us-cms-medicare-manuals-pub-100-06-fin106c06•100-06 Medicare Financial Management Manual: Chapter 6 - Medicare Administrator Contractor (MAC) Financial Reports
100-06 Medicare Financial Management Manual: Chapter 6 - Medicare Administrator Contractor (MAC) Financial Reports
us-cms-medicare-manuals-pub-100-06-fin106c06100-06 Medicare Financial Management Manual: Chapter 6 - Medicare Administrator Contractor (MAC) Financial ReportsGuidance
Medicare Financial Management Manual Part A and Part B Medicare Administrative Contractors (A/B MACs) Reports Table of Contents (Rev. 12894 ; Issued: 10-17-24) Transmittals for Chapter 6 10 - Monthly Intermediary and Carrier Workload Report (Form CMS-1566 and CMS-1565) - General 10.1 - Purpose and Scope 10.2 - Due Date 20 - Completing Page One of the Monthly Intermediary Workload Report 20.1 - Heading 20.2 - Checking Reports 20.3 - Type of Bill 20.4 - Body of Report 30 - Completing Pages 2 through 21 of Intermediary Workload Report 30.1 - Heading 30.2 - Checking Reports 30.3 - Body of Report 30.4 - Completing Page 22 of Intermediary Workload Report 30.5 - Heading 30.6 - Checking Reports 30.7 - Body of Report 40 - Monthly PRO Adjustment Bill Report (Inactive) 40.1 - Heading 40.2 - Body of Report 40.3 - Checking Reports 40.4 - Report Form 50 - Quarterly Supplement To Intermediary Workload Report (Form CMS-1566A) - General 50.1 - Purpose and Scope 50.2 - Due Date 60 - Completing Quarterly Supplement To The Intermediary Workload Report, CMS-1566A, Pages 1 And 2 60.1 - Heading
60.2 - Checking Reports 60.3 - Type of Bill 60.4 - Body of Report 70 - Completing Quarterly Supplement To The Intermediary Workload Report, CMS-1566A, Page 3 70.1 - Heading 70.2 - Checking Reports 70.3 - Type of Bill 70.4 - Body of Report 70.5 - Completing Medicare Fraud Unit Quarterly Workload Status Report, CMS-1566B - General (Inactive) 70.6 - Heading (Inactive) 70.7 - Checking Reports (Inactive) 70.8 - Type of Fraud Workload Item (Inactive) 70.9 - Body of Report (Inactive) 70.10 - Completing Quarterly Periodic Interim Payment (PIP) Report, CMS-1566C - General 70.11 - Heading 70.12 - Checking Reports 70.13 - PIP Items Reported - The intermediary reports the PIP workload items in the following lines for all columns of Form Q 70.14 - Quarterly Supplement to the Intermediary Workload Report - CMS-1566A, Pages 1,2,3 70.15 - Medicare Fraud Unit Quarterly Workload Status Report - CMS- 1566B 70.16 - Quarterly Periodic Interim Payment (PIP) Report - Form CMS- 1566C 70.17 - Completing Quarterly Report on Provider Enrollment (Inactive) 70.18 - Heading (Inactive) 70.19 - Checking Reports (Inactive) 70.20 - Type of Provider (Inactive) 70.21 - Completing Lines One through Eleven - Workload Operations (Inactive) 70.22 - Completing Lines Twelve through Seventeen - Reason for Denial Recommendation (Inactive) 70.23 - Completing Lines Eighteen through Twenty-Two - Reason for Return (Inactive) 70.24 - Completing Lines Twenty-Three through Twenty-Six - Application Processing Times (Inactive) 70.25 - Completing Lines Twenty-Seven through Thirty-One - Age of
Applications Pending (Inactive) 70.26 - Completing Lines Thirty-Two through Thirty-Seven - CHOW Workloads (Inactive) 70.27 - Exhibits 80 - Monthly Intermediary Report On Medicare Secondary Payer Savings (Form CMS-1563) 80.1 - General 80.2 - Purpose and Scope 80.3 - Due Date 80.4 - Form Heading 80.5 - Savings Calculations 80.6 - Recording Savings 80.7 - Source of Savings 80.8 - Type of Savings 80.9 - Electronic Submission 90 – Monthly Intermediary Part A and Part B Appeals Report (Form CMS-2591) 90.1 – Purpose and Scope 90.2 – Due Date 100 – Completion of Items on Form CMS-2591 100.1 – Heading 100.2 – Section A – Intermediary Appeal Requests 100.3 – Section B – Part B Hearing Results 100.4 – Section C – Part A and Part B ALJ Hearings 100.5 – Section D – Limitation of Liability 100.6 – Section E – Part A and Part B Reopenings 110 – Checking Reports 110.1 – Exhibit 1 110.2 – Exhibit 2 110.3 – Exhibit 3 110.4 – Exhibit 4 110.5 – Exhibit 5 110.6 – Exhibit 6 120 - Completing Page One of the Carrier Performance Report 120.1 - Classification of Claims for Counting 130 - Completion of Items on Page One of Form CMS-1565 130.1 - Heading 130.2 - Part A - Monthly Workload Operations 130.3 - Part B - Inquiries (Inactive) 130.4 - Part C - Miscellaneous Claims Data
