HI 00920.110 EOMB's and Disallowance Notices

These notices originating from the carriers and intermediaries, will inform the individual of the action taken on his claim. Entitlement problems may be brought to the attention of the DO by the beneficiary. The procedures in HI 00920.120 below apply only when a beneficiary questions a disallowance of a HI or a SMI claim for one of the following reasons and State buy-in is not involved.

1. Not entitled to HI benefits.

2. Not entitled to SMI benefits.

3. Expenses incurred prior to current entitlement.

4. Expenses incurred after-termination of current entitlement.