.

Press Enter. The referral list displays all unassigned referrals for the county.

NOTE: Unassigned referrals maintain a status of UN (unassigned).

e. To view referral details, key an ‘s’ in the S column next to the referral and press Enter. The REFERRAL DETAIL 1 screen displays.

f. To view REFERRAL DETAIL 2 screen, press the F10 function key. The REFERRAL DETAIL 2 screen displays.

g. To return to the previous screen, press the F12 function key. The REFERRAL DETAIL 1 screen displays.

h. To return to the REFERRAL LIST screen, press the F12 function key. The REFERRAL LIST screen displays.

or

To exit and return to the MAIN MENU, press the F3 function key. The MAIN MENU displays.

2. To assign a referral via the Referral List (Supervisor only):

a. From the MAIN MENU, key the number 2 in the Enter Option field and press Enter. The REFERRAL MENU displays.

b. From the REFERRAL MENU, key the number 1 in the Enter Option field and press Enter. The REFERRAL LIST screen displays.

c. Do not enter a value in the INVESTIGATOR ID field.

d. Enter UN in the STATUS field. Press ENTER. A list of referrals with a UN (Unassigned) Status for your county displays.

e. In the S column next to the referral, key ‘S’ and press Enter. The REFERRAL DETAIL 1 screen displays.

f. In the ASSIGN REFERRAL field, key ‘Y’ to assign the referral.

g In the INVESTIGATOR ID field, key the investigator ID of the investigator who will accept the referral.

h. To save the updates, press the F9 function key.

NOTE: The ASSIGNMENT DATE field is system generated with today’s date.

The REFERRAL STATUS field automatically populates with a PE (pending) code.

i. To return to the REFERRAL LIST screen, press the F12 function key. The REFERRAL LIST screen displays.

or

To exit and return to the MAIN MENU, press the F3 function key. The MAIN MENU displays.

3. Users with State Level access can query by specific county and view referrals.

Supervisors can view all referrals within their county.

To display a referral list and view referral details by County (State Level and Supervisor access only):

a. From the MAIN MENU, key the number 2 in the Enter Option field and press Enter. The REFERRAL MENU displays.

b. From the REFERRAL MENU, key the number 1 in the Enter Option field. The REFERRAL LIST screen displays.

c. Do not enter a value In the INVESTIGATOR ID field.

d. If you have State Level access, you must enter the county you wish to view.

NOTE: Supervisors cannot modify the county field. It will default to the county in which they are assigned.

e. Press Enter to display all the referrals owned by the county with the exception of unassigned referrals.

f. To view referral details, key an ‘s’ in the S column next to the referral and:

(1) Press Enter or the F6 function key. The REFERRAL DETAIL 1 screen displays. Within Referral Detail screen, press F10 to view Referral Detail 2.

(2) Use the F5 function key to view the Claim Detail screen. Within the Claim Detail screen other data related to the Claim Detail screen may be viewed.

(3) Use the F9 function key to view the payment history for the referral.

g. To return to the REFERRAL LIST screen, press the F12 function key. The REFERRAL LIST screen displays;

or

To exit and return to the MAIN MENU, press the F3 function key. The MAIN MENU displays.

h. To return to the previous screen, press the F12 function key. The REFERRAL DETAIL 1 screen displays.

i. To return to the REFERRAL LIST screen, press the F12 function key. The REFERRAL LIST screen displays.

or

To exit and return to the MAIN MENU, press the F3 function key. The MAIN MENU displays.

D. County Level Access Users

A user who has County Level access to EPICS (i.e., Investigators) can only query by their investigator ID and the county in which they are assigned. The referral list allows an investigator to view a list of all their referrals as long as the 100 page limit has not been met. Select those referrals in PE (Pending) status to accept them from the supervisor. To narrow your search and to view only those referrals in PE status, enter PE in the STATUS field. The referral list displays only referrals that are in PE status for that investigator ID and county.

A supervisor can also query by a particular investigator number within their county.