140 - Completing Pages Two through Eleven of the Carrier Performance Report 140.1 - Heading 150 - Part D(1) - Claims Processing Timeliness - All Claims 160 - Part D(2) - Claims Processing Timeliness - EMC Claims and Adjustments for CPEP CPT Calculations 170 - Completing Page 12 of the Carrier Performance Report 170.1 - Classification of Claims for Counting 170.2 - Heading 170.3 - Part E - Interest Payment Data 180 - Completing Page Thirteen of the Carrier Performance Report (Inactive) 180.1 - Instructions for Completing the Carrier Performance Report - All Trunks Busy (ATB) 180.2 - Heading 180.3 - Part F-ATB Data 190 - Checking Reports Prior to Submittal to CMS 200 - Exhibits 210 - Monthly DMEPOS State Report - General (Inactive) 210.1 - Completion of Items on the DMEPOS State Report 210.2 - Checking Report 210.3 - Exhibits 220 - Quarterly Supplements to Carrier Performance Report (Forms CMS-1565A, CMS-1565B, CMS-1565C, CMS-1565D, and CMS-1565E) - General 220.1 - Purpose and Scope 220.2 - Due Date 230 - Completing Form CMS-1565A 230.1 - Classification of Claims for Counting 240 - Completion of Items on Form CMS-1565A 240.1 - Heading 240.2 - Part A - Claims Reduced and Denied 240.3 - Checking Form A Prior to Submittal to CMS 250 - Completing Medicare Fraud Unit Quarterly Workload Status Report, CMS- 1565B - General (Inactive) 250.1 - Heading 250.2 - Checking Reports 250.3 - Type of Fraud Workload Item 250.4 - Body of Report 260 - Completing Form CMS-1565C 260.1 - Classification of Claims for Counting 270 - Completion of Items on Form CMS-1565C
270.1 - Heading 270.2 - Part D - Selected Claim Data by Participation Status 270.3 - Checking Form G Prior to Submittal to CMS 280 - Completing Comprehensive Limiting Charge Compliance Program (CLCCP) Quarterly Report, CMS-1565D - General 280.1 - Heading 280.2 - Checking Reports 280.3 - LCER Data 280.4 - Monetary Data 280.5 - Verification Data for Refunds and Adjustments 280.6 - LCMR Data 280.7 - Sanction Referral Data 290 - Completing Health Professional Shortage Area (HPSA) Quarterly Report, Form CMS-1565E - General 290.1 - Heading 290.2 - Checking Reports 290.3 - Current Quarter Payments 290.4 - Current Quarter Reviews 290.5 - Prior Quarter(s) Reviews 290.6 - Error Descriptions 300 - Exhibits 310 - Carrier Beneficiary Overpayment Activity Report (Form CMS-2174) - General (Inactive) 310.1 - Purpose and Scope 310.2 - Due Date 320 - Completing Carrier Beneficiary Overpayment Activity Report (Inactive) 320.1 - Classification of Claims for Counting 330 - Completion of Items on Form CMS-2174 (Inactive) 330.1 - Heading 330.2 - Section A - Beneficiary Overpayments 330.3 - Section B - Cause of Overpayments 330.4 - Section C - How Overpayments Were Discovered 330.5 - Checking Reports Prior to Submittal to CMS 340 - Exhibit - Medicare Program Carrier Beneficiary Overpayment Activity Report - (Form CMS-2174) 350 - Carrier Appeals Report (Form CMS-2590) 350.1 - Purpose and Scope 350.2 - Due Date
360 - Completion of Items on Form CMS-2590 360.1 - Heading 360.2 - Section A - Carrier Appeal Requests 360.3 - Section B - ALJ Hearings 360.4 - Section C - Reopenings (Claim Counts) 360.5 - Section D - Limitation of Liability (Claim Counts) 370 - Checking Reports 380 - Exhibits 390 - Participating Physician/Supplier Report 390.1 - Purpose and Scope 390.2 - Due Date 400 - Completion of Items on Participating Physician/Supplier Report 400.1 - Heading 400.2 - Definitions of Columns One Through Eight 400.3 - Specialty Codes 400.4 - Physician/Limited License Physician Specialty Codes 400.5 - Non-Physician Practitioner/Supplier Specialty Codes 410 - Checking Reports 420 - Exhibit 430 - Completing Quarterly Report On Provider Enrollment (Inactive) 430.1 - Heading 430.2 - Checking Reports 430.3 - Type of Provider 430.4 - Completing Lines One Through Eleven - Workload Operations 430.5 - Completing Lines Twelve Through Seventeen - Reason for Denial 430.6 - Completing Lines Eighteen Through Twenty-Two - Reason for Return 430.7 - Completing Lines Twenty-Three Through Twenty-Six - Application Processing Times 430.8 - Completing Lines Twenty-Seven Through Thirty-Four - Denials Appealed 430.9 - Exhibits 440 - Monthly Carrier Report on Medicare Secondary Payer Savings (Form CMS- 1564) 440.1 - General 440.2 - Purpose and Scope 440.3 - Due Date 440.4 - Form Heading 440.5 - Savings Calculations
