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Interface Data

Revised October 28, 2007

Purpose:

ACES Interfaces Beneficiary and Earnings Data Exchange (BENDEX) Request a BENDEX Re-accretion View and/or Disposition BENDEX Accretion Data Beneficiary Earnings Exchange Record (BEER) Case Management Information System (CAMIS) Central Accounting Disqualified Recipient System (DRS) Intentional Program Violator ( IPV) Data Discrepancies Division of Child Support (DCS) Child Support New Hire Information Employment Security (ES) UCBMatching View and / or Disposition a UCB Discrepancy from Alerts List View and / or Disposition a Wage Discrepancy from Alerts View ES Wage Information View the UC SSN / Name List (UCBL) Screen Wage Matching Federal Bureau of Indian Affairs (BIA) Financial Services Administration (FSA) Income and Eligibility Verification System (IEVS) Internal Revenue Service (IRS) Labor and Industries (L&I) Medicaid Management Information System ( MMIS) Interface What is the MMIS interface? How often does the MMIS interface take place? What Client Information is sent to HRSA in the ACES to MMIS interface? What Client Information is sent to ACES from HRSA in the MMIS Interface? How do I access Third Party Liability Carrier Information? How do I access Provider and Rate Information? Medicare Buy-In Office of Financial Recovery (OFR) Prisoner Match Interface with SSA Public Assistance Reporting Information System (PARIS) Social Service Payment System (SSPS) State Data Exchange (SDX) Open New SSI Case View SDX Information from the File Inquiry (LMEN) Submenu Treasurer's Office Washington Telephone Assistance Program (WTAP) XRPIEN / Numident / SSA Numident XRPIEN

ACES Interfaces ACES interfaces with other state agencies to verify client data, increase program integrity and reduce payment errors. Interfaces occur in batch processing. Results are sent to the user via on-line alerts or may trigger automated update to a client's record. Each of the ACES interfaces has a schedule for batch processing. The processing is performed daily, weekly, monthly, quarterly, or at eligibility review depending on the schedule. To determine if there is a ‘match’ or ‘hit’ on an interface, ACES compares information in the ACES database and information on file with the other agency. Either full or partial matches can occur. A full ‘hit’ is a match on the social security number and first three (3) letters of the client’s last name. A partial ‘hit’ is a match on social security number only. Each time an automated interface finds a match information is returned to ACES and an alert is generated. Sometimes there is more information in the interface match than can be displayed on the alert display line. These alerts are called two-tiered alerts and have additional information that can be accessed by selecting the alert and pressing <F13>.  See Alerts. Some discrepancies require that the user indicate the disposition of the discrepancy. ACES calculates and reports on the savings amounts associated with the match discrepancies. ACES interfaces with the following files: Beneficiary and Earnings Data Exchange (BENDEX) Beneficiary Earnings Exchange Record (BEER) Case Management Information System (CAMIS) Disqualified Recipient System (DRS) Division of Child Support (DCS) DSHS Central Accounting - Office of Accounting Services (OAS) Employment Security ( ES) Federal Bureau of Indian Affairs ( BIA ) Income and Eligibility Verification System (IEVS) Internal Revenue Service (IRS) Labor and Industries ( L&I ) Medicaid Management Information System ( MMIS) Interface Medicare Buy-In Office of Financial Recovery (OFR) State Data Exchange (SDX) Social Service Payment System (SSPS) Treasurer's Office Washington Telephone Assistance Program ( WTAP ) XRPIEN / Numident / SSA

