HI 00820.075 Processing Center Processing of Termination


A. Termination and cancellation of termination received together

When a termination request and cancellation are received in the processing center together, both should be NANed and filed in the folder.

B. Interview unnecessary or being attempted by FO

When a request to terminate clearly expresses a considered and unshakable determination or indicates that the FO is still attempting to contact the enrollee, process the termination. Send a CMS-L457 to the enrollee if the request did not come from the FO (the FO is responsible for sending the CMS-L457 if the request is taken or received in their office).

C. Interview appropriate and necessary

If a clear request to terminate is received in the Processing Center but an interview has not been conducted because the request did not come through the FO, or if the FO did not provide an acceptable explanation as to why an interview was not conducted, send the enrollee a completed CMS-L457 letter (if the FO has not already given or sent one) and process the termination. Also, make a copy of the request and forward it to the FO to follow the guides in HI 00820.070, unless the request suggests that an interview would be undesirable or the time-frame is such that an interview could not be conducted before the termination date. Notify the FO if an CMS-L457 has been sent to the enrollee. Control the request for reply by the middle of the month following the effective date of termination.

If a timely cancellation request is subsequently received, notify central office of the cancellation, file the request in the folder, and cancel the FO development request and/or diary.

If the interview by the FO results in an affirmation of the termination request or if the FO is unable to contact the enrollee, cancel the development request diary, and NAN and file the papers returned.

D. Ambiguous request

If an ambiguous request is received, send it to the FO for development. (See HI 00820.070.) Since the request cannot be definitely defined as a termination request, the processing center should not notify central office and the enrollee should not be sent an acknowledgement letter (CMS-L457). It is not necessary to maintain control of the request.

E. Request for termination received in central office

If central office receives a voluntary termination request, the request should be date stamped and forwarded to the servicing processing center for processing as in HI 00820.075C.

F. A Final termination letter

The HCFA-L325, HCFA-L326, HCFA-L327, or HCFA-L328 is sent to the enrollee by the processing center when central office notifies them that final processing of the termination request has occurred. This is a computer processed letter.

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HI 00820.075 - Processing Center Processing of Termination - 11/29/2000
Batch run: 03/29/2017