CCE Crosswalk changes

CCE Medicare Beta Rerelease Changes.docx

Application for Enrollment in Medicare Part A, Internet Claim (iClaim) Application Screen, Modernized Claims System and Consolidated Claim (CMS-18F5)

CCE Crosswalk changes

OMB: 0938-0251

Document [docx]
Download: docx | pdf

CCE Medicare Only Beta – 2021 Screenshots (if different)

CCE Medicare Only Beta Re-Release – 2025 Screenshots (if different)

Change

Shape1

Changed label to Office Code

Shape2

Changed button to Establish New Medicare Only Claim

Shape3

Abbreviated Social Security Number to SSN and added Office and Unit

Picture 2

Retitled to mark as T18 for Medicare Only displayed Systems Generated Messages and all determination pages

Moved earnings questions to technician use only (like for RIB), removed multiple SSN override (like for RIB)

Shape4

Removed Possible Misinformation, Error or inaction optional question

Shape5

Adjusted talking points per stakeholder changes

Shape6

Adjusted sub-text for Verified for State Buy-in Eligibility

Shape7

Removed Spouse enrolled in SMI field

Changed button to Add GHP

Shape8

Adjusted talking points per stakeholder changes

25 Edits and Alerts.png

Reformatted Edits/Alerts to show Systems Generated Messages (like for RIB)

Shape9

Reformatted Pre-Adjudicative Results and Adjudicative Results

Shape10

Displaying Enrollment Periods and Civil Service Information

Shape11

Retitled the page and fields to reflect Signature and Certification rather than Attestation

Shape12

Added unit code, contact method, preview document instructions (like for RIB)


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorMaloney, Renee
File Modified0000-00-00
File Created2025-06-24

© 2025 OMB.report | Privacy Policy