HI 00803.020 Protective Filing and Leads for EHH Medicare
A. Protective filing for EHH Medicare
The earliest possible protective filing date for EHH Medicare is when the law became effective on March 23, 2010. Do not apply protective filing dates established prior to March 23, 2010 to EHH Medicare claims. Other than this limitation, normal protective filing rules apply. For additional information on protective filing, refer to GN 00204.010.
B. Lead for EHH Medicare
1. Establishing a lead for EHH Medicare
If an individual contacts you about a change in the law regarding Medicare coverage for asbestos-related illnesses in the Libby/Troy, Montana area, take the following actions to establish a lead for EHH Medicare:
tell the individual that we need to obtain information from him or her to assist us with his or her claim;
access the EHH Medicare Leads form. The form is available at the following link: http://denet.kc.ssa.gov:4545/surveys/frmSurvey.aspx?Key=3F5349443D3637312653483D ;
complete the form with the individual. Do not click any button on the form more than once;
click the “Validate and Finish” button at the bottom of the page to submit the information; and
tell the individual the SSA Kalispell, Montana office (FO 872) will contact him or her shortly.
NOTE: A completed EHH Medicare Leads form is protective filing for Title II benefits.
2. Close out procedures for Libby Provision Medicare Leads form
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 form see HI 00803.001A.
Establish a lead using the 800 number lead system:
show the application type as HI/SMI;
enter Office Code 872 (Kalispell, Montana); and
enter the remark, “Environmental Health Hazard Case - Contact FO 872 if re-contacted by applicant”.
Send a close out notice via:
the 800 number leads system if the date of the establishment of the lead in the 800 number leads system is in the same month as the date of the protective filing; or
DPS if the date of establishment of the lead in the 800 number leads system is after the month of the protective filing date.