Identification Number:
GN 02403 TN 43
Intended Audience:See Transmittal Sheet
Originating Office:Centers for Medicare & Medicaid Services (CMS)
Title:Procedures for Handling Remittances and Premium Payments in the Field Office
Type:POMS Transmittals
Program:Medicare,Medicaid
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. 43, 10/15/2021

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

CMS

Effective Date

Upon Receipt

Background

Summary of Suggested Changes: Expansion of instructions for paying premiums in the FO and question about remittances recorded as Trust Fund Code "N" (Not Applicable) and Reason Code "H" (CMS Lockbox Premium)

 

Summary of Changes

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

Updated POMS section according to CMS request

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

A. Policy - Medicare Premium Remittances

Payment of premiums in the field office (FO) should be discouraged for reasons given in HI 01001.025. However, if the beneficiary insists on paying their premiums in the FO, they may submit one of the premium types below.

 

  1. 1. 

    Regular monthly/quarterly premiums.

The Centers for Medicare & Medicaid Services (CMS) controls these premiums. FOs should receive them with the payment coupon from a pre-printed Medicare Premium Bill, (CMS-500 ). If the beneficiary does not have their CMS-500 payment coupon, the FO should create a manual CMS-500 coupon. To reduce delays as much as possible, send the payment out the same day it is received from the beneficiary with the CMS-500 coupon to the address below for the Medicare Premium Collection Center (MPCC).

 

NOTE: The Medicare Number must be clearly shown on the check/money order. The letters B,I,L,O,S and Z aren't used in Medicare Numbers because they are similar to certain numerals.

These payments are sent to:


Medicare Premium Collection Center
PO Box 790355
St. Louis, MO 63179-0355

 

NOTE: All payments with the exception of retroactive installments, go to the MPCC.

DO NOT SEND REGULAR MONTHLY PREMIUMS TO MATPSC.

These transactions will appear on the Field Office Daily Receipt Listing

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 Billing System (DBS) , forward these premium payments to the Medicare Premium Collection Center and not to the MATPSC. These remittance transactions will appear on the (FODRL).

MATPSC ONLY handles the following remittances:

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). See GN 02403.020 and MS 01104.008.

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

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

Payment of premiums in the FO should be discouraged for the reasons given in HI 01001.025.

Follow the steps in HI 01001.090 to handle Medicare Premium payments received in the FO, only if the beneficiary insists on paying their premiums in the FO.

1. Interviewer

a. If the premium payment is received:

  • with a Medicare Premium Bill (CMS-500) or ,

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

  • without a bill but with the entire SSN or a Medicare Number and beneficiary name annotated on the check (This occurs when the DBS cannot produce a bill), 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 Electronic Remittance System (SERS) processing.

CAUTION: Do not deposit a beneficiary payment intended for Medicare premiums into Social Security’s Trust Fund. Depositing the funds into Social Security’s Trust Fund will initiate the Inter-Governmental Payment and Collection (IPAC) system process and will cause an even more significant delay.

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 Remittance System (SERS) processing

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. Give the receipt to the remitter. Mail the CMS-500 payment coupon 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 Medicare Premium Collection Center lockbox (address below), and let the PSC know what has occurred.

NOTE: The Medicare Number must be clearly shown on the check/money order. The letters B,I,L,O,S and Z aren't used in Medicare numbers because they are similar to certain numerals.


Medicare Premium Collection Center
P.O. Box 790355
St. Louis, MO 63179-0355

Do not accept a premium payment before the HI/SMI award is prepared, the Medicare Premium Collection Center is not equipped to accept payments before a beneficiary record exists.

c. Enter the payment into the system via eFOR system, and give the automated receipt to the remitter, and explain the advantages of paying their future premiums directly to the Medicare Premium Collection Center: it saves the time and expense of visiting the FO, and also helps hold down administrative costs, which affects the cost of premiums each year. Payments received in the FO could delay the payment process by at least 5-7 days. Additionally, note that credit card payments cannot be accepted in the SSA field office or over the phone. In addition to the receipt, DMS will generate a forwarding instruction sheet indicating how to handle the remittance.

REFERENCE: See MS 01103.006, MS 00303.007 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 02403.009B.1.

f. Give the remittance to the remittance clerk.

2. Remittance Clerk

a. Obtain FODRL and compare the remittance to it.

REFERENCE: See MS 01104.009 for how to obtain the FODRL.

b. Hand carry the FODRL 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 FODRL.

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

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


Medicare Premium Collection Center
P.O. Box 790355
St. Louis, MO 63179-0355

Seal the envelope and mail it the same day to reduce possible delays as much as possible.

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

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

C. Exhibit - Medicare Premium Bill (CMS-500)

The Medicare Premium Bill (CMS-500) 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. Mail premiums received with this bill to the CMS Medicare Premium Collection Center at:

Medicare Premium Collection Center
P.O. Box 790355
St. Louis, Mo 63179-0355

 

D. Exhibit - Medicare Premium Bill (CMS-500) in Spanish

The CMS-500A is also available in a Spanish version.


GN 02403 TN 43 - Procedures for Handling Remittances and Premium Payments in the Field Office - 10/15/2021