HI 01001.115 Processing RRB Cases with HI/SMI Entitlement through MADCAP
When it is necessary to code HI/SMI for beneficiaries who are RRB annuitants, code
the HOC/SOC of “P” and the appropriate DOES and DOEH in the RID 6. Code a SENC of “K” if the HI/SMI is based on renal disease entitlement and no HI/SMI is recorded on
the MBR. If HI/SMI is recorded on the MBR, and renal entitlement should be recorded,
code the HOC/SOC of “P,” the appropriate DOES and DOEH, and a HENC and SENC of “K.” If SMI has been refused, code the SOC of “R,” HOC of “P” and the appropriate DOEH.