9004 - Active Medi-Cal Recipient - Deceased per SSA Buy-In - Priority Alert

This alert is generated to advise the EW that either a state initiated Medicare Part A and/or Part B accretion transaction was rejected by Social Security Administration (SSA), or SSA initiated a Part A and/or Part B deletion because, according to their records, the recipient is deceased. However, MEDS record shows an active record for the recipient.

Sample Alert

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Possible Screens to Resolve This Alert

ReviewReview INQE Screen for death information:
ReviewReview INQB Screen for Buy-In Information:

The Buy-in Status Code indicates a death deletion. Refer to STATUS for a list of Buy-In Status Codes.

Action Required

The EW must verify whether the recipient is deceased and take the following actions:

If deceased, enter the death information on the Decease Date field on the Individual Demographics Detail page to terminate eligibility in CalSAWS. CalSAWS will generate an EW40 (Terminate) batch transaction to terminate the recipient’s MEDS record.
If the recipient is NOT deceased, refer the recipient to the local SSA office for resolution. If necessary, contact State Medicare Buy-In Unit to restore Buy-In for the recipient. Refer to MC HB Chapter 5: Medicare Coverage, Section State Medicare Buy-In Problem Form for additional details on Medicare Buy In unit.

9004 - Active Medi-Cal Recipient - Deceased per SSA Buy-In - Priority Alert

Sample Alert

Possible Screens to Resolve This Alert

Action Required

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