440.6 - Recording Savings 440.7 - Source of Savings 440.8 - Type of Savings 440.9 - Electronic Submission 440.10 - Exhibit 460 - Monthly Statistical Report on A/B and DME Medicare Administrative Contractor (MAC) Part A and Part B Appeals Activity Form (CMS-2592) 460.1 - General 460.2 – Section I - Redeterminations 460.3 – Section II - Qualified Indepenedent Contractor (QIC) Reconsiderations 460.4 – Section III - Administrative Law Judge Results 460.5 – Section IV - Section IV – Medicare Appeals Council Effectuations 460.6 – Clerical Error Reopenings 460.7 – Validation of Reports 460.8 - Exhibit 480 - Special Purpose Data 480.1 - Heading 480.2 - Exhibit
10 - Monthly Intermediary and Carrier Workload Report (Form CMS- 1566 and CMS-1565) - General (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3892 and B3 13300 Intermediaries and carriers must prepare and submit to CMS each month the appropriate workload report (Form CMS-1566 for intermediaries and Form CMS-1565 for carriers) showing their workloads under the health insurance program. A separate report is required for each office assigned a separate contractor number. A separate report is required for each Business Segment Identifier (BSI) assigned to the contractor, even if a separate contractor number is not assigned. 10.1 - Purpose and Scope (Rev. 6, 08-30-02) A3-3892.1 and B3 13300.1 The monthly Workload Report is the source of current information on the status of workloads. The data derived from the report, together with information from other sources, are used by CMS for such purposes as: • Estimating workloads, • Analyzing manpower and material requirements, • Establishing operating norms and pars, • Comparing the performance of individual intermediaries, and • Identifying problem areas for resolution by the intermediary and/or CMS. The workload report is designed to serve as a basic management tool for individual contractors. It provides data needed for budgeting, financing, work-planning, progress evaluation, and identification of operating problems. The form must be submitted in accordance with the following instructions. 10.2 - Due Date (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3892.2 The report is transmitted to CMS CO via PC or terminal as soon as possible after the end of the month being reported, but no later than the 10th of the following month using instructions in the Contractor Reporting of Operational and Workload Data (CROWD) User Guide available via the CMS Enterprise Portal.
20 - Completing Page One of the Monthly Intermediary Workload Report (Rev. 6, 08-30-02) A3-3893 20.1 - Heading (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3893.1 This report is referenced as Form D for CROWD. The intermediary submits the appropriate information for the reporting period for each office assigned a separate contractor number and BSI. It reports the number of working days scheduled for the reporting period, less any days where no claims were processed as a result of a strike, snowstorm, etc. It does not count Saturdays, Sundays, or holidays. 20.2 - Checking Reports (Rev. 6, 08-30-02) A3-3893.2 Before submitting Form D to CMS, the intermediary checks its completeness and arithmetical correctness. This check not only ensures accuracy but also uncovers other errors and inconsistencies. It uses the following checklist: For each column: • Line 1 + 2 = 3. • Line 7 + 8 = 6. • Line 10 + 11 = 9. • Line 6 + 9 = 12. • Line 3 + 4 - 12 = 13. • Line 5 must be equal to or less than line 4. • Line 14 must be equal to or less than line 13. • Line 15 must be equal to or less than line 14. • Line 18 + 19 + 20 + 21 = 17. • Line 23 + 24 + 25 + 26 = 22. • Line 28 + 29 + 30 + 31 = 27.
