These policies, procedures and internal controls depend on the F/EA's billing processes.
On a weekly basis, <<Staff Title>> produces a claim file for all payrolls processed in the most recent payroll cycle and any claims that were put on hold from a previous payroll cycle. Claims are produced per the format for electronic submission as specified by State/MMIS Provider.
Process will vary based on program rules and F/EA systems.
The internal controls used by F/EA to monitor this process establish responsibility, segregate duties, document procedures and ensure independent internal verification.
Claims submitted to <<MMIS/State>> for payments made on behalf of consumers for tax purposes are referred to as service claims.
Post Service Payment to Billing System
<<Process will vary depending on State payment process and F/EA billing system and processes>>
The internal controls used by F/EA to monitor this process establish responsibility, segregate duties, document procedures and ensure independent internal verification.
Service Claim Denials are processed within 10 days of an Service Claim payment being posted. The <<Staff Title>> researches each denied claim. Where applicable, the <<Staff Title>> adjusts the claim and resubmits it. The Service Claim Accounts Receivable is updated per denials and resubmissions.
The internal controls used by F/EA to monitor this process establish responsibility, segregate duties, document procedures and ensure independent internal verification.
After successfully submitting a valid service claim file, the <<Staff Title>> reconciles the recently submitted claim to the Accounts Receivable balance in the billing sub-system. The <<Staff Title>> updates the Billing Control form with the applicable Accounts Receivable values and creates a journal entry template.
Post Service Billing to General Ledger
Post Accruals to General Ledger
<<Insert Process>>
The internal controls used by F/EA to monitor this process establish responsibility, segregate duties, document procedures and ensure independent internal verification.