Identification Number:
GN 02403 TN 29
Intended Audience:See Transmittal Sheet
Originating Office:DCBFM OFPO
Title:Procedures for Handling Remittances and Premium Payments in the Field Office
Type:POMS Transmittals
Program:Medicare
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part GN – General
Chapter 024 – Checks
Subchapter 03 – Procedures for Handling Remittances and Premium Payments in the Field Office
Transmittal No. 29, 02/06/2019

Audience

PSC: DS, IES, LDS;
OCO-OEIO: BIES, BTE, CCRE, CR, CTE, FCR, PETL, RECOVR;
OCO-ODO: BTE, CCE, CR, CST, CTE, CTE TE, DSE, PAS, PETE, PETL, RC, RCOVTA, RECOVR;
FO/TSC: CS, CS TII, CS TXVI, CSR, CTE, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

OFPO

Effective Date

Upon Receipt

Background

A Field Office (FO) may receive remittances as payment for Health Insurance premiums. FOs can receive four kinds of premiums. This discusses how the FO processes these remittances.

Summary of Changes

GN 02403.030 Processing Medicare Premium Remittances Received in the FO

This section discusses how the FO staff process the four types of remittances that they might receive.

GN 02403.030 Processing Medicare Premium Remittances Received in the Field Office (FO)

A. Policy - Medicare Premium Remittances

Field Office (FO) may receive remittances as payment for Health Insurance premiums. FOs can receive four kinds of premiums.

  1. 1. 

    Regular monthly/quarterly premiums.

The Centers for Medicare and Medicaid Services (CMS) controls these premiums. FOs should received them with a pre-printed Notice of Medicare Premium Payment Due, (CMS-500 formerly HCFA-500). These payments are sent to:

Centers for Medicare & Medicaid Services
Medicare Premium Collection Center
PO Box 790355
St. Louis, MO 63179-0355

DO NOT SEND REGULAR MONTHLY PREMIUMS TO MATPSC.

These transactions will appear on the Field Office Daily Receipt Listing (FORDL)

2. Manually prepared CMS-500 by the Program Service Center (PSC).

In situations when the PSC manually prepares a CMS-500 for regular monthly or quarterly premiums when the beneficiary cannot be billed electronically by the Direct Bill (DB) system. Forward these premiums to the Medicare Premium Collection Center and not to the MATPSC. These remittance transactions will appear on the FODRL.

3. Retroactive premiums being paid on an installment basis (HI 00830.060)

The PSC controls these premiums and should receive them with a CMS-500. There should be very few of these remittances. Send these remittances to MATPSC (the address shown on the CMS-500 should be changed to the MATPSC address); these transactions will appear on the Field Office Remittance Transmittal (FORT).

Social Security Administration
PO Box 3430
Philadelphia, PA 19122-9985

See GN 02403.020 and MSOM MS 004.008

4. Retroactive premiums being paid in a lump sum.

The servicing PSC controls these premium remittances. However, these premiums may not accompany the CMS-500. These transactions will appear on the FORT.

These two categories of retroactive premiums are the only premium payments that go to the MATPSC.

B. Procedure - Medicare Premium Remittances

Follow the steps below to handle Medicare Premium payments received in the FO.

1. Interviewer

a. If the premium payment is received:

  • with a Notice of Medicare Premium Payment Due (CMS-500) or ,

  • other than installment payment (this occurs when the DB system cannot produce a bill), or

  • without a bill but with an SSN or a Medicare number and beneficiary name annotated on the check (This occurs when the DB system cannot produce a bill), stamp the remittance “For Deposit Only, CMS.”

Stamp the remittance "For Deposit Only, CMS".

In DMS or eFOR system, record the remittance under Trust Fund Code "N" (Not Applicable) and Reason Code "H" (CMS Lockbox Premium). These payments are excluded from Social Security Remittance System (SERS) processing.

CAUTION: DO NOT STAMP THESE "For Deposit Only, SSA". The lockbox bank will not accept these as CMS deposits.

b. If the premium payment is received:

  • is a retroactive premium being paid based on an installment agreement,

  • has no SSN or Medicare number

Process a regular remittance per procedure GN 02403.006 and send it to MATPSC.

In DMS or eFOR systems, record the remittance under Trust Fund Code "O" (Other) and Reason Code "P" (Premium Installments). These payments are excluded from Social Security Electronic System Processing (SERS)

Include a CMS-500 or some other documentation that is clearly marked to alert the PSC to the purpose of the remittance. (See example of CMS-500 below). DMS will generate a payment coupon in addition to the receipt. The receipt should be given to the remitter. They payment coupon should be mailed with the remittance and the FORT to MATPSC.

If a single remittance represents a lump sum retroactive payment and a regular monthly premium, forward the full amount to the lockbox (address below), and let the PSC know what has occurred.

Centers for Medicare & Medicaid Services
Medicare Premium Collection Center
P.O. Box 790355
St. Louis, MO 63179-0355

If a premium payment is received before the HI/SMI award is prepared, make sure the front of all money orders and checks are clearly annotated with the Medicare number, beneficiary's name and "Prepayment HI/SMI premium" in red ink.

At the end of each workday, forward all "prepayment remittances" to the CMS Medicare Premium Collection Center in the same envelope. Annotate "Prepayment" in red ink.

c. Enter the payment into the system via eFOR system, and give the automated receipt to remitter, In addition to the receipt, DMS will generate a forwarding instruction sheet indicating how to handle the remittance.

REFERENCE: See MSOM MS 003.006 , MSOM MS 003.007 for how to input acceptable remittance and how to obtain an automated FO receipt.

d. Enter the receipt number and the Medicare number on each check.

e. If the payment is cash, follow steps GN 02403.009.B.1 .

f. Give the remittance to the remittance clerk.

2. Remittance Clerk

a. Obtain FORDL and compare the remittance to it.

REFERENCE: See MSOM MS 004.009 for how to obtain the FORDL.

b. Hand carry the FORDL and premium remittance to the remittance supervisor.

3. Remittance Supervisor

a. Review any mailroom or reception area logs completed that day. Ensure any premium remittances annotated on a log are included on the FORDL.

b. Record any discrepancies and resolve them with the remittance clerk and/or interviewer.

c. Place all premium remittances in an envelope addressed to:

Centers for Medicare & Medicaid Services
Medicare Premium Collection Center
P.O. Box 790355
St. Louis, MO 63179-0355

Seal the envelope and mail it the same day.

Forward the CMS-500 to CMS with the remittances; do not send any FO control forms, photocopies of the DMS receipts, or Receipt File Query Display.

d. If the client later alleges that he/she was not given credit for the remittance, follow the procedures in HI 01001.375.

C. Exhibit - Form CMS-500

This premium billing notice is mailed automatically to those Medicare beneficiaries who must be billed directly for Medicare premiums. It may be manually prepared by the PSC when the DB system cannot prepare an electronic bill. Premiums received with this bill should be mailed to the CMS Medicare Premium Collection Center at the address shown in GN 02403.030A .

Notice of Medicare Premium Payment Due — English

 

D. Exhibit - Form CMS-500SP

This premium billing notice is also available in a Spanish version.

Notice of Medicare Premium Payment Due — Spanish


GN 02403 TN 29 - Procedures for Handling Remittances and Premium Payments in the Field Office - 2/06/2019