Mod 8- AET
Mod 9- MOE
Mod 10- Medicare
Mod 11-RIB Adjudication
Mod 12- Spouse's Benefits
100
What month do we count accrued sick leave received by Mona in 10/2009. She stopped work in 08/2009 and filed for RIB in 09/2009? What is the name of this type of payment?
What is 08/2009, the month the employer/employee relationship ended. The are special wage payments.
100
ARF
What is adjustment of the reduction factor
100
This happens with Medicare when NH reaches age 65 while already receiving T2 benefits.
What is automatic enrollment.
100
Type of claim that will need final processing actions to be completed by PC is called...
What is a manual claim.
100
Henry is entitled to benefits 5/2011. He was divorced from Marilyn after 14 yrs of marriage. She is 45 yrs old and has 2 children of NH in care. Is she eligible for benefits?
What is NO.
200
The 3 types of grace years
What is initial, break in entitlement and termination
200
John, born 1/23/1945 files for RIB in 09/2011. He plans to make $50000 in 2011 and his PIA is $1320.80. What is his MOEL? For which months will he be paid.
What is 03/2011 for MOEL. He will receive payments for 3/2011 and continuing.
200
Mrs. Gupta is age 65 on 04/20/11. She files for RIB in 05/2011. When is she entitled to HI and SMI?
What is HI 04/2011 and SMI 07/2011?
200
Type of adjudication when NH meets all entitlement factors and has alleged military wages which would increase PIA.
What is partial adjudication.
200
Michele married Pete 02/2011. Pete has been receiving RIB for 1 year. Michele had the NH's child in 4/2011. Is she eligible for benefits? If so, when?
What is 05/2011. no duration of marriage required if bio mom of NH's natural child.
300
Mary born 8/20/1945 plans to make $70000 for 2011. She is filing for RIB in 01/2011. Her PIA is $1823.40. Are we holding back any checks. If so, how many?
What is 2
300
Election/Entitlement option for unreduced benefits for NH under FRA and has material earnings.
What is A?
300
Mr. Kennelly, age 67, has group health insurance and plans to stop work 06/30/2011. He wants SMI to start 07/2011. When can he enroll to make this happen?
What is 04/2011-07/2011.
300
Proc Code used to send A101 to PC.
What is N.
300
Ethel came into the office to file for spouse's benefits. Her husband, Joe, has been on RIB since 01/2008. They have been married for 40 yrs and neither has been married before. Her alleged date of marriage matches his NMAR screen. She did not bring her marriage certificate. What, if any, proof do we need?
What is we need to contact NH to verify no change in marital history.
400
A more than $10000 difference in earnings from one year to the next.
What is a significant decline?
400
Election/Entitlement option for unreduced benefits.
What is D?
400
Forms needed to file Part B Medicare when NH is in his SEP and already entitled to Part A.
What is HCFA 40B and HCFA 564. also acceptable is CMS 40B and CMS 564.
400
You start a RIB claim and realize it should be a DIB. What do you do and how do you do it?
What is delete the claim by going to MCS System Menu and inputting 2 and 20.
400
What documentation is required to establish child-in-care, if child and claimant live together, child is over age 16, disabled and mentally competent.
What is a statement from claimant regarding personal services provided and a similar statement from child.
500
Ms. Smith is filing for RIB. She has cut her hours down from 40 hrs/wk down to 20 hrs/wk at the flower shop she runs and owns. She plans to make the annual limit this year. Her son, Billy, is taking over the day-to-day operations. He looks forward to stop touring with his band which is the only work he has ever done. This is an example of ...
What is questionable retirement.
500
Annual report or work notice--- NH reports earnings were $16000 in 2010 instead of $20000 and he did not work 08/10 or 09/10 due to illness.
What is AR?
500
Paula was found to disabled as of 04/15/2010. Her MOE is 10/2010. When will her Medicare start?
What is 10/2012.
500
You want to process a denial through EC but you receive an adjudicative edit that cannot be resolved. What do you do?
What is MACADE.
500
Eileen, born 09/12/1947, files for RIB and spouse's benefits in 03/2011. Her PIA is $545.80 and she receives a non-covered pension of $2900 per month. Her husband's PIA is $1488.60. What is her MBA?
What is ZERO.
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