Beneficiary and Earnings Data Exchange (BENDEX) What is BENDEX (Beneficiary and Earnings Data Exchange)?   How often is the BENDEX file received?   How do I access the BENDEX screen?   How do I access the BENDEX information in aces.online?   What information is received from Social Security Administration (SSA) via the BENDEX?   How am I notified if there is a change in Social Security Payments or Medicare Entitlements?   What circumstances will ACES process the BENDEX payment information?     What is BENDEX (Beneficiary and Earnings Data Exchange)?   ·         The Beneficiary and Earnings Data Exchange (BENDEX) is an interface which provides information about Social Security and Medicare entitlement for applicants and recipients.   ·         The BENDEX daily processor will analyze the incoming BENDEX Data, and compare it to the most current record on the ACES BENDEX Database.  When appropriate it will compare against matching ACES case data to determine if the client requires having the ACES database auto-updated.  In some situations the case will not be auto processed; instead the worker will be sent an alert e.g. demographic or address mismatch   ·         SSA sends, via BENDEX, the net SSA amount after deductions that a client is receiving.  However, BENDEX does not indicate all the reasons for the deduction if one is being taken.  Users need to be aware that at times a payment reduction is taken from SSA income.  The reduction may be for child support.  Because BENDEX does not indicate this type of deduction, users should ask clients if any deductions are coming out of their check.  If the deduction is not excludable, the user may need to code the UNER to have this money counted.     How often is the BENDEX file received?   ·         Effective 2/23/2007, SSA will start sending the BENDEX file on a daily basis.      How do I access the BENDEX screens?   The BENDEX screen can be access from the LMEN screen.   1.      Enter [A] in the Selection field.   2.      Enter the CLID (if not already provided) in the Client ID field.   3.      Enter [BT] in the IEVS Match Type field and <TRANSMIT>, the BENI screen appears.   4.      Enter [Y] in the appropriate SEL Field and <TRANSMIT>, the BEN1 screen appears.   5.      Press <F14> for BEN2 screen.   ·         The LMEN screen can also be access from the client’s UNER screen by pressing  <F20>.     How do I access the BENDEX information in aces.online?   1.      On the Welcome back page of aces.online, use the Quick Navigation section to do the following: o        In the Select a Type of ID drop down box, click Client o        Enter the Client ID in the Enter an ID box. o        In the Select a Page drop down box, click Summary. o        Click the Go button and the Client >> Summary page displays. 2.      On the Client >> Summary page, under the Incomedropdown box, select the BENDEXlink.  The Client >> Income >> BENDEX Historypage displays.   3.      On the Client >> Income >> BENDEX History page, click the Claim Number for the BENDEX you want to view.  The Client >> Income >> BENDEXpage displays.     What information is received from Social Security Administration (SSA) via the BENDEX?   ·         Social Security Payments and Medicare Entitlements to include Part A and Part B information is displayed on the BEN1 and BEN2 screens.      How am I notified if there is a change in Social Security Payments or Medicare Entitlements?   ·         When the client’s BENDEX Social Security Number, Name and Date of Birth match exactly with a client already in ACES, this will be considered an exact match.   ·         Matches regarding Social Security amounts are automatically updated, but discrepancies of client data cause the generation of two-tier alerts which are user dispositioned.   ·         When there is a discrepancy in the Social Security Number, Name or Date of Birth between BENDEX and ACES, a discrepancy alert 253 – SOCIAL SECURITY/SSA DISCREPANCY – SEE 2ND TIER FOR DETAILS will be generated.   ·         When ACES receives a record with a date of death for an active ACES client, ACES will generate alert 271 – SOCIAL SECURITY INTERFACE INFORMATION – WORKER ACTION REQUIRED.   ·         Alerts for Take Charge (P06) clients will not be generated.   ·         The following alerts are generated to notify the worker of any changes:   o       253 – SOCIAL SECURITY/SSA DISCREPANCY SEE 2ND TIER   o       271 – SOCIAL SECURITY INFORMATION – WORKER ACTION REQUIRED   o       281 – BENDEX HAS DIFFERENT TPL DATA THAN WTPY REVIEW   o       306 – BENDEX INTERFACE – “UINC” UPDATED WITH RSDI   o       310 – SECOND SOCIAL SECURITY BENEFIT UPDATE BY BENDEX     What circumstances will ACES process the BENDEX payment information?   ·         When the payment status code is C and there are any unearned income amounts on the BENDEX record for a client who is receiving SSA Benefits.   ·         When the client has multiple payment status codes.   ·         When the payment status code indicates a suspended status (S0, S1, S2, S3, S4, S5, S6, S7, S8, S9, SF, SH, SJ, SK, SL, SM, SP, SS, or SW) ACES will leave the claim number on the client’s unearned income and will update the amount with zero.   ·         When the payment status code is S6 or S8, ACES will generate alert 271 – SOCIAL SECURITY INFORMATION – WORKER ACTION REQUIRED only when the prior payment status code received for the client was not S6 or S8.   ·         When the payment status code indicates a terminated, withdrawal, or other adjustment status (TA, TB, TC, TJ, TL, TP, T, T0, T1, T2, T3, T4, T5, T6, T7, T8, T9, U). ACES will generate alert 271 – SOCIAL SECURITY INFORMATION – WORKER ACTION REQUIRED.   ·         The BENDEX interface is a source of Medicare Part A and Part B data.  ACES automatically updates or creates the TPL1 for clients with Medicare Part A or Part B participation.  ACES sends the user an informational alert regarding updates.   ·         When ACES finds a new source of income on BENDEX, it will update the UNER as a new income source.   Request a BENDEX Re-accretion Enter Option [O] - AU / Client Misc - in the Selection field on the (WMEN). <TRANSMIT> and the (OMEN) displays. Enter Option [G] – BENDEX Reaccretion - In the Selection field on the(OMEN). <TRANSMIT> and a message is displayed for confirmation of request. View and / or Disposition BENDEX Accretion Data Enter [Y] in the S field at the alerts list screen. Press the tier function key <F13> for the(BEAP). The (BEAP) displays. The user can view the information displayed, determine where the discrepancy exists between ACES and the BENDEX. To disposition the discrepancy, the user must return to the (DEM1)  to correct the discrepancy, then access the (OMEN) to request a BENDEX re-accretion. Press <F3> to return to the alerts list screen from the (BEAP). Option [G] – BENDEX Re-accretion – on the (OMEN) screen allows the user to request a BENDEX re-accretion for a client. Data is forwarded to BENDEX for three months, then not again unless there is another request.