1. To display a referral list and view referral details by investigator ID:

a. From the MAIN MENU, key the number 2 in the Enter Option field and press Enter. The REFERRAL MENU displays.



b. From the REFERRAL MENU, key the number 1 in the Enter Option field. The REFERRAL LIST screen displays.

NOTE: The INVESTIGATOR ID field defaults to the investigator ID number who is logged into the system. The COUNTY field defaults to the county in which the user is assigned and cannot be modified.

c. Press Enter. The referral list for the investigator displays. All referrals for that investigator is displayed unless the 100 page limit is reached. To narrow your search, use the STATUS field and/or the PROGRAM field. Referrals are listed based on the criteria entered.

d. To view referral details, key an ‘s’ in the S column next to the referral and:

(1) Press Enter or the F6 function key. The REFERRAL DETAIL 1 screen displays. Within Referral Detail screen, press F10 to view Referral Detail 2.

(2) Use the F5 function key to view the Claim Detail screen. Within the Claim Detail screen other data related to the Claim Detail screen may be viewed.

(3) Use the F9 function key to view the payment history for the referral.

e. To return to the REFERRAL LIST screen, press the F12 function key. The REFERRAL LIST screen displays.

or

To exit and return to the MAIN MENU, press the F3 function key. The MAIN MENU displays.

2. To accept a referral (via the Referral List):

Prior to working on the investigation of a referral in EPICS, the investigator must accept the referral.

a. From the MAIN MENU, key the number 2 in the Enter Option field and press Enter. The REFERRAL MENU displays.

b. From the REFERRAL MENU, key the number 1 in the Enter Option field. The REFERRAL LIST screen displays.

c. Press Enter. The referral list for the investigator displays.

d. Locate the assigned referral.

NOTE: Assigned referrals maintain a status of PE.

e. To select the referral, key ‘S’ in the S column and press Enter. The REFERRAL DETAIL 1 screen displays.

f. In the ACCEPT REFERRAL field, key ‘Y’ to accept the referral.

g. In the COLLECTOR field, key collector ID, if different from the Investigator ID.

NOTE: The COLLECTOR field defaults to the Investigator ID.

h. To save the updates, press the F9 function key.

NOTE: The ACCEPTANCE DATE field is system generated with today’s date.

The REFERRAL STATUS field automatically changes to AC (accepted).

i. To return to the REFERRAL LIST screen, press the F12 screen, press the F12 function key. The REFERRAL LIST screen displays.

or

To exit and return to the MAIN MENU, press the F3 function key. The MAIN MENU displays.

3. If a referral is in AC (accepted) status and ready for investigation, the investigator may open the referral. Opened referrals maintain a status of IN (investigation).

To open a referral (via the Referral List):

a. From the MAIN MENU, key the number 2 in the Enter Option field and press Enter. The REFERRAL MENU displays.

b. From the REFERRAL MENU, key the number 1 in the Enter Option field and press Enter. The REFERRAL LIST screen displays.

c. Press Enter. The referral list for the investigator displays.

d. Locate the accepted referral.

NOTE: Accepted referrals maintain a status of AC.

e. To select the referral, key an ‘s’ in the S column and press Enter or the F6 function key. The REFERRAL DETAIL 1 screen displays.

f. In the OPEN INVESTIGATION field, key ‘Y’ to open the investigation.

g. To save the updates, press the F9 function key.

NOTE: The OPEN DATE field is system generated with today’s date.

The REFERRAL STATUS field changes to an IN (Investigation) status.

h. To return to the REFERRAL LIST screen, press the F12 function key. The REFERRAL LIST screen displays.

or

i. To exit and return to the MAIN MENU, press the F3 function key. The MAIN MENU displays.

V. REFERRAL DETAIL

If you know the referral ID of the specific referral you want to display, view, or update, you can use the Referral Detail option from the REFERRAL MENU.

