BENEFITS QUALITY CONTROL
STATE OPERATIONS HANDBOOK

 

 

TABLE OF CONTENTS

  Page
Chapter I. Benefits QC Overview

  1. Introduction
  2. Background
  3. Overview of Benefits QC
  4. Overview of Handbook

 

I-1
I-1
I-2
I-3
REQUIRED PROCEDURES  
Chapter II. Organization and Authority
  1. Organization
  2. Authority
  3. Written QC Procedures
  4. BQC Software

 

II-1
II-1
II-1
II-1
Chapter III. Data Processing - SESA Mainframe Computer Operations and Interfaces with QC Computer
  1. Introduction
  2. Overview
  3. Detailed Instruction to State ADP Staff
  4. Record Type Three Definitions, Format, and Record Layout
  5. Input Control Data Record for COBOL Program
  6. Output of COBOL Edit of Transactions Universe File
  7. Definition of the BQC Population (Sampling Frame)
  8. Sample Selection Process
  9. Data Processing Record Format for Record Type One
  10. Definition and Data Format for Record Type Two
  11. Formatting Data for Transfer to the Artecon/Sun Computer

 

 

III-1
III-1
III-2
III-11
III-19
III-20
III-25
III-26
III-30
III-35
III-38
Chapter IV. Data Collection
  1. Introduction
  2. Overview
  3. Data Elements and Descriptions

 

V-1
IV-1
IV-2
Chapter V. Classifying Propriety of Payments
  1. Introduction
  2. Coding Proper Payments
  3. Coding Improper Payments
  4. Key Week Error Summary Sheet
  5. Case Completion
  6. Reopening Cases
V-1
V-1
V-2
V-11
V-23
V-24
Chapter VI. Investigative Procedures
  1. Introduction
  2. General Investigative Requirements
  3. Investigative Guide
  4. Forms
  5. Fact-Finding Statements
  6. Claimant Interview
  7. Work Search Contact Interviews
  8. Employer Interviews
  9. Disqualifying/Deductible Income Verifications
  10. Other Third Party Verifications
  11. Dependency Eligibility Verifications
  12. UCFE
  13. UCX
  14. Interstate Requests
  15. Summary of Investigation
  16. Appeals
  17. Completion of Cases and Timely Data Entry
  18. Reopening Cases

 

VI-1
VI-1
VI-2
VI-2
VI-3
VI-3
VI-4
VI-4
VI-4
VI-5
VI-5
VI-5
VI-5
VI-6
VI-6
VI-7
VI-7
VI-8
Chapter VII. Records and Reporting
  1. Introduction
  2. Documentation
  3. Retention of Records
  4. Reporting

 

VII-1
VII-1
VII-1
VII-1
APPENDICES
  1. Regulation
  2. Claimant Questionnaire
  3. Investigative Guide
 


BENEFITS QUALITY CONTROL
STATE OPERATIONS HANDBOOK
ET HANDBOOK NO. 395
2ND EDITION, CHANGE NO. 2
JANUARY 1993