• Line 33 must be equal to or less than line 32. • Line 35 + 36 + 37 = 34. • Columns 2 + 3 + 4 + 5 + 6 = 1 for lines 1-33. • Columns 2 + 3 = 1 for lines 34-37. The intermediary bases all data reported on the CMS-1566 on actual counts and not on any types of estimates or samples. 20.3 - Type of Bill (Rev. 10521; Issued: 12-16-20; Effective: 01-01-21; Implementation: 01-04-21) The A/B MAC (A) includes provider bills in the following columns of the report: Column (1) Total - All provider bills. Column (2) Inpatient Hospital - CMS-1450s submitted by hospitals for inpatient services with the following two-digit classification codes in Form Locator 4: 1-1 (inpatient hospital); and 4-1 (Religious Nonmedical Health Care Hospital- inpatient). Column (3) Outpatient - CMS-1450s submitted by hospitals or SNFs for outpatient services with the following two-digit classification codes in Form Locator 4: 1-3 (Hospital-outpatient); 2-3 (SNF-outpatient); 4-3 (Religious Nonmedical Health Care Hospital-outpatient); 5-3 (Religious Nonmedical Health Care-SNF-outpatient); and 8-3 (Hospital-outpatient-surgical procedures-ASC). Column (4) SNF - CMS-1450s with the following two-digit classification codes in Form Locator 4; 1-8 (hospital swing-bed); 2-1 (SNF-inpatient); 2-8 (SNF- swing bed); and 5-1 (Religious Nonmedical Health Care-SNF-inpatient). Column (5) HHA - CMS-1450s submitted by HHAs, with the following two-digit classification codes in Form Locator 4: 3-2 (HHA-Part B visits and use of DME); 3-3 (HHA-Part A visits and DME); 3-4 (HHA-Other-Part B benefits). Include HH PPS Requests for Anticipated Payment (RAPs) with three-digit classification code 3-2-2 or 3-3-2 with dates of service 10/01/2000 and greater in addition to claims in this column. Column (6) Other - CMS-1450s with the following two-digit classification codes in Form Locator 4: 1-2 (hospital inpatient-Part B benefits), 1-4 (hospital-Other-Part B benefits),
2-2 (SNF-inpatient-Part B benefits), 2-4 (SNF-Other-Part B benefits), 4-2 (Religious Nonmedical Health Care-inpatient-Part B benefits), 4-4 (Religious Nonmedical Health Care-inpatient-other), 5-2 (Religious Nonmedical Health Care-SNF inpatient-Part B benefits), 5-4 (Religious Nonmedical Health Care-SNF inpatient-other), 7-1, 7-2, 7-3, 7-4, 7-5 (Clinics-provider and independent RHCs, ESRD hospital-based or independent renal dialysis facilities, FQHCs, CMHCs, ORFs, and CORFS), and 8-1 and 8-2 (Hospices) 8-7 (Opioid Treatment Facility) 20.4 - Body of Report (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) SECTION A: INITIAL BILL PROCESSING OPERATION The intermediary completes every type of bill column (1 through 6) for each reporting item as described below. It includes data on all bills received for initial processing from providers (including all RHCs) directly or indirectly through a RO, another intermediary, etc. It also includes data on demand bills and no-pay bills submitted by providers with no charges and/or covered days/visits. It does not include: • Bills received from institutional providers if they are incomplete, incorrect, or inconsistent, and consequently returned for clarification. Individual controls are not required for them; • Adjustment bills; • Misdirected bills transferred to another intermediary; • HHA bills where no utilization is chargeable and no payment has been made, but which it has requested only to facilitate record keeping processes (There is no CMS requirement for HHAs to submit no payment non-utilization chargeable bills.); and • Bills paid by an HMO and processed by the intermediary.
