SOC Responsibility

Provider Responsibility

Providers are responsible for taking the following actions for SOC:

Verify client’s MC eligibility on-line
Record on-line the amount paid or obligated to pay by the client for health services or prescription drugs.
When a “Letter of Authorization” (SCD 2595) is requested and amount obligated to pay was not recorded on-line (MEDS is showing SOC has not been met even thought it has), complete the MC 1054 only when all of the following criteria are met:
- The service has not already been paid by Medicare, other health coverage, or anyone else
- The services were given within the month specified on the MC 1054

The EW is responsible for:

Ensuring the client’s record is active on MEDS
Recording the client’s SOC accurately
Explaining the SOC to the client
If the provider is unwilling or unable to input on-line (or for any other reason, the SOC was not updated on-line), the EW must complete the MEDS “Share of Cost Obligation” (SOCO) form (SCD 1296 SOCO) to request the “MEDS Terminal Operator” (MTO) to generate a SOCO transaction.