A. To Display a Referral

1. From the MAIN MENU, key the number 2 in the Enter Option field and press Enter. The REFERRAL MENU displays.

2. From the REFERRAL MENU, key the number 2 in the Enter Option field and press Enter. The REFERRAL DETAIL 1 screen displays.

3. In the REFERRAL ID field, key the referral ID and press Enter. The referral displays.

NOTE: If you do not know the referral ID, you can use the F4 key, which displays the REFERRAL LIST screen.

4. View the referral details.

5. To view details on the REFERRAL DETAIL 2 screen, press the F10 function key. The REFERRAL DETAIL 2 screen displays.

6. To exit and return to the MAIN MENU, press the F3 function key. The MAIN MENU displays.

B. To Update a Referral Detail Information

1. From the MAIN MENU, key the number 2 in the Enter Option field and press Enter. The REFERRAL MENU displays.

2. From the REFERRAL MENU, key the number 2 in the Enter Option field and press Enter. The REFERRAL MENU displays.

3. In the REFERRAL ID field, key the referral ID you need to update and press Enter. The referral displays.

NOTE: If you do not know the referral ID, you can use the F4 key, which displays the REFERRAL LIST screen.

4. Update the necessary fields.

5. To save the updates, press the F9 function key.

6. To make updates to the REFERRAL DETAIL 2 screen, press the F10 function key. The REFERRAL DETAIL 2 screen displays.

7. Update the necessary fields

NOTE: To update the ALIAS NAMES, EPICS ADDRESS and PHONE NUMBER fields, type a U in the S column.

To update an ALIAS SSN, edit the number. To delete an ALIAS SSN, key a D in the S column.

8. To save the updates, press the F9 function key.

NOTE: If the program type is SAAC, SAAQ, SADC, or SADQ, a warning message, ‘IS THIS SA MEDICAID? PRESS F9 TO UPDATE, PRESS <ENTER> TO REKEY’, will be displayed to ensure that only the Medicaid portion of the Special Assistance overpayment is entered.

9. To exit and return to the MAIN MENU, press the F3 function key. The MAIN MENU displays.

C. To Close a Referral

If the entire investigation on a referral is completed (i.e., unsubstantiated), it is required that the investigator close the referral. The investigator must still complete the Claim Detail screen prior to closing a referral.

Referrals that have been paid off do not require this process. The REFERRAL STATUS automatically populates to CL (closed) when the current balance on the CLAIM DETAIL screen is set to 0 and sets the CLOSE REFERRAL field to Y.

1. From the MAIN MENU, key the number 2 in the Enter Option field and press Enter. The REFERRAL MENU displays.

2. From the REFERRAL MENU, key the number 2 in the Enter Option field and press Enter. The REFERRAL DETAIL 1 screen displays.

3. In the REFERRAL ID field, key the referral ID you need to close and press Enter. The referral displays.

NOTE: If you do not know the referral ID, you can use the F4 key, which displays the REFERRAL LIST screen.

4. In the CLOSE REFERRAL field, key ‘Y’ to close the referral.

5. In the REASON CLOSED field, key the reason the referral is closed.

NOTE: If you do not know the reason code, you can use the F4 key, which displays the REASON CLOSED TABLE.

NOTE: This field will not allow the referral/claim to be closed if the balance is greater than zero and the program is Medicaid or AFDC/TANF. If a closed reason code is entered with the balance greater than zero, the error message CLAIM BALANCE IS GREATER THAN 0.00. ONLY FS CLAIMS MAY BE TERMINATED displays.

6. To save the changes, press the F9 function key.

NOTE: The DATE CLOSED field is system generated with today’s date. Also, the REFERRAL STATUS field automatically populates to:

• CL (closed) when the claim balance on the CLAIM DETAIL screen is 0

• TE (terminated) when the claim balance on the CLAIM DETAIL screen is greater than 0

Exception (Work First Only) and is displayed as TE:

Claims that have a balance greater than 0, Claim Type AE (Agency Error) and Agency Error Type C (County) are considered County Responsible Overpayment (CROP).