Beneficiary Earnings Exchange Record (BEER) The Beneficiary Earnings Exchange Records (BEER) interface consists of ACES updating the (BENC)with unearned income data from SSA. Due to strict federal mandated security requirements for BEER, all BEER data must be cleared through the ESA - Division of Employment and Assistance Programs (DEAP) in Olympia. DEAP staff generate alerts to the appropriate users for updates to matched clients. The (BENC) is accessed through a two-tier alert off of an alerts list screen. At the alerts list screen, enter [Y] in the S field next to the alert wanted. Press <F13>-tier, and the (BENC) displays. The (BENC) displays Wage Payer / Payee data for a client with the ability to update the disposition code. A single BEER compensation (wage payer) with the maximum number (4) of AU’s is displayed on each screen occurrence. View wage payer / payee data. Press <F3> to return to the alerts list screen.

Case Management Information System (CAMIS) The ACES interface with CAMIS is designed to identify foster care clients and ensure that the correct medical coverage, TANF, and food assistance benefits are issued to households when children are removed from an active assistance unit. CAMIS provides to ACES, in batch, a file containing client information of children receiving benefits through CAMIS. ACES runs the CAMIS file against the ACES database to identify matches. When a match is found Alert 190 - ACES Child in Foster Care – Date Placed MM–DD–YYYY - is sent to the user of record for the ACES case. This allows the user to take whatever case action is appropriate.  See Alerts.

Central Accounting ACES provides a file to DSHS’s central accounting system, Agency Financial Reporting System ( AFRS), on a daily basis, containing all one time and monthly grant extracts and warrant cancellations. These include: Warrants Warrant Register Accounting Information for AFRS Combined/Merged Information for the State Auditor Batch Balance Report for the State Treasurer’s Office OCR Warrant Tape for the State Treasurer’s Office OS Cards Tape for the State Treasurer’s Office Register Control Tape for the State Treasurer’s Office Warrant cancellations This interface requires no action to be taken by the user.