• Claims submitted by HHAs under the HH PPS with three-digit classification 3-2-9 or 3-3-9 are processed as adjustments to a previously submitted RAP record. However, the intermediary counts both HHPPS RAPs and claims as initial bills for this report. It does not exempt HH PPS claims as adjustments. Opening Pending Line 1 - Pending End of Last Month - The system will pre-fill the number pending from line 13 on the previous month's report. Line 2 - Adjustments - If it is necessary to revise the pending figure for the close of the previous month because of inventories, reporting errors, etc., the intermediary reports the adjustment. It reports bills received near the end of the reporting month and placed under computer control sometime after the reporting month as bills received in the reporting month and not as bills received in the following month. In the event that some bills may not have been counted in the proper month's receipts, it counts them as adjustments to the opening pending in the subsequent month. It reports on line 2 any necessary adjustments, preceded by a minus sign for negative adjustments, as appropriate. Line 3 - Adjusted Opening Pending - The system will sum line 1 + line 2 to calculate the adjusted opening pending. Receipts Line 4 - Received During Month – The intermediary reports the total number of bills received for initial processing during the month. It counts all bills immediately upon receipt regardless of whether or not they are put into the processing operation with the exception of those discussed below. NOTE: It counts bills submitted by providers electronically after they have passed intermediary consistency edits. Prior to that time, it may return these bills or the entire tape reel (where magnetic tape is the medium of submission) without counting them as "received." However, once the bills or tapes have passed consistency edits and are counted as received, it uses the actual receipt date, not the date the edits are passed, in calculating pending and processing times. If a bill belonging to one of the above-excluded categories is inadvertently counted as an initial bill received (e.g., certain adjustment bills unidentifiable at the time of receipt), the intermediary subtracts it from the receipt count when the bill is correctly identified. Line 5 - Electronic Media Bills - The intermediary reports the net number of bills included on line 4 which were received in paperless form via electronic media from providers or their billing agencies and read directly into the intermediary claims
processing system. It does not count on this line bills that it received in hardcopy and entered using an Optical Character Recognition (OCR) device. It does not count any bills received in hardcopy and transferred into electronic media by any entity working for it directly or under subcontract. Clearances Line 6 - Total CWF Bills (7 + 8) – The intermediary reports the number of initial bills (described in lines 7 and 8 below) processed through CWF and posted to CWF history. It does not include bills sent to CWF and rejected, unless they were resubmitted and posted to CWF history in the reporting month. It reports these bills in the month that it moves the bill to a processed location in the intermediary system after receipt of the host's response to pay or deny. Line 7 - Payment Approved (CWF) – The intermediary reports the number of initial bills for which it approved some payment and for which the CWF host responded accepting the intermediary determination. It includes bills for which it approved payment in full or in part as a result of a determination that both the beneficiary and the provider were without fault (liability waiver). (See the Medicare Claims Processing Manual, Chapter 30, Financial Liability Protections.) The intermediary reports here those fully adjudicated, approved-for-payment bills for which it has received a response from the host and are holding only due to the payment floor. Line 8 - No Payment Approved (CWF) - The intermediary reports the number of initial bills processed through CWF during the month for which it approved no payment. It reports here those bills for which payment is not made because the deductible has not yet been met and payment is therefore applied to the deductible. Line 9 - Total Non-CWF Bills (10 + 11) - The intermediary reports the number of initial bills (described in lines 10 and 11 below) processed outside CWF. Non-CWF bills are those either rejected by or not submitted to CWF that the intermediary finally adjudicates outside of CWF and, therefore, are not posted to its history in the reporting month. The intermediary reports these bills as non-CWF, even if it plans to submit an informational record in the future. It reports such bills in the month in which it made the determination as to their final disposition. It does not include home health bills where no utilization is chargeable and no payment has been made, but which it requested only to facilitate record keeping processes. Line 10 - Payment Approved (Non-CWF) - The intermediary reports the number of initial bills processed outside CWF for which it approved some payment. It includes bills for which it approved payment in full or in part as a result of a determination that both the beneficiary and the provider were without fault (liability waiver). (See the Medicare Claims Processing Manual, Chapter 30, Financial Liability Protections.)
Line 11 - No Payment Approved (Non-CWF) – The intermediary reports the number of initial bills processed outside CWF during the month for which it approved no payment. Line 12 - Total Processed - The intermediary reports the sum of lines 6 and 9. NOTE: It reports as processed on line 12 those bills it has moved to a processed location after being accepted by the host and is holding only due to the payment floor. However, for pages 2-12 of this report, it reports these bills as processed in the month during which the scheduled payment date falls (which may be in a subsequent reporting period). The intermediary reports HMO bills it paid on line 12 and on pages 2-12. It does not report those bills paid by HMOs and processed by the intermediary on line 12 or on pages 2-12. It reports such HMO paid bills only on line 39 of page 1. Closing Pending Line 13 - Pending End of Month - The system will calculate the number of bills pending at the end of the month by adding line 3 (adjusted opening pending) to line 4 (receipts) and subtracting line 12 (total processed). The intermediary does not report as pending those bills that it has moved to a processed location after being accepted by the host and is holding only due to the payment floor. It reports such bills as processed on line 12. Line 14 - Pending Longer Than 1 Month – The intermediary reports the number of bills included in line 13 pending longer than 1 month, i.e., those received prior to the reporting month but not processed to completion by the end of the reporting month. For example, for the reporting month of October 2001, it reports the number of bills pending at the end of October 2001 which had been received prior to October 1, 2001. It excludes bills received in the reporting month. Line 15 - Pending Longer Than 2 Months - The intermediary reports the number of bills included in line 13 pending longer than 2 months, i.e., those received prior to the month preceding the reporting month but not processed to completion by the end of the reporting month. For example, for the reporting month of October 2001, it reports the number of bills pending at the end of October 2001 that had been received prior to September 1, 2001. It excludes bills received in the reporting month and one month prior to the reporting month. Bill Investigations Line 16 - Bill Investigations Initiated - The intermediary reports the number of initial bills that, for purposes of processing the claim to completion, required outside contact (via telephone, correspondence, or on-site visit) with providers, social security offices, or beneficiaries during the month. This includes contacting outside parties to resolve problems with covered level of care determinations, insufficient medical information or