7. To exit and return to the MAIN MENU, press the F3 function key. The MAIN MENU displays.

D. To Transfer a Referral Out of State – Food and Nutrition Services Only

If a client moves out of state, it may be necessary to transfer the claim out of state.

Only those claims in CO (collection) status are eligible for Out of State transfers.

NOTE: EPICS does not send notification to the debtor or to the out of state case worker. The ‘OT’ Referral Status stops all forms of collections. For example: Recoupment, TOP, DOR, or Lottery.

1. From the MAIN MENU, key the number 2 in the Enter Option field and press Enter. The REFERRAL MENU displays.

2. From the REFERRAL MENU, key the number 2 in the Enter Option field and press Enter. The REFERRAL DETAIL 1 screen displays.

3. In the REFERRAL ID field, key the referral ID you need to transfer and press Enter. The referral displays.

NOTE: If you do not know the referral ID, you can use the F4 key, which displays the REFERRAL LIST screen.

4. In the REFERRAL STATUS field, enter OT for Out of State Transfer.

5. To complete the transfer, press the F9 function key.

6. To exit and return to the MAIN MENU, press the F3 function key. The MAIN MENU displays.

E. To Reopen a Referral from Out of State Status – Food and Nutrition Services Only

A referral that has been in OT (Out of State) status may need to be reopened by the county if the client moves back to the originating state. For example, a client moved from Bertie County to VA, and the county issued an Out of State transfer. The client then moves back from VA to Bertie County. Once the county is aware that the client is back, the referral should be reopened in EPICS.

1. From the MAIN MENU, key the number 2 in the Enter Option field and press Enter. The REFERRAL MENU displays.

2. From the REFERRAL MENU, key the number 2 in the Enter Option field and press Enter. The REFERRAL DETAIL 1 screen displays.

3. In the REFERRAL ID field, key the rederral ID you need to reopen and press Enter. The referral displays.

NOTE: If you do not know the referral ID, you can use the F4 key, which displays the REFERRAL LIST screen.

4. In the REFERRAL STATUS field, enter CD for Collection.

NOTE: All fields become unprotected with exception of the client’s demographic information and the assign, accept, and open fields.

The referral is assigned to the original investigator. If the referral needs to be reassigned to another investigator, the supervisor must do this via Case Reassignment.

5. To complete the transfer, press the F9 function key.

6. To exit and return to the MAIN MENU, press the F3 function key. The MAIN MENU displays.

F. To Create a Referral from an Out of State Source

If a county receives an allegation against a client from an out of state source, the referral must be entered in EPICS. For example, Gates County receives a phone call from a person in VA that someone in their county is committing a suspected fraud.

This is considered a Transfer from Out of State referral.

1. From the MAIN MENU, key the number 2 in the Enter Option field and press Enter. The REFERRAL MENU displays.

2. From the REFERRAL MENU, key the number 3 in the Enter Option field and press Enter. The REFERRAL DETAIL 1 screen displays.

NOTE: If you do not know the code or value for a field, you can use the F4 key, which displays a list of codes or values for selection. This field attribute is only available for those fields that contain a + (plus sign) to the right of the field.

3. In the REFERRAL TYPE field, key the code for the type of referral.

4. In the INDIVIDUAL ID field, key the case head payee’s ID.

If you do not know the case head payee’s ID, press the equal sign (=) and F4 key. The Name Search screen displays. You may search in one of four ways which is outlined on the screen. Press ENTER. The Name List screen displays.

If the individual is displayed, enter an ‘S’ by the name under the Sel column. Press Enter. The Referral Detail 1 screen is displayed with individual ID that was selected. If your individual is not displayed and an individual ID number must be assigned, press the F11 key. The Maintain Client screen displays.

