A Gross Receivable is created when a financial entity owes the State money. It is the financial means by which the State recovers money that is owed to them. Examples of gross level receivable types include: cost settlements, fraud and abuse, audit findings, etc.
One example of when a gross receivable may need to be authorized is when include an audit finding indicates that the State overpaid a financial entity based on a system error or pricing rule change. The State can authorize a Gross Level request to cover this amount, and the financial entity will then reimburse the amount over a period of time. The amount will be subtracted from the financial entity’s adjudicated claims payments and used to “pay down” the amount defined.
The State department sends an accounting transaction request providing the financial entity information. An account receivable (A/R) is created using the activity code and reason code contained in the accounting transaction request received from the State.
After the gross receivable is created, the amount owed and reason code can be updated if the receivable has not been processed in a claims payment and reporting cycle.
During the next claims payment and reporting cycle, the account receivable record is used to begin the process of paying down the accounts receivable by applying payment to the receivable. During the creation of the account receivable, the recoupment options selected determines when and how much of the financial entities payment is applied to paying down the receivable.
The gross level receivable recoupment type code determines how the monies are being recovered. The recoupment type code options are: default, no recoupment, percentage amount, dollar amount and scheduled payments.
When the scheduled payments option is selected, payment details are added to the account receivable indicating the due date and amount.
Note: For scheduled payments, the recoupment is not part of the claims payment and reporting cycle process. However, if the payment schedule agreement is not met, an indicator (called default on payment schedule) is set and recoupment can be done thru the claims payment and reporting cycle process.
A recoupment made during the claims payment reporting cycle, by check or by a returned (system-generated) check creates a financial control number (FCN).
When the financial entity chooses the option to send a check or return a ND MMIS-generated check to pay down the receivable, it is recorded as a financial receipt. The financial control number can be viewed on the gross level receivable using the North Dakota MMIS Web Portal.
How to Add or Edit a Gross Level Receivable
Version as of 5/16/14.
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