TN 1 (07-87)
GN 02335.015 Carrier and Intermediary Actions in Underpayment Claims
When the carrier or intermediary receives notice of the enrollee's death while his
claim is being processed, or where an unnegotiated check has been returned, the carrier
or intermediary determines from its records, or by contacting the physician, supplier,
or provider, whether the services have been paid for. If a Part B claim filed by the
enrollee was based on an unpaid bill, the carrier or intermediary will ascertain whether
the physician, supplier, or provider wishes to claim the payment under the terms in
If the physician, supplier, or provider does not wish to claim the payment, the carrier
or intermediary, subject to the $50 tolerance in GN 02335.030B., will notify the survivors or estate of the deceased beneficiary of this and that
Medicare payments may be made to a person who has assumed the legal obligation to
pay the bill.
When the Part A or Part B services have been paid for, the carrier (or intermediary)
will develop a claim for the underpayment (or request DO assistance) subject to the
$50 tolerance in GN 02335.030B. When requesting assistance from the DO, the carrier identifies the information needed
to establish the proper payee; e.g., a CMS-1490S or CMS-1450.