Program_Memos / 2002 / AB-02-184

Why This Topic Matters

It helps readers understand a Medicare administrative update that affects denial communication workflows, provider outreach, and contractor processing procedures.

Article Sections

1. Program Memorandum and subject announcement

   Introduces the transmittal, dates, and the general purpose of the memorandum. It frames the policy communication change and the operational audience affected.

2. New RA remark code

   Describes the addition of a remittance advice remark code for use with existing denial messages. It also notes the timeline for applying the message to newly established and existing edits.

3. MR Activities

   Outlines responsibilities for medical review operations in connection with claim review edits and denial communication. It also addresses procedures for postpayment review and related provider communication.

4. Customer Service Activities

   Explains how customer service staff should respond to provider questions about policy-based denials and how support resources may be used. It includes coordination with education and training staff and escalation pathways.

5. Effective date and implementation

   States the effective date, implementation milestones, and a system-related waiver provision. It also notes budget and retention guidance plus contact information for follow-up questions.