CMS Part A/B Enrollment Detail

WINDOW OVERVIEW:

The CMS Part A/B Enrollment Detail displays Part A and/or B enrollment information, Part A and/or B buy-in information.

The window opens when the Part A/B Enrollment button is selected on the CMS List window.

See also:

CMS Overview

FIELD DESCRIPTIONS:

Record Received: This field displays the Month/Day/Year that this record was received from CMS.

Record Month/Year: This field displays the eligibility Month and Year where the client was found to be a dual eligible
Eligible for Medicaid and enrolled in Medicare. client.

Part A History List Box:

Start Date: This column displays the date (Month/Day/Year) Part A benefits began.

End Date: This column displays the date (Month/Day/Year) Part A benefits ended.

Entitlement Status: This column displays the persons entitlement status for Part A benefits.

Premium Payer: This column displays the person or agency that is paying the Part A premium.

Payer Begin: This column displays the date (Month/Day/Year) the payer began paying the Part A premium.

Payer End: This column displays the date (Month/Day/Year) the payer stopped paying the Part A premium.

Part B History List Box:

Start Date: This column displays the date (Month/Day/Year) Part B benefits began.

End Date: This column displays the date (Month/Day/Year) Part B benefits ended.

Entitlement Status: This column displays the persons entitlement status for Part B benefits.

Premium Payer: This column displays the person or agency that is paying the Part B premium.

Payer Begin: This column displays the date (Month/Day/Year) the payer began paying the Part B premium.

Payer End: This column displays the date (Month/Day/Year) the payer stopped paying the Part B premium.

ACTION BUTTON:

Select the OK button to return to the CMS List window.

(02-2007)