As an Employment Network (EN) operating under the Social Security Administration's (Social Security's) Ticket to Work Program (Ticket program), your organization has made a commitment to work with individuals receiving Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI). Social Security places certain requirements on all ENs with regard to working with beneficiaries and functioning as an EN under the Ticket program.
Adhering to the processes, procedures and expectation detailed in this section of the website will ensure that your organization is meeting all applicable requirements.
The Ticket Program Manager (TPM) is responsible for all operational tasks that affect/support Ticket Providers, beneficiaries, Social Security and the MAXIMUS Ticket to Work Project.
TPM provides support and oversees the following operations:
Program Integrity (PI)
TPM's monitoring role is to ensure EN adherence to contractual and regulatory guidelines, such as the EN TPA, 20 CFR Part 411, or any program direction provided by SSA. The PI staff, in concert with SSA's EN Services Team (ENST), works to provide ongoing evaluation of ENs' business conduct with Ticket Holders, clients, providers, and employees to ensure consistency with program obligations and ethical standards; and to prevent, detect, and correct program fraud, waste, and abuse. The PI team's QA role is to systematically monitor and evaluate various aspects of EN activity to help ensure that standardization of quality is met.
Beneficiary Support staff (Beneficiary Helpline or Call Center) maintains a toll-free telephone number with trained staff that markets this service to beneficiaries and other interested parties as the "Social Security Ticket to Work Helpline". The Call Center staff provides vital services to beneficiaries, including:
- Providing general program information;
- Benefits planning;
- Work assistance counseling; and,
- Appropriate referral to a WIPA project, when indicated.
The Call Center staff provides beneficiaries with assistance on a variety of inquiry types that require staff to have a broad base of program knowledge and a clear understanding of the appropriate responses and actions depending on a beneficiary's specific circumstances.
Specific tasks the Call Center staff perform are listed below:
- Respond to questions and provide general information about the Ticket Program;
- Provide baseline benefits awareness and information;
- Provide guidance about planning for employment;
- Provide, as needed, referral of eligible and appropriate beneficiaries to a WIPA using the National WIPA Data Base, Efforts to Outcome (ETO) software;
- Assist beneficiaries in locating and assigning their Ticket to ENs.
- Assist all beneficiaries who received services from an SVRA, where the SVRA elected to receive payment under the cost reimbursement option and has closed the beneficiary’s case;
- Take appropriate action on requests for a "Ticket on Demand. The staff inputs requests into iTOPSS to generate/mail tickets to beneficiaries.
- Take appropriate and immediate action on questions from beneficiaries about Ticket status and Ticket assignments
- Take appropriate action on questions from beneficiaries about Timely Progress Reviews (TPR)
TPM EN Payments staff work with Social Security to initiate and implement quality control and quality assurance activities into processes resulting in an effective method for ensuring that ENs are properly compensated. The staff's ongoing efforts to validate and improve the accuracy and timeliness of payment processing help minimize unnecessary draws on SSA funds and maintain strong relationships with the provider network. EN Payments staff process > 95% of all payments to ENs. The remaining percentage of payments that require manual processing and overrides are "pushed" to the Social Security Administration for payment after the EN Payments staff assess the claims and make the payment determinations. The staff also create Payment Denials to notify ENs of claims the staff are unable to pay. The staff create and process these Payment denials for claims ENs submit and claims that payment staff determine as "not available". Some of the tasks staff perform are listed below:
- Administer the EN Payment Process and maintain documentation.
- Explain to ENs and SVRAs Requirements of the Payment Process.
- Respond directly to ENs that submit inquiries on complex issues via phone or email.
- Review EN Payment Requests for accuracy and completeness.
- Verify and post earnings data. TPM staff use the Social Security Administration rules and policies to identify various types of earnings and post this data to Social Security's Ticket to Work System: Internet Ticket Operations Support System (iTOPSS).
- Maintain electronic file of payment requests, awards, and denials.
- Ensure Quality of EN Payments. Resolve EN Payment issues.
The staff work with the Social Security Administration to clarify payment issues such as how payments are affected by beneficiaries that have certain situations such as approved Expedited Reinstatement (EXR) Claims and BOND beneficiaries.
TPM performs a variety of services that support ENs, the Social Security Administration's EN Service Team (ENST)) and MAXIMUS Ticket to Work Project.
This staff operates a toll-free telephone Help Desk for ENs from 9 a.m. to 5 p.m., ET, Monday through Friday of each week, excluding Federal holidays. The Help Desk features after-hours service via voice-mail; simultaneous service to multiple callers; Spanish language service; Text Telephone Communication Service for the hearing- and speech-impaired; and referral of those inquiries not related to EN/SVRA activities under the Ticket Program to the appropriate destination. The staff responds to inquiries on payment-related issues via telephone and email, and inquiries/clarification/problems ENs submit concerning Social Security's Ticket Portal. The staff also:
- Assists ENs on navigating the portal and provides guidance on "how to's" to clarify ENs understanding of portal processes.
- Provides technical assistance to beneficiaries to access Social Security sponsored Virtual Job Fairs (VJF)