TN 22 (11-01)
HI 01001.310 Billing for Premiums after an Incorrect Termination
In some cases, although premiums were paid timely they may not be recorded timely
and the enrollee may be notified erroneously that his/her Supplementary Medical Insurance
(SMI) coverage has been terminated (e.g., premiums were paid just before the end of
the grace period, etc.). In most cases, the error will be detected promptly, entitlement
reinstated, and he/she will subsequently receive a premium billing notice.
However, in some cases, the error may not be caught and corrected in time (e.g., the
enrollee's premium payment was credited to some other person). In these cases, a premium
payment adjustment will be made to his/her record, the enrollee's entitlement will
be reinstated and he/she will be billed for all premiums due in accordance with HI 01001.085.
Where the enrollee visits the field office (FO) protesting an incorrect premium bill
or termination of his/her entitlement on the ground that he/she paid his/her premium
timely, ask only for the evidence of payment (canceled check or a copy of the front
and back of the check). If the enrollee does not have a copy of the canceled check,
obtain a statement concerning the time and manner of payment.
Where evidence (canceled check) is presented at the FO, the FO representative should
review the on-line direct billing record to determine if the payment was applied after
the bill was sent. If the payment is shown, inform the enrollee that the payment was
received and processed. If the payment is not shown, forward a copy of the canceled
check (back and front) to Centers for Medicare & Medicaid Services, Center for Beneficiary
Choices, Division of Information and Assistance, 7500 Security Boulevard, S1-20-21,
Baltimore, MD 21244-1850.