Disqualified Recipient System (DRS) The Disqualified Recipient System ( DRS) interface contains monthly exchanges of information between the Federal government and ACES regarding Intentional Program Violators ( IPV) in the Food Assistance program. ACES attempts to match the IPV data with new or current Food Assistance recipients. For clients active in ACES enter IPV data on the Client Sanctions (SANC) screen. ACES generates an alert to inform user of any updates performed. If discrepant data is found between interface data and the data entered on (SANC) ACES generates a two-tier alert to be dispositioned by the user. The second tier screen displayed from the IPV data alert is the (DRSI).  See Disqualified / Sanctioned Assistance Unit / Individual. Intentional Program Violator ( IPV) Data Discrepancies The (DRSI) is for inquiry only.  Detailed disqualification information is presented. To access the(DRSI): At the alerts list screen, enter [Y] in the S field for the two-tier alert to be inquired upon. Press the tier function key, <F13>, and the (DRSI) screen displays. The(DRSI) displays the DRS Inquiry Results and Disqualification Details of a client. Disqualification Details include: the Effective Date of the disqualification, Length of disqualification, Type of disqualification, FIPS State and County. FIPS (Federal Information Processing Standards) is a set of Federally issued state and county codes consisting of five numbers. The first two digits represent the state and the remaining three digits represent the county. The(DRSI) displays the DRS Inquiry Results and Disqualification Details of a client.  Disqualification Details include: the Effective Date of the disqualification, Length of disqualification, Type of disqualification, FIPS State and County.  FIPS (Federal Information Processing Standards) is a set of Federally issued state and county codes consisting of five numbers. The first two digits represent the state and the remaining three digits represent the county. To return to the previous screen, press <F3>.

Division of Child Support (DCS) Child Support DCS maintains the following information relating to child support Non-Custodial Parent Addresses Child Support Payments Health Insurance Coverage Paternity ACES and DCS share information by exchanging data files. ACES creates a tape containing information about: Newly approved TANF AUs Added persons to TANF AUs TANF AUs for a child suddenly deprived of parental support because of absence and previously deprived of parental support for another reason Any new non-custodial parents being added DCS creates a tape containing information about: Updated non-custodial parent addresses Information about insurance coverage of TANF AU members Information about changes of insurance coverage of TANF AU members Child support payment collections information ACES uses all this information to determine if child support plus other income is sufficient to meet the AU ’s needs. ACES automatically updates the database with new or changed data received, except for excess child support amounts received. ACES generates alerts for discrepant data received, excess child support amounts and for address matches of the non-custodial parent with the TANF client. New Hire Information A job is run once a week in ACES to determine if persons listed on the DCS New Hires File are receiving benefits from ACES. The DCS file data is compared to data in ACES and matches to social security number sent. If a match is found then the following criteria is evaluated: The first 5 letters of the last name match on ACES and the DCS file. The client is active or pending in any cash, food assistance, or MA medical coverage group G04, G03, G95, S02, S07, K03, L02 or L04. The client financial responsibility code is anything except NM. The client is; 18 or older or; if under 18 is HOH and has FINL RESP of RE or; is at least 16 but not yet 18 and not the HOH and not attending school full time. The client has neither employer, nor earned income in ACES. If the client has earned income but the employer in ACES is not the same as the employer in the data from DCS. When these conditions are met Alert 287 - Client Appears Hired in the Last 30-45 Days (a two-tiered alert) displays.  See Alerts. Information included in the second tier of the alert: Date of the match Name of employee SSN of employee ACES Date of Birth DCS Date of Birth Employer Name, FEIN number, and address The DCS new hire information is purged after 60 days. If the alert is not worked within 60 days employer information is not available.

