decisionhealth Newsletters, Answer Books - 2006 Issue 10 (October)
Medicare_Claims_Processing_Manual / Transmittal_173
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Article Overview
This article is a CMS Medicare Claims Processing Manual transmittal for contractors and other Medicare operations staff. It covers a second update to the 2004 Medicare Physician Fee Schedule Database, including background, policy basis, effective and implementation dates, contractor responsibilities, and references to revised payment files. It is relevant to organizations that manage Medicare payment file updates, claims processing workflows, and provider notification procedures.
Why This Topic Matters
It helps readers determine whether they need to follow a Medicare system update tied to the 2004 fee schedule database and related contractor notification requirements.
Article Sections
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Summary of Changes
Provides a high-level statement of the purpose of the transmittal and the timing of the update.
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General Information
Gives background, cites the policy basis, and notes provider education availability and distribution expectations.
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Business Requirements
Lists mandatory contractor actions related to notice, claims handling, file retrieval, and provider communication.
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Supporting Information and Possible Design Considerations
Summarizes additional implementation-related categories such as instructions, interfaces, dependencies, and testing.
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Schedule, Contacts, and Funding
States the effective and implementation dates and provides contact information.
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Attachments
Points to supporting attachment material and identifies revised payment file names.
What You Will Learn
- The scope of the 2004 Medicare Physician Fee Schedule Database update
- How CMS frames contractor responsibilities for implementing revised payment information
- What categories of implementation support and scheduling details are included in the transmittal
- Which attachment references and file updates accompany the instruction
Who Should Read This
- Medicare contractors
- Carriers
- Fiscal intermediaries
- Claims processing staff
- Revenue cycle and payment file maintenance teams
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