TN 50 (09-13)
GN 02602.660 Worksheets for the Medicare Non-utilization Project (MNUP)
A. Introduction to the worksheets
There are three worksheets designed to assist in the MNUP development process. You can complete the worksheets manually or, preferably, electronically via the Intranet at the MNUP website).
You must update the website for each case interview. It is important that you complete the worksheet during each interview. Proper development is crucial to the success of the project. There are specific development steps you must follow to verify the beneficiary’s status. Using the interview worksheets ensures that you collect the proper information during the interview.
You can print and complete the sheets manually (handwritten).
If you completed a handwritten worksheet, you must:
enter the information from the handwritten worksheet onto the MNUP website; and
destroy the handwritten worksheet.
NOTE: The reference to GN 00301.322 refers to documents faxed into an electronic folder.
See the following links for copies of the worksheets:
NOTE: The Centenarian Project and MNUP use the same interview worksheets.
B. Procedure for completing the worksheets
1. Telephone interview worksheet
Use this worksheet for interviews conducted by telephone. Because a telephone interview is the preferred contact method, you will use this worksheet more often than the other worksheets.
If you determine during the telephone interview that the beneficiary is deceased, use the telephone worksheet to document your development of the beneficiary’s death. You are still required to update Shared Processes (GN 00301.287) with the necessary information pertaining to the beneficiary’s death. For a sample of the worksheet, see GN 02602.571.
2. Face-to-face interview worksheet
Use this worksheet for face-to-face interviews conducted at the field office or at the beneficiary’s residence. If during the face-to-face interview you determine that the beneficiary is deceased, use the face-to-face worksheet to document your development of the beneficiary’s death. You must still update Shared Processes with the necessary information pertaining to the beneficiary’s death. For a sample of the worksheet, see GN 02602.570.
3. Unable to locate the beneficiary
Use this worksheet when you are unsuccessful in locating the beneficiary. Prior to completing this worksheet, make sure you complete the failure to respond procedures in GN 02602.630. For a sample of the worksheet, see GN 02602.573.