HI 00815.094 CMS Central Office Procedures for Resolving Buy-In Problem Cases

CMS"s Central Office Clerical Staff in the Premium Module will attempt to resolve a problem case within three updates (approximately 90 days). The Premium Module does not routinely provide a response to the DO/BO on each problem case. However, it will advise the DO/BO if the action requested cannot be taken.

In order to verify that the problem case has been corrected, the DO/BO should obtain an HMQ or MBR printout. Due to CMS/SSA processing considerations allow three Third Party updates to elapse before querying the system. If the case is still unresolved, send a CMS-1957 to the CMS Regional Office clearly marked “Second request.” Attach current printouts to the CMS-1957.