If the denial is for medical improvement, (item 11 of the SSA-833 indicates a MIRS
denial):
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•
Input a medical cessation through POS to stop provisional payments. For termination
instructions, see MS 06303.024 and DI 13050.025J,
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•
Use option 10=CESSATION to clear the EXR event from the Disability Control File (DCF),
If the denial is coded “not the same as or related impairment” (item 11 of the SSA-833
is 28)
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•
Do not use POS to terminate provisional benefits, as the Dib line will update to reflect
Medical Improvement and POS will also terminate the Extended Medicare (if in effect).
A “not the same as” denial does not result in termination of Extended Medicare; instead,
send a request to the program center (PC) to stop the provisional payments.
To contact the PC of jurisdiction:
Access the Detailed Office/Organization
Resource System (DOORS) using the search SSN function to send an email to the appropriate PC module with the
subject line "EXR Denial."
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•
Use option 5, SSR/MBR/STOP CDR to close the EXR event on the DCF, per DI 13010.620.