If an individual contacts you to file for- Medicare coverage based on exposure to an Environmental Health Hazard (HI 00803.001) take the following actions to establish a lead for EHH Medicare:

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  tell the individual that we need to obtain information from them to assist us in taking claim;

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  Establish a lead using the enhanced Leads and Appointment System (eLAS)

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  enter office Code 872 (Kalispell, Montana);

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  show the application type as HI/SMI; and

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  enter the remark, "Environmental Health Hazard Case-Contact FO 872"

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  tell the individual the SSA Kalispell, Montana office (FO 872) will contact them shortly.

If FO 872 is not able to contact the individual to take the EHH Medicare claim or, if when contacted, the individual is no longer interested in pursuing the Medicare claim, FO 872 must take the following actions to close out the EHH Medicare Leads form. For more information on the EHH Medicare Leads see HI 00803.001A.

1. a. 

   Establish Access the enhaced Leads and Appointment System (eLAS). and verify the following information:

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     the application type shows as HI/SMI;

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     Office Code 872 (Kalispell, Montana); and

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     enter the remark shows, “Environmental Health Hazard Case - Contact FO 872 if re-contacted by applicant”.

2. b. 

   Send a close out notice via:

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     if the date the lead is established in (eLAS) is in the same month as the date of protective filing; or

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     DPS if the date of establishment of the lead in the (eLAS) is after the month of the protective filing date. date.