missing, inconsistent, or incorrect items on the bill. It does not count routine submissions by providers of additional medical evidence with bills as investigations in themselves. It counts only the number of bills requiring investigation, not the number of contacts made. It excludes bills reported as investigated in a prior month from this count even if the investigation continued into the reporting month. It does not count as bills investigated those returned to providers because they were incomplete, incorrect or inconsistent, and consequently were not counted as "receipts." SECTION B: ADJUSTMENT BILLS This section includes data on the number of adjustment bills processed and pending for the reporting month, including those generated by providers, PROs, or as a result of MSP or other activity. In reporting adjustment bills, the intermediary counts only the number of original bills requiring adjustment, not both the debit and credit. Claims submitted by HHAs under the HH PPS with three-digit classification 3-2-9 or 3- 3-9 are processed as adjustments to a previously submitted RAP record. However, both HHPPS RAPs and claims are counted as initial bills. The intermediary does not report HH PPS claims as adjustments. Clearances Line 17 - Total CWF Processed (18+19+20+21) - The intermediary reports the number of adjustment bills processed through CWF during the month. It counts adjustment bills as processed in final only when acceptance from CWF is received. Since §3664 precludes the processing of a utilization adjustment bill until CWF accepts the bill upon which the adjustment action is based, no utilization adjustment billing action may be processed until CWF has accepted the original bill. Line 18 - PRO Generated (CWF) - The intermediary reports the number of adjustment bills included in line 17 which were generated by PROs. Line 19 - Provider Generated (CWF) - The intermediary reports the number of adjustment bills included in line 17 which were generated by providers. Line 20 - MSP (CWF) - The intermediary reports the number of adjustment bills included in line 17 which were generated as a result of MSP activity. Line 21 - Other (CWF) - The intermediary reports the number of adjustment bills included in line 17 which were generated by other than PROs, providers, or MSP activity. It includes HMO adjustments where the HMO acted as an intermediary and made payment on the initial bill. Line 22 - Total Non-CWF Processed (23+24+25+26) - The intermediary reports the number of adjustment bills that it processed outside of CWF during the month. It counts such adjustment bills as processed in final only when no further action is required.
If it receives an adjustment bill from a provider when the original bill is still in its possession, it takes the final adjustment action on the original bill before it is submitted to CWF. It counts the adjustment bill as cleared when acceptance of the original bill is received from CWF. Line 23 - PRO Generated (Non-CWF) - The intermediary reports the number of adjustment bills included in line 22 which were generated by PROs. Line 24 - Provider Generated (Non-CWF) - The intermediary reports the number of adjustment bills included in line 22 which were generated by providers. Line 25 - MSP (Non-CWF) - The intermediary reports the number of adjustment bills included in line 22 which were generated as a result of MSP activity. Line 26 - Other (Non-CWF) - The intermediary reports the number of adjustment bills included in line 22 that were generated by other than PROs, providers, or MSP activity. It includes HMO adjustments where the HMO acted as an intermediary and made payment on the initial bill. Pending Line 27 - Total Pending (28+29+30+31) - The intermediary reports the number of adjustment bills which were not processed to completion by the end of the reporting month. Line 28 - PRO Generated – The intermediary reports the number of adjustment bills included in line 27 which were not processed to completion by the end of the reporting month and which were generated by PROs. Line 29 - Provider Generated - The intermediary reports the number of adjustment bills included in line 27 which were not processed to completion by the end of the reporting month and which were generated by providers. Line 30 - MSP - The intermediary reports the number of adjustment bills included in line 27 which were not processed to completion by the end of the reporting month and which were generated by MSP activity. Line 31 - Other - The intermediary reports the number of adjustment bills included in line 27 which were not processed to completion by the end of the reporting month and which were generated by it or by a source other than PROs, providers, or MSP activity. It includes HMO adjustments not processed to completion where the HMO acted as an intermediary and made payment on the initial bill. SECTION C: MEDICAID CROSSOVER BILLS
This section presents data on the volume of Medicaid crossover bills sent to Medicaid State agencies or their fiscal agents. Clearances Line 32 - Transmitted to State Agencies - The intermediary reports the total number of Medicaid crossover bills transmitted to State agencies or their fiscal agents in the reporting month. Line 33 - Transmitted Electronically – The intermediary reports the number of bills included in line 32 which were transmitted via electronic media to State agencies or their fiscal agents. SECTION D: MISCELLANEOUS DATA INQUIRIES (Inactive) This section presents data on the volume of provider or beneficiary inquiries that were processed during the reporting month. Include only processed inquiries dealing with Medicare bill processing issues. These issues correspond to the workload budgeted under line 1 of the CMS-1523 budget form. The intermediary counts inquiries as follows: Beneficiary - It counts one per contact (telephone, walk-in, or written), regardless of the number of bills being questioned. For example, if a letter from a beneficiary requests information on the status of one or more bills, it counts the response (interim or final) as one written beneficiary inquiry. It counts each completed reply, terminated telephone conversation, or in-person discussion as processed, regardless of the need for subsequent contact on the same issue. Responses resulting from additional intermediary follow up or analysis, or from additional contact by the beneficiary, are separate inquiries. Beneficiary inquiries include those made by anyone on behalf of the beneficiary, except by a provider. Provider - The intermediary counts one per contact (telephone, walk-in, or written). For example, if a provider calls or writes to obtain the status of 3, 6, or 10 separate bills, it counts the response as 1 provider telephone or written inquiry. It includes or excludes beneficiary and provider inquiries as follows: • It counts as inquiries requests for Medicare information from beneficiaries or providers or their representatives that are directed to it for response. • It does not count processed inquiries that are concerned solely with its line of business.
