decisionhealth Newsletters, Answer Books - 2009 Issue 9 (September)
Carriers - Medicare / Overview
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Article Overview
This article explains the role of Medicare carriers in administering Part B claims and payments, along with the general support responsibilities they owe to providers. It is relevant to billing staff, physician practices, suppliers, and anyone who needs a high-level understanding of Medicare contractor functions and carrier-provider communication requirements.
Why This Topic Matters
Understanding carrier responsibilities helps providers know who processes claims, where payment and coverage questions are handled, and what kinds of notices, education, and support Medicare contractors are expected to provide. The article also gives context for how Medicare participation materials and fee schedule information are distributed each year.
What You Will Learn
- The role of Medicare carriers as contractors administering Part B
- How carrier responsibilities relate to claims processing and payment functions
- The kinds of provider support and communication Medicare expects carriers to provide
- How carrier interactions with local medical communities and provider organizations are described in Medicare guidance
- What type of annual participation and fee schedule information carriers distribute
Who Should Read This
- Physicians
- Medical practice staff
- Billing and coding staff
- Suppliers
- Healthcare administrators
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