decisionhealth Newsletters, Answer Books - 2006 Issue 3 (March)
Program_Memos / 2001 / AB-01-181
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Article Overview
This CMS program memorandum explains a 2001 update to Medicare coordination of benefits outreach for providers. It describes the roles of the COB contractor, intermediaries, and carriers; the broad categories of MSP information gathering and inquiry handling; and the provider-facing communication that was to be distributed and posted. The article is useful for billing staff, providers, suppliers, and Medicare administrative personnel who need to understand the operational scope of the change and the agencies involved.
Why This Topic Matters
It helps readers determine whether the article addresses Medicare secondary payer workflow, contractor responsibilities, and provider outreach operations under CMS guidance.
Article Sections
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Background
Overview of the CMS coordination of benefits contract and the transition of certain Medicare secondary payer activities. Provides context for the memorandum and the implementation timeline.
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Outreach to Providers
Explains how the provider community was to be informed about the change and how the attached fact sheet was to be distributed. Covers the general purpose of the outreach and education effort.
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Next Steps in Outreach and Education
Summarizes the continuation of outreach activities and identifies the memorandum’s effective, implementation, and discard dates.
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COB Contractor Fact Sheet for Providers
Introduces the attached provider fact sheet and its broad explanation of the coordination of benefits initiative and related Medicare secondary payer topics.
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Information Gathering
Describes the general methods and programs used to identify situations involving other health coverage and Medicare secondary payer status. Includes broad references to enrollment, data matching, claims investigation, and voluntary data exchange.
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Provider Requests for Claims Payment
Covers the distinction between claims processing and coordination of benefits contractor activities, along with the general handling of billing-related and MSP-related inquiries.
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Medicare Secondary Payer Auxiliary Records in CMS’s Database
Explains the role of CMS database records in maintaining Medicare secondary payer information and the types of external updates that may affect those records.
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Contacting the COB Contractor
Provides the general contact pathway for MSP inquiries and the customer service availability information for the contractor.
What You Will Learn
- How CMS described the coordination of benefits contractor’s role in Medicare secondary payer operations.
- What broad categories of provider outreach and education were addressed in the memorandum.
- Which general MSP information-gathering methods were discussed.
- How the memorandum distinguishes claims processing questions from MSP inquiry handling.
- What CMS said about updating and maintaining MSP information in its database.
- Where providers were instructed to direct MSP-related questions and concerns.
Who Should Read This
- Providers
- Billing staff
- Suppliers
- Medicare administrative contractors/intermediaries/carriers
- Medicare compliance and reimbursement personnel
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