Employment Security Department (ESD) The ESD interface provides ACES with monthly client information regarding Unemployment Compensation Benefits ( UCB) and wages received in Washington. When a match is made between a person who is receiving UCB or wages and is on ACES, a two-tier alert is generated. UCB Matching ACES performs a nightly match process for: Pending applications Added persons Added or modified Social Security numbers. ACES continues to attempt to match clients, for as long as their income is considered in the determination of eligibility for an active or pending assistance unit, according to the following schedule: Monthly for each of the three months following application month Monthly for each person currently receiving UCB Upon receipt of an updated version of the UCB file ACES attempts a second match of all people whose applications are pending. View and / or Disposition a UCB Discrepancy from Alerts List To view and / or disposition a UCB discrepancy from the alerts list: Enter [Y] in the S field next to the alert on the alerts list screen Press <F13-tier> function key. The (UCBD) displays. Enter [the disposition code] in the Disposition Code field. (see F1 Help) to disposition the discrepancy, Enter the [savings information] in the Savings Confrmd Amt field. The user determines the savings amount by accessing Option [R] - Interim Historical Change - on the (AMEN) and the appropriate benefit month. The user updates the case with the correct data, runs eligibility, compares the previous amount issued to the amount the client is eligible for based on the new information. The difference between the two amounts is the amount the user enters in this field. To view detailed information for the client, press <F13-ucbi> function key. Press <F3> to return to the alerts list screen. The (UCBI) displays the UCB payment dates and amounts paid to the client. Press <F3> to return to the(UCBD). The user can view or disposition a UCB discrepancy from the (LMEN) screen, Option [L] on the (WMEN). To view or disposition a UCB discrepancy select the appropriate IEVS Discrepancy option on the (LMEN), option: A = IEVS Discrepancy Inquiry B = IEVS Discrepancy Update ACES displays the appropriate UCB. Processing is the same as described above for viewing or dispositioning a UCB discrepancy from the alerts screens. View unemployment compensation ( UC) information Submenu - in the Selection field. <TRANSMIT> and the (LMEN) displays. Enter Option [C] – IEVS Full File Inquiry - in the Selection  field. Enter [the client’s SSN] in the Client SSN field. Enter [the CLID] in the Client ID field. Enter [the code for the match desired] in the IEVS Match Type field. To access the various match types available, press <F1>. An error message will display if an unauthorized user makes a selection that requires a privileged user profile. <TRANSMIT> and the (UCBL) displays. This screen will display the list of client names and SSNs from the UC interface. On the (UCBL), enter [Y] in the SEL field next to the SSN and name wanted for viewing. <TRANSMIT> and (UCBI) displays. View and / or Disposition a Wage Discrepancy from Alerts Enter [Y] in the S field on the alerts list screen. Press <F13-tier> function key. ACES displays the (WGED). This screen displays ESD Wage discrepancy data for a client. On this screen the user has the ability to update the disposition code and savings data. Only a single Employment Security employer is shown per screen. Enter [the disposition code] in the Disposition Code field to disposition the discrepancy Enter [savings data] in the Savings Confrmd Amt field. The user determines the savings amount by accessing Option [R] – Interim Historical Change - on the (AMEN) and entering the appropriate benefit month. The user updates the case with the correct data, runs eligibility, compares the previous benefit amount to the benefit amount the client is eligible for based on the new information. The difference between the two amounts is the savings amount entered in this field. To view detailed information press <F13-wgei> function key and ACES displays the (WGEI) screen. The (WGEI) displays Employment Security wage information for up to two wage-segments. To return to the alerts list screen press <F3>. The ESD interface provides ACES with monthly client information regarding Unemployment Compensation Benefits ( UCB) and wages received in Washington. When a match is made between a person who is receiving UCB or wages and is on ACES, a two-tier alert is generated. UCB Matching ACES performs a nightly match process for: Pending applications Added persons Added or modified Social Security numbers. ACES continues to attempt to match clients, for as long as their income is considered in the determination of eligibility for an active or pending assistance unit, according to the following schedule: Monthly for each of the three months following application month Monthly for each person currently receiving UCB Upon receipt of an updated version of the UCB file ACES attempts a second match of all people whose applications are pending. View and / or Disposition a UCB Discrepancy from Alerts List To view and / or disposition a UCB discrepancy from the alerts list: Enter [Y] in the S field next to the alert on the alerts list screen Press <F13-tier> function key. The (UCBD) displays. Enter [the disposition code] in the Disposition Code field. (see F1 Help) to disposition the discrepancy, Enter the [savings information] in the Savings Confrmd Amt field. The user determines the savings amount by accessing Option [R] - Interim Historical Change - on the (AMEN) and the appropriate benefit month. The user updates the case with the correct data, runs eligibility, compares the previous amount issued to the amount the client is eligible for based on the new information. The difference between the two amounts is the amount the user enters in this field. To view detailed information for the client, press <F13-ucbi> function key. Press <F3> to return to the alerts list screen. The (UCBI) displays the UCB payment dates and amounts paid to the client. Press <F3> to return to the(UCBD). The user can view or disposition a UCB discrepancy from the (LMEN) screen, Option [L] on the (WMEN). To view or disposition a UCB discrepancy select the appropriate IEVS Discrepancy option on the (LMEN), option: A = IEVS Discrepancy Inquiry B = IEVS Discrepancy Update ACES displays the appropriate UCB. Processing is the same as described above for viewing or dispositioning a UCB discrepancy from the alerts screens. View unemployment compensation ( UC) information Submenu - in the Selection field. <TRANSMIT> and the (LMEN) displays. Enter Option [C] – IEVS Full File Inquiry - in the Selection  field. Enter [the client’s SSN] in the Client SSN field. Enter [the CLID] in the Client ID field. Enter [the code for the match desired] in the IEVS Match Type field. To access the various match types available, press <F1>. An error message will display if an unauthorized user makes a selection that requires a privileged user profile. <TRANSMIT> and the (UCBL) displays. This screen will display the list of client names and SSNs from the UC interface. On the (UCBL), enter [Y] in the SEL field next to the SSN and name wanted for viewing. <TRANSMIT> and (UCBI) displays. View and / or Disposition a Wage Discrepancy from Alerts Enter [Y] in the S field on the alerts list screen. Press <F13-tier> function key. ACES displays the (WGED). This screen displays ESD Wage discrepancy data for a client. On this screen the user has the ability to update the disposition code and savings data. Only a single Employment Security employer is shown per screen. Enter [the disposition code] in the Disposition Code field to disposition the discrepancy Enter [savings data] in the Savings Confrmd Amt field. The user determines the savings amount by accessing Option [R] – Interim Historical Change - on the (AMEN) and entering the appropriate benefit month. The user updates the case with the correct data, runs eligibility, compares the previous benefit amount to the benefit amount the client is eligible for based on the new information. The difference between the two amounts is the savings amount entered in this field. To view detailed information press <F13-wgei> function key and ACES displays the (WGEI) screen. The (WGEI) displays Employment Security wage information for up to two wage-segments. To return to the alerts list screen press <F3>.