From the Maintain Client screen, enter the Name, SSN (if no ssn enter zeroes), Sex, Race (you may enter up to 5 codes), Ethnicity, Language, Address, and County Code. Phone Number is optional. Press the F6 key. The Maintain Client screen is redisplayed with the individual ID number assigned and the message:

CCIPN65D Person and Address Created Successfully

Press the F12 key. The Name List screen is redisplayed with the individual. Enter the ‘S’ by the individual under the Sel column and press ENTER. The Referral Detail 1 screen is displayed with the individual ID assigned and selected.

5. In the PROGRAM field, key the code the identifies the benefits program to which the suspected overpayment applies.

6. In the CASE ID field, key the individual’s Case ID.

7. In the REFERRAL DATE field, key the date the referral was received using the 10-character date format: MM/DD/YYYY.

8. In the DATE OF DISCOVERY field, key the date of discovery. This is a required field and must be in MM/DD/CCYY format.

a. This date cannot be greater than the REFERRAL DATE.

b. This date cannot be greater than the current date.

c. This date can be prior to or the same as the REFERRAL DATE.

d. This date can be changed if the referral status is not CL, TE, or OT

9. In the REFERRAL PERSON field, key the name of the person who provided the referral information.

10. In the REFERRAL SOURCE field, key OT for Transfor from Out of State.

11. In the NATURE OF REFERRAL field, key the code that represents the nature of violation.

12. If applicable, enter date in the optional fields.

NOTE: To determine which fields are optional, see Referral Detail 1 Field Descriptions.

13. To add/save the data on the REFERRAL DETAIL 1 screen and continue entering required data on REFERRAL DETAIL 2 screen, press the F6 function key. The REFERRAL DETAIL 2 screen displays.

NOTE: EPICS attempts to validate the data, ensuring all required fields are populated. If not, the system informs you of the fields that require details and will not proceed to REFERRAL DETAIL 2 screen until you provide the fields with the appropriate data.

If either the case head payee or the Program and Case ID is not found in EIS/FSIS, you are prompted with a message: The override function can only be completed by State Staff Program Integrity Staff when applicable.

For auditing and reviewing purposes, you must maintain all supporting documentation that warrants the override.

14. In the ALLEGATIONS field, key a descriptions of the alleged fraud.

15. If applicable, enter data in the optional fields.

NOTE: To determine which fields are optional, see Referral Detail 2 Field Descriptions.

16. To add data in the optional fields, key the appropriate code in the S column.

17. To add/save the referral, press the F6 function key.

18. To exit and return to the MAIN MENU, press the F3 function key. The MAIN MENU displays.

VI. NOTEPAD

A. After you add a referral, you may record notes regarding the referral, claim, or investigation by using the Notepad feature (which is accessed from the REFERRAL DETAIL 1 screen). The NOTEPAD feature contains 2 screens: NOTEPAD SUMMARY and NOTEPAD DETAIL.

The NOTEPAD SUMMARY screen lists all notepad entries for a particular referral, displaying the note title/description, date created, and date last updated.

Notepad Summary Function Key Descriptions

Key	Description
F1	To access EPICS on-line help
F3	To exit and return to the Main Menu
F6	To add a notepad entry (save)
F7	To display a previous screen (page down)
F8	To display the next screen (page up)
F12	To cancel or return to the previous screen

B. The NOTEPAD DETAIL screen is utilized to add, update, and view NOTEPAD information (e.g., title/description, date created, date last updated, and description of the note entry).

Notepad Detail Function Key Descriptions

Key	Description
F3	To exit and return to the Main Menu
F6	To add a new note (save)
F7	To display the previous screen (page down)
F8	To display the next screen (page up)
F9	To update a note
F10	To delete a note
F12	To cancel or return to the previous screen

1. To add a note to a referral, the referral must already exist in EPICS.

NOTE: The notepad feature becomes Read-Only once a referral is in Collections (CO), Closed (CL), or Terminated (TE) status.

a. To add a note to the Notepad:

(1) From the MAIN MENU, key the number 2 in the Enter Option field and press Enter. The REFERRAL MENU displays.

(2) From the REFERRAL MENU, key the number 2 in the Enter Option field. The REFERRAL DETAIL 1 screen displays.

