TN 27 (05-94)

HI 00801.520 Subsequent Handling After Issuance of Notice

A. Procedure — Disallowance cases

If it is determined, after a temporary notice has been issued, that the claim should be denied, immediately notify the claimant (and any known providers or suppliers which furnished services based on the notice), that no entitlement to HI and/or SMI exists. Ask the claimant to return the erroneous notice.

Annotate the SSA-3428-U2 Coding Sheet to show that a temporary notice was issued and send a HCFA-2178 (see HI 00930.080) to CMS to delete the EDB record.

Consider equitable relief where SMI is involved (see HI 00805.210).

B. Procedure — Temporary record established on incorrect claim number

If a notice is issued based on an incorrect or inactive claim number, send a HCFA-2178 to CMS Transaction Branch to correct the EDB record and move any health insurance data to the proper claim number. Issue a new notice with the correct claim number and have the individual return the incorrect notice.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0600801520
HI 00801.520 - Subsequent Handling After Issuance of Notice - 04/23/2015
Batch run: 04/23/2015
Rev:04/23/2015