• It does not count inquiries concerned with professional relations activities. • It does not count inquiries related solely to payment issues, MR or utilization review, MSP, audits, etc. These are areas for which it receives separate Medicare funding. This exclusion achieves comparability with the CMS-1523 budget form. • It counts voice inquiries captured electronically as telephone inquiries, and electronic mail inquiries as written inquiries. It counts electronic inquiries only if the response is provided by telephone or in writing and requires its involvement. It does not count electronic inquiries if the provider can directly access its system to determine bill status. • It counts Congressional inquiries according to whether they were made on behalf of a beneficiary or provider. • It counts inquiries made by ROs or SSA district offices only if they concern a Medicare bill and are made on behalf of a beneficiary or provider. • It counts misdirected telephone inquiries referred to another source for a final response. It does not count misdirected written inquiries. • It does not count inquiries that are, in fact, explicit or implicit requests for reconsiderations or hearing. See Medicare Claims Processing Manual, Chapter 29, Appeals of Claims Decisions, for specifics on what is a request for reconsideration or review. • It reports the number of inquiries from beneficiaries (column 2) and providers (column 3) processed during the reporting month, as follows: Line 34 - Total - It reports in the appropriate column the total number of inquiries processed. Line 35 - Telephone Inquiries - It reports in the appropriate column the total number of telephone inquiries processed. Line 36 - Walk-in Inquiries - It reports in the appropriate column the total number of walk-in contacts processed. Line 37 - Written Inquiries - It reports in the appropriate column the total number of written inquiries responded to. OPTICAL CHARACTER RECOGNITION BILLS Line 38 - Total Bills Received - It reports the total number of bills that it received in hardcopy and entered using an OCR device. It does not count these bills as electronic media bills on line 5, page 1, or in column 8, pages 2-11.
BILLS PAID BY HMOs Line 39 - Total HMO Bills Processed - It reports the number of bills that were paid by HMOs and processed by it during the reporting month. It reports HMO bills paid by it on line 12 but does not report such bills on line 39. MEDICARE SUMMARY NOTICES (MSNs) Line 40 - Total MSNs Mailed - It reports the number of MSNs mailed to beneficiaries during the reporting month. 30 - Completing Pages 2 through 21 of Intermediary Workload Report (Rev. 6, 08-30-02) A3-3894 30.1 - Heading (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3894.1 These pages are referenced as Form U (pages 2-11) and Form E (pages 12-21) for CROWD. The intermediary submits the appropriate information for the reporting period for each office assigned a separate contractor number and BSI. 30.2 - Checking Reports (Rev. 6, 08-30-02) A3-3894.2 Before submitting Forms U and E to CMS, check for completeness and arithmetical accuracy, the intermediary uses the following checklist: • For each column, line 38 must equal the sum of lines 1-37. • For lines 1-38 on pages 2-11, column 1 must equal the sum of columns 2-7. • For each of lines 1-38 on pages 2-11, column 8 must be less than or equal to column 1. • For each of lines 1-38 on pages 12-21, column 1 must be less than or equal to column 2 for the corresponding bill type on pages 2-11. • For each of lines 1-38 on pages 12-21, column 2 must be less than or equal to column 3 for the corresponding bill type on pages 2-11.
