1. |
Current Pay (PSY:C0l) HI Number present in the unearned income history (UMIH) field
(Type A) Income.
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SISC in SID line reflects non-pay status (SISC is not E, S, or C) |
Force a SSR finder to update the MBR by requesting a type M offline query. See SM
02001.040 and SM 01301.325. Be sure that identifying data on the MBR and SSR are consistent;
otherwise, the SSR/MBR interface cannot occur. Verify that the requested action was
accomplished by obtaining a second MBR 14 days after inputting the Type M off- line
query. If the forced finder corrects the MBR’s SID line, the following occurs: 1)
the Third Party System (TPS) is updated on the 25th of the month; 2) the TPS updates
the Third Party line of the MBR by the 13th of the following month; 3) the erroneous
premium deduction is stopped in next month’s check. Erroneous deductions should be
refunded 14 days after the Third Party line is corrected, e.g., SISC code corrected
March 2; TPS updated March 25; Third Party line of MBR corrected April 12, premium
refund made about April 26; benefit check May 3 no longer has premium deduction. If
the finder does not correct the SID line, or if it does but does not result in the
Third Party line correction as described above, send a CMS-1957 to CMS Central Office
at the address shown in HI 00815.088C.3. Attach a print- out of the full SSI record and all MBR replies. Add remark to the
CMS-1957, “SID field correction attempted via force finder on (show date) at the top of the form”.
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2. |
Current Pay (Psy: CO1) SSID does not contain X-reference to HI number (“Type A” income in the unearned income history (UMIH of the SSI query). |
No SID Line |
Be sure that the identifying data on the MBR and SSR are consistent; otherwise, the
SSR/MBR interface cannot occur. Transmit SSA-1719B/C entering HI alpha numeric number
in the unearned income field. See SM 01305.225E. This will force a finder record to
correct the MBR and HI records. When an individual is receiving SSI on one SSN and
has an established HI record as a primary beneficiary on another SSN, do not use the
SSA-1719B/C procedure. The SSR must be reestablished on the proper SSN. Use PR1 procedures
(SM 01015.020) or if not possible, T30/start date procedures (SM 01801.001 ff.)
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3. |
Current Pay (PSY:CO1) |
SISC in SID line is E, S, or C. Third Party line does not show current Buy-in status |
Send CMS-1957 to CMS Central Office at the address shown in HI 00815.088C.3 recent SSR update of MBR is shown in the MBR’s Transaction History field, i.e., BACOM
SSI update. In this case allow for TPS interface to update MBR’s Third Party line
by the 13th of the month following the month BACOM SSI update is made.
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4. |
Current Pay(PSY: C01) |
SISC in SID line is E, S, or C. Third Party billing codeand third- party entitlement
date in third-party line are correct and there is no Part B third-party termination
date (TTDS) present
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If the individual complains that premium billing notices are still being sent, request
a BCM. If the BCM has the individual in billing status, send an SSA-5002 HB to the
appropriate PSC. Annotate the remarks field - “SSR/MBR correct, beneficiary being billed for SMI premiums - State Buy-in case, please
correct the BCM in accordance with SM 00711.310 ”. Attach copies of SSR, MBR and BCM to the 5002 form.
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5. |
Current Pay (PSY: C01) |
SISC in SID line is E, S, or C. Third Party billing |
Send CMS-1957 to CMS Central Office at the address shown in HI 00815.088C.3. code in the Third Party line is correct. Third Party entitlement date (TEDS) is in-
correct
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6. |
Current Pay (PSY: C01) |
SISC in SID line is E, S, or C. Third Party line shows current Buy-in status. State
Buy-in indicator in the HI portion is not a 1.
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Send CMS-1957 to CMS Central Office at the address shown in HI 00815.088C.3. Annotate the remarks space “SSR/MBR correct, Buy-in indicator not in Enrollment Database
(EDB)- process “U” RIC"".
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7. |
Not in Current Pay (PSY: Other than C01) |
SISC in SID line is other than E, S, or C. No current Buy-in in the Third Party line |
Contact local welfare office to determine whether individual should be on Buy-in,
based on eligibility for some non-SSI assistance (e.g., AFDC, MAO) Send CMS-1957 to
local welfare office if appropriate. (See Chart in HI 00815.009 for State Coverage Groups).
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