NOTE: ES Wage Discrepancies can also be viewed or dispositioned from the (IMEN).

To view or disposition an ES wage discrepancy select the appropriate IEVS Discrepancy option on the (LMEN) option: A = IEVS Discrepancy Inquiry B = IEVS Discrepancy Update ACES displays the appropriate ES wage screen. Processing is the same as described above for viewing or dispositioning an ES wage discrepancy from the alerts screens. View ESD Wage Information Enter Option [L] --File Inquiry Submenu in the SELECTION field on the (WMEN). <TRANSMIT> and the (LMEN) displays. Enter Option [C] – IEVS Full File Inquiry in the SELECTION field. Enter the [client’s SSN] in the CLIENT SSN field or the [CLID] in the CLIENT ID field. Enter [the code for the match desired] in the IEVS MATCH TYPE field. (see F1 Help) <TRANSMIT> and the (WGEL) displays. This screen will display the list of client names and SSNs from the ES wage interface. Enter [Y] in the SEL field next to the SSN and name of your person on the (WGEL) <TRANSMIT> and ACES displays the ES Wage Inquiry - (WGEI). View the UC SSN / Name List ( UCBL) Screen The (UCBL) displays a list of unemployment compensation benefit clients, with their associated SSNs. The (UCBL) allows a user to select a client and obtain detailed information regarding their unemployment compensation benefits To view the(UCBL): Enter Option [C] – IEVS Full File Inquiry on the (LMEN). Enter either [the client’s SSN or last name] in the either the CLIENT SSN or CLIENT L NAME field as appropriate. Enter the [client’s IEVS match type] in the IVES MATCH TYPE field. <TRANSMIT> If the user entered the last name of the client, the (UCBL) displays a list of names of people who are receiving unemployment compensation beginning with the last name entered on the (LMEN) and all names listed alphabetically after the name entered. OR If the user entered the SSN on the (LMEN), ACES goes directly to the UC Inquiry (UCBI). Wage Matching ACES performs wage matching:  Each night for all applicants who have gone through Screening. On a monthly basis for the prior quarter for all assistance units certified as eligible. For any period of time within the prior two calendar quarters for food assistance units.

Federal Bureau of Indian Affairs (BIA) The monthly Federal Bureau of Indian Affairs (BIA) interface consists of ACES selecting clients from the client database who are included on a medical AU and transferring this information to the Federal Bureau of Indian Affairs (BIA). This allows BIA to identify all medically eligible clients that they may be extending services to. The information included in the interface is: AU ID Aid Program Client Name Client ID Birth Date Sex SSN Residence Address No user action is required for this interface.

Financial Services Administration (FSA) Financial Service Administration (FSA) interface is run once a month during the Monthly Issuance weekend. The determination regarding what premium amount is sent for each household, is based on the effective dates. The file sent to FSA contains information for all optional non-exempt children in the household. The sent information includes: Head of household data Address Name of each optional child listed in the head of household’s AU Household premium amount.