(3) In the REFERRAL ID field, key the referral ID of the referral that you need to add a note and press Enter. The referral details display.

(4) Press the F5 function key. The NOTEPAD SUMMARY screen displays.

(5) Press the F6 function key. The NOTEPAD DETAIL screen displays.

(6) In the TITLE/DESCRIPTION field, key a title to the note that will describe your entry.

(7) Press TAB.

(8) In the space provided, key the referral notes.

(9) To add/save, press the F6 function key.

NOTE: The DATE CREATED field is system generated with today’s date. The DATE LAST UPDATED field will populate with a system generated date of the last edit.

(10) To exit and return to the MAIN MENU, press the F3 function key. The MAIN MENU displays.

b. To display and update a note in Notepad:

(1) From the MAIN MENU, key the number 2 in the Enter Option field and press Enter. The REFERRAL MENU displays.

(2) From the REFERRAL MENU, key the number 2 in the Enter Option field. The REFERRAL DETAIL 1 screen displays.

(3) In the REFERRAL ID field, key the referral ID of the referral that you need to update the note and press Enter. The referral displays.

(4) Press the F5 function key. The NOTEPAD SUMMARY screen displays.

(5) In the S column, key ‘S’ next to the note that you need to display and press Enter. The NOTEPAD DETAIL screen displays.

(6) View the note details and, if needed, modify the title/ description and/or note details.

(7) To save the changes, press the F9 function key.

NOTE: The DATE LAST UPDATED field is system generated with the current date.

(8) To exit and return to the MAIN MENU, press the F3 function key. The MAIN MENU displays.

If the note entry is no longer applicable to the referral, you can delete the entry. This delete is not reversible.

2. To delete a note from Notepad:

a. From the MAIN MENU, key the number 2 in the Enter Option field and press Enter. The REFERRAL MENU displays.

b. From the REFERRAL MENU, key the number 2 in the Enter Option field. The REFERRAL DETAIL 1 screen displays.

c. In the REFERRAL ID field, key the referral ID of the referral that you need to delete the note from and press Enter. The referral details display.

d. Press the F5 function key. The NOTEPAD SUMMARY screen displays.

e. In the S solumn, key ‘S’ next to the note that you need to display and press Enter. The NOTEPAD DETAIL screen displays.

f. To delete the note entry, press the F10 function key.

g. To exit and return to the MAIN MENU, press the F3 function key. The MAIN MENU displays.

VI. UTILIZING F4

If you do not know the code or value for a field, you can use the F4 function key, which displays a list of codes or values for selection. This field attribute is only available for those fields that contain a + (plus sign) to the right of the field.

To enter field details using F4:

A. In the field that contains a + (plus sign) to the right of the field, key = (equal sign) and press the F4 function key. The specific code list screen displays.

B. To select a code or value, table to the appropriate code/value in the S column and key ‘S’.

C. Press Enter. The previous screen displays with the field populated with the selected code or value.

D. Continue entering or updated the screen details.

VII. NAME SEARCH

When you are working with referrals and are uncertain of the individual ID, use the Name Search function. This searching method provides you with the capability to search CNDS for an individual ID number. There are 4 search criteria. You can only select one search method:

• Name, Sex, Date of Birth only
• SSN (social security number ) only
• Individual ID only
• Case ID only

A. Name Search Function Key Descriptions

Key	Description
F1	To access EPICS on-line help
F3	To exit and return to the Main Menu
F4	To clear the search criteria fields
F11	To display the Maintain Client screen
F12	To return to the previous screen

B. To Search an Individual ID Using the Name Search Function

1. In the INDIVIDUAL ID field, key = and press F4. The NAME SEARCH screen displays.

2. Select a search method and key the appropriate information in the field(s).

3. To initiate the search, press Enter. The Name List screen displays with all records that match your search criteria.

4. In the Sel column, key ‘S’ in the field next to the appropriate individual and press Enter. The previous screen displays with the data from the search.

5. Continue entering or updating the screen details.