decisionhealth Newsletters, Answer Books - 2006 Issue 3 (March)
Program_Memos / 2000 / AB-00-119
Subscribe or sign in to view the full article.
Article Overview
This program memorandum explains changes to encounter data collection and processing for several Medicare demonstration programs, including Medicare Choices, long-term care demonstrations, Department of Defense subvention, and dual eligible demonstrations. It is relevant to intermediaries, carriers, and managed care organizations that handle demonstration claims and encounter submissions. The article covers the transition timing, affected demonstration groups, participating plan identifiers, and operational handling of submissions within HCFA systems.
Why This Topic Matters
Organizations involved in Medicare demonstration claims processing needed updated guidance on where and how encounter data should be submitted after the transition date. The memo clarifies the administrative scope of the change and identifies which demonstration plans move to the Medicare+Choice process versus which continue under their existing demonstration handling.
Article Sections
-
MEDICARE CHOICES DEMONSTRATION
Describes the transition of selected Medicare Choices plans and the related processing environment for their encounter submissions. It also identifies the plans affected by the transition and the handling of submissions within HCFA systems.
-
OTHER DEMONSTRATIONS
Summarizes the other demonstration groups covered by the memorandum and the shift in their encounter data submission process. It lists the participating demonstration categories and related operational context.
-
INTERMEDIARIES AND CARRIERS
Lists the intermediary and carrier organizations associated with processing demonstration claims. It also notes implementation and funding administrative information.
What You Will Learn
- Which demonstration programs are affected by the memorandum
- How encounter data processing is being reassigned across demonstration groups
- Which organizations and plan groups are referenced in the transition
- What implementation timing and administrative context the memorandum provides
Who Should Read This
- Medicare intermediaries
- Medicare carriers
- Managed care organizations
- Claims processing staff
- Health care administration professionals
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com