NOTE: If an authorized Rep Type Code NE – Other F06/F07-Receives Premium Bills Generated from FSA is entered on (AREP), the authorized representative’s name and address is sent.

FSA sends delinquent premium information on the 16th of each month. The file provides F06 and F07 AUs with an outstanding balance for each of the past three months. FSA sends paid delinquent premium information daily. The file contains the F06/F07 Head of Household name that have paid their delinquent premium amount in full.

Income and Eligibility Verification System (IEVS) The Income and Eligibility Verification System (IEVS) interface contains information from Employment Security, Beneficiary Data Exchange (BENDEX), Beneficiary Earnings Exchange Record (BEER), State Data Exchange (SDX), NUMIDENT, XRPIEN, and the Internal Revenue Service (IRS). The purpose of this interface is to provide inquiry access to the ES Wage and SDX database information.  See Interface Data – Employment Security (ES) and Interface Data – State Data Exchange (SDX).

Internal Revenue Service (IRS) The Income and Eligibility Verification System (IEVS) provides the IRS information for ACES to match with client data.  See Interface Data – Income and Eligibility Verification System (IEVS). The IRS match is used to verify income and resource information given to ACES by clients and includes: Interest income Unearned income from sources other than interest IRS matching occurs each month for: Currently pending, active and suspended AUs with an application date since the last IRS match; People in currently active or suspended AUs with a Client status of "active" or "pending" and with an application date since the last IRS match; and People in currently active or suspended AUs for whom there has been a social security number added or changed since the last IRS match. IRS matches are also performed once a year for all active and suspended AUs. ACES compares client data to IRS information and identifies both full and partial hits. ACES examines all matches and identifies two kinds of discrepancies between client data and IRS information: A client is shown by the IRS to have an account unreported or under reported to ACES; and A client is shown by the IRS to have income not reported to ACES. The Division of Income Assistance (DIA) in Olympia receives all matches from the IRS interface on the (IRSD). If user action is required, a notification of action will be forwarded to the appropriate user. The (IRSD) is accessed through a two-tier alert off an alerts list screen. At the alerts list screen select the alert for inquiry or update and press the tier function key to display the (IRSD). The (IRSD) displays IRS payer / payee data for a client with the ability to update disposition code and savings data. A paging function is offered; only a single IRS payer is shown per screen.

Labor and Industries (L&I) The interface between L&I and ACES occurs weekly and identifies any ACES client in receipt of worker’s compensation payments. Identified matches are forwarded to L&I and the OFR for possible overpayments.

