Program_Memos / 2000 / AB-00-30

Why This Topic Matters

The article matters because it documents how Medicare and related contractors were to process RNHCI-related elections, revocations, claims, and notices during the program’s rollout, including dates and operational changes that affect reimbursement workflows.

Article Sections

1. Subject and background

   Introduces the memorandum’s purpose and the Medicare policy background for RNHCI services, including references to the governing legislation and regulatory framework.

2. Election requirements

   Summarizes beneficiary election concepts, eligibility-related attestations, and contractor notification considerations tied to RNHCI participation.

3. Revocation of election

   Describes the election revocation framework and the timing rules that affect subsequent beneficiary elections.

4. Payment

   Outlines the general basis for Medicare payment in the RNHCI setting when coverage conditions are met.

5. Specialty contractor

   Identifies the specialty contractor role and the operational responsibilities assigned for RNHCI processing.

6. Appropriate bill types

   Explains the bill type and record reporting formats used for RNHCI-related submission workflows.

7. Claims processing criteria

   Addresses processing requirements, effective dates, and general handling considerations for RNHCI claims and related services.

8. Common Working File (CWF) notification of elections

   Covers election notice submission to the Common Working File and the associated processing notifications.

9. Common Working File (CWF) notification of revocations

   Covers how revocation notices are submitted and acknowledged through the Common Working File process.

10. Common Working File (CWF) notification of cancellations to notifications of elections and revocations

    Describes cancellation handling for previously submitted notices and related correction scenarios.

11. Completion of the Uniform (Institutional Provider) Bill (Form HCFA-1450) Notice of Election

    Provides form-completion guidance for the institutional billing notice of election used in the RNHCI process.

12. CWF changes and subsequent non-RNHCI contractor actions

    Summarizes how claim history, contractor actions, and post-processing updates interact when beneficiaries receive care outside the RNHCI setting.

13. DME, Orthotic/Prosthetic Devices

    Addresses how certain equipment-related claims are handled within the RNHCI framework.

14. RNHCI Specialty Contractor MSN Messages

    Lists beneficiary notice messaging categories used when RNHCI-related claims are denied.

15. Remittance Advice Notices

    Describes remittance advice coding categories used for denial scenarios involving RNHCI-related claims.

16. Provider notification

    Notes the requirement for contractor communication to providers about the program instructions and changes.