| Section |
|
Latest
Transmittal |
| Inquiries and Referrals for HI/SMI
|
| HI 00825.001 |
HI/SMI Inquiries Received from Beneficiaries |
|
| HI 00825.005 |
Determining Enrollment Status |
|
| HI 00825.015 |
Premium Inquiries |
TN 10 04-21 |
| HI 00825.020 |
Correspondence Pertaining to State Buy-In, Group Payers, Civil Service, or RRB |
|
| HI 00825.055 |
Undeliverable HI/SMI Letters and Forms |
|
| HI 00825.060 |
HI/SMI Notices and Forms HCFA-40B, HCFA-40D |
|
| HI 00825.065 |
Forms CMS-1966, Medicare Health Insurance Card |
TN 15 07-24 |
| HI 00825.070 |
Undeliverable SMI Premium Notice |
|
| HI 00825.075 |
Processing Returned SMI Refund Checks |
TN 10 04-21 |
| HI 00825.080 |
Establishing a SMI Premium Payer for Uninsured (T, M, J, or K) Enrollee |
TN 9 01-20 |
| HI 00825.095 |
FormCMS-2178-U2, HIB/SMIB Entitlement Problem — Priority |
TN 11 07-21 |
| HI 00825.100 |
Entitlement Issue |
TN 11 07-21 |
| HI 00825.105 |
Miscellaneous Issue |
|
| HI 00825.110 |
Interpretation of Combined HIM and MBR Query Replies |
|
| HI 00825.115 |
CMS-1725 (Program Service Center Referral) |
|
| HI 00825.120 |
Telephone Calls |
|
| HI 00825.125 |
Disclosure of Information |
|
| HI 00825.130 |
Disposition of Completed Correspondence |
|
| HI 00825.905 |
Phone Call Record of Critical HI/SMI Issue — Sample |
|
| HI 00825.906 |
Sample MBR Reply to Combined MBR/HIM Query |
|
| HI 00825.907 |
Sample HIM Reply to Combined MBR/HIM Query |
|
| HI 00825.908 |
Form SSA-3339-U2, Interim Reply to HIB/SMIB Referrals |
|
| HI 00825.909 |
Transmittal Used by OCRO to Forward Earnings Statements to PSC |
|
| HI 00825.910 |
HCFA-1778 HIMEXC PSC Request Card |
|
| HI 00825.912 |
Form CMS-1725 (Program Service Center Referral) |
|
| HI 00825.913 |
Health Insurance Printout (HIPO) |
|