Selects beneficiaries who are to receive a bill for a particular month or quarter.
Records are selected on the 27th of the month (unless it is a weekend or holiday),
for the next month. If the 27th falls on a Saturday, the selection is made on the
26th. If the 27th falls on a Sunday, the selection is made on the 28th. HI premium
bills are sent out at the same time as the quarterly billings for SMI.
Prepares and releases a billing tape for processing or electronically transmits billing
data (English and Spanish) to the Medicare printing and mailing contractor.
Monitors and oversees the daily operations of the printing and mailing contractor
and the Medicare Premium Collection Center.
Maintains the billing and collection history for beneficiaries in direct billing status.
Performs the following direct billing operations:
Receives and applies payment information from the Medicare Premium Collection Center.
Processes adjustments from MBR changes and direct inputs from SSA’s PSC and CMS's
Reverses terminations and notifies the EDB when remittances are received and processed
during the due process period.
Maintains and updates the Direct Billing System on a daily basis.
Maintains premium liability.
Identifies records for potential terminations.
Identifies records for final terminations and passes the termination data to SSA for
posting to the MBR via the Title 2 system.
Sends a Part B premium refund file to SSA when a refund is due after direct billing
stops and the refund amount is equal to, or less, than three months’ premiums.
Generates "Potential Refund" alerts to SSA PSCs when the Part B premium refund is
more than three months of premiums, a death or rep-payee is involved, or a Part A
refund is due after direct billing stops. (See SM 00711.090)