Medicare_Carriers_Manual / 7201 / 7201

Why This Topic Matters

These instructions affect how pending Medicare claims are completed when death occurs before settlement. They are important for avoiding improper payment routing and for understanding the documentation Medicare expects in estate-related claim situations.

Article Sections

1. Ed. Note

   A brief editorial reference to related material in another chapter on a patient’s death or disability before claim settlement.

2. 7201. Death of Enrollee or Assignee Before Claim Is Settled

   General instructions for handling payment when a beneficiary, assignee, or physician dies before a claim is settled. The section includes estate payment procedures, unpaid and paid charge scenarios, documentation requirements, and physician-death handling.

3. EOMB/Check Stuffer Message (Payment to the Estate)

   Notice language and message handling guidance for checks issued to estates under these procedures.

4. Returned Checks

   A cross-reference directing staff to related instructions when an underpayment check is returned.

5. Claim Information From an Inquiry

   Guidance for responding to inquiries about payment after a beneficiary’s death and the related Medicare communication process.