decisionhealth Newsletters, Answer Books - 2008 Issue 5 (May)
Medicare_Carriers_Manual / 14002 / 14002.3_MEDICARE_INTERMEDIARIES.-
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Article Overview
This short Medicare Carriers Manual article explains the responsibilities of Medicare intermediaries in processing Part A and Part B claims and in coordinating fraud and abuse detection, reporting, and inter-contractor communication. It is relevant to reimbursement, program integrity, and administrative staff who work with Medicare contractor operations and referrals.
Why This Topic Matters
Understanding intermediary responsibilities helps readers place the article in context for Medicare claims administration and fraud/abuse program integrity workflows. It is useful for people assessing contractor duties, communication expectations, and the broader Medicare oversight structure.
What You Will Learn
- The general role of Medicare intermediaries in claim payment.
- How intermediary functions relate to fraud and abuse detection and referral.
- The importance of communication and coordination among Medicare contractors.
- The administrative context in which intermediaries interact with HCFA and OI.
Who Should Read This
- Medical coders
- Billing specialists
- Compliance staff
- Medicare contractors
- Revenue cycle professionals
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