Medicaid Management Information System (MMIS) Interface What is the MMIS interface? The MMIS interface is an exchange of information between ACES and Health and Recovery Services Administration (HRSA). HRSA uses this information to authorize payment for medical bills from medical providers, generate reports, and obtain federal funding. ACES uses the data received from MAA to automatically update the appropriate screens with the new or updated Third Party Liability (TPL) data, provider data, and rate information. How often does the MMIS interface take place? The MMIS interface takes place on a daily, weekly, and monthly basis depending on what client or provider information is being exchanged. What Client Information is sent to HRSA in the ACES to MMIS interface? Listed below are four components of the ACES to MMIS interface. Any changes to the following sections in ACES will trigger the section to be sent to MMIS. The Demographics Section - The Demographics Section contains client and AU level information. The following are some of the items includes in the Demographics section: ACES Client IDs and Social Security Numbers Head of Household Name and Client Names AU Address Client Living Arrangement PIC Code Boss Code AU Total Number in Household Client Buy-In Data The Eligibility Section - The Eligibility Section contains the client and Assistance Unit eligibility data. The following are some examples of what is included in the Eligibility Section: Client Eligibility Begin and End Dates AU Number and CSO Client’s Total Payment Client ACES Program Type and Coverage Group Client Closing Reason The Spenddown Section - The following are examples of what is included in the Spenddown Section: AU Spenddown Certification Begin Date AU Spenddown Expense Incurred AU Spenddown Expense Amount and Paid Date AU Spenddown TPL Amount AU Spenddown Expense Provider Name and Number AU Split Bill Responsibility AU Medicaid Deductible Amount The Third Party Liability (TPL) Section - The following are examples of what is included in the TPL Section: Client TPL Data Record PIC Code ACES Client ID and Social Security Number Client TPL Detail Data What Client Information is sent to ACES from HRSA in the MMIS Interface? TPL information: When TPL information changes in MMIS, ACES updates the client’s (TPL1) screen with the current TPL information. Provider information: When provider and rate information changes in MMIS, ACES updates the (PROV) screen. Third Party Liability Carrier information: Each month, ACES updates the (TPLC) screen with the names, addresses, and carrier codes of all TPL carriers known to the state. Medical Coverage information such as: the name of the Health Management Organization, Detox, patient restrictions, and DDD indicator. Managed Care information: Information provided to MMIS for clients receiving managed care for Program of All-inclusive Care for the Elderly (PACE), Medicare/Medicaid Integration Project (MMIP), or Washington Medicaid Integration Project (WMIP) service providers. Information includes the client’s enrollment date, provider name and phone number, disenrollment date and reason. . If the client has any Managed Care information, the information will auto-populate on the client’s (MANC) screen. The enrollment date sent from MMIS will always be the first day of the ongoing month. The disenrollment date sent from MMIS will always be the last day of the current month. MMIS sends ACES a monthly file containing the managed care information about seven working days prior to the end of the month. How do I access Third Party Liability Carrier Information?  TPL carrier information can be accessed in two ways, either by the carrier name or carrier code. If you know the carrier name, from the (LMEN) screen: Enter [F] in the Selection field. Enter the [Carrier Name] in the Carrier Name field. Press <Enter> and the (TPLL) screen displays. On the (TPLL) screen, enter a [Y] in the Sel field that corresponds to the Carrier name, press <Shift> and <F4>, and the (TPLC) screen displays. If you know the carrier code, from the (LMEN) screen: Enter [G - Health Insurance Carriers – By Code] in the Selection field. Enter the [Carrier Code] in the Carrier Code field. Press <Enter> and the (TPLC) screen displays. How do I access Provider and Rate Information? From the (MMEN): Enter [D] in the Selection field. Enter the [Vendor ID Number] in the Vendor ID field. Press <Enter> and the (PROV) screen displays.

Medicare Buy-In The primary objective of this interface is to use the monthly Buy-In Billing files generated by Health Care Financing Administration ( HCFA) to ensure clients are accreted to and deleted from the State’s Buy-In program. Additionally, ACES uses the transaction data to update Clients’ Medicare (Title XVIII) data on the ACES Client database. ACES produces a potential Buy-In file of clients who appear to be eligible for Buy-In, but who have not yet been identified by either ACES or HCFA as having been ‘bought in.’ ACES uses the data received from HCFA to automatically update changes of Medicare Part A and Part B premium payment data on the (TPL1) in the PAID BY field. A specialized unit of Medical Assistance Administration ( MAA ) in Olympia processes all Buy-In information. If user action is required, notification from MAA is sent to the appropriate user. The actions that a user may be responsible to perform include an update to ACES to reflect any changes or reconcile any discrepant data. To accomplish any updates or reconciliation of case data, requires that the user access the discrepant data through the case maintenance process, and then perform any needed changes.

Office of Financial Recovery (OFR) The daily referral information required by the Accounts Receivable Management System (ARMS) for BEGs that have been verified or authorized by the user is sent by ACES to OFR. The daily obligation referrals to Office of Financial Recovery include: ACES AUIDs ACES CLIDs of the active clients participating in the AU (at the time the overpayment occurred) SSNs of the active clients participating in the AU Client demographic data of the active clients participating in the AU (at the time the overpayment occurred) Household address information Household language code ACES program code, program type and medical coverage group code Income information Resource information Effective dates Overpayments by month Overpayment reason code. OFR processes SSI interim assistance reimbursement payments when a General Assistance client begins receiving SSI and the initial SSI check is sent to the state. A copy of the letter sent to the client about the payment is sent to the appropriate CSO. Detailed reimbursement information can be obtained by calling the OFR - SSI Interim Assistance Reimbursement Section.

Prisoner Match Interface with SSA An electronic interface between SSA prisoner database and ACES identifies individuals potentially ineligible for TANF and/or food assistance benefits. By presidential order the Social Security Administration (SSA) must allow states access to their prisoner database. A daily and monthly file is sent to SSA through SVES (State Verificatio