• The "Total" pages (pages 11 and 21) must equal the sum of all the bill types (pages 2-10 and 12-20, respectively) for each data element on the page, except line 39. 30.3 - Body of Report (Rev. 6, 08-30-02) A3-3894.3 SECTION E (1): CLAIMS PROCESSING TIMELINESS - ALL CLAIMS Pages 2-11 of the CMS-1566 include data on intermediary activity in processing all bills to completion during the reporting period. The intermediary counts the bill as processed to completion on the "scheduled payment date," which is the date the check it issued is mailed, deposited by it in the provider's account, or transferred electronically. For PIP bills and no payment bills, the "scheduled payment date" is the date for payment bills in the same adjudication batch. Base data shown on reliable counts of all bill processing activity. The intermediary does not estimate bill counts. It reports data on initial bills only (including demand bills and no-pay bills submitted by providers with no charges and/or covered days/visits). It does not include: • Bills received from institutional providers if they are incomplete, incorrect, or inconsistent and consequently returned for clarification. Individual controls are not required for these bills; • Adjustment bills; • Misdirected bills transferred to a carrier or another intermediary; • HHA bills where no utilization is chargeable and no payment has been made, but which the intermediary requested only to facilitate record keeping processes. (There is no CMS requirement for HHAs to submit no payment non-utilization chargeable bills); • Bills paid by an HMO and processed by the intermediary, and • HH PPS RAPs with three-digit classification code 3-2-2 or 3-3-2 with dates of service 10/01/2001 and greater. Apart from these exceptions, it includes in the report all bills (including PIP, EMC, provider and independent RHC, as well as HMO bills paid by it) processed to completion (i.e., paid bills, complete denials, and no payment bills) in the reporting month. It reports bills in the month the scheduled date of payment falls. See The Medicare Claims Processing Manual, Chapter 1, General Billing Requirements for the definition of scheduled payment date for all bills, including PIP and no payment bills. "Clean" bills are those that do not require investigation or development external to the intermediary operation on a prepayment basis. Bills that do not meet the definition of “clean” are
"other" bills. See The Medicare Claims Processing Manual, Chapter 1, General Billing Requirements for examples of "clean" and "other." Bills paid are those for which some payment was made (i.e., payment greater than zero). Bills not paid are those for which no payment was made (i.e., bill charges applied completely toward deductible or fully denied). On each page 2-11 (there is a separate page for each type of bill category listed below), the intermediary reports: • In column 1, the total number of bills processed to completion; • In column 2, the number of "non-PIP clean" bills paid; • In column 3, the number of "non-PIP other" bills paid; • In column 4, the number of "PIP clean" bills paid; • In column 5, the number of "PIP other" bills paid; • In column 6, the number of "clean" bills not paid; • In column 7, the number of "other" bills not paid; and • In column 8, the number of "clean" and "other" bills processed to completion, which were received via electronic media from providers or their billing agencies and read directly into the intermediary claims processing system. The intermediary does not count on this line bills that it received in hardcopy and entered using an OCR device. It does not count any bills received in hardcopy and transformed into electronic media by any entity working for it directly or under subcontract. For each category, it shows the number processed to completion on the line corresponding to the number of days from receipt by it to the scheduled date of payment or other final action, if a no-pay bill. See The Medicare Claims Processing Manual, Chapter 1, General Billing Requirements for definition of receipt date. NOTE: For bills received by tape, the date the intermediary receives the tape should be used as the receipt date and not the date the tape passes the edits. To calculate the processing time for a claim, the intermediary subtracts the Julian receipt date from the processed to completion Julian date. When the processed to completion date falls in the year following the year of receipt, it adds to the Julian date of completion 365 (or 366 if the year of receipt is a leap year). If a claim is processed to completion on the same day it is received, the processing time is one day. This definition applies to all lines of the report, including line 39.
On line 39 the intermediary reports the mean processing time (PT) to one decimal place for each column. To calculate the mean PT, it adds the processing times for all the bills shown in lines 1-37 of that column and divides by line 38. It does not use the categories on the report to calculate the mean PT. Because of the aggregation of claims in lines 34- 37, it must use the processing times for the individual claims as explained below to make this calculation. Mean Processing Time Calculation for All Claims • Subtract the Julian date of receipt from the Julian date of payment (or equivalent action for those not paid) for each claim. • Sum the result for each claim into a total number of days for all claims. • Divide this result by the total number of claims. • Round to one decimal place. EXAMPLE: Claim Julian Date Receipt Paid Counter by Days Counter by Claims A 91103 91133 30 1 B 91105 91206 101 2 C 91115 91177 62 3 D 91120 91213 93 4 E 91122 91215 93 5 F 91130 91223 93 6 Total Days = 30 + 101 + 62 + 93 + 93 + 93 = 472 Mean = 472/6 = 78.6666 = 78.7 The intermediary completes the report for each bill type: • Inpatient Hospital - Of the bills reported on the "All Claims" page, it shows on page 2 data on the number of CMS-1450s submitted by hospitals for inpatient services with the following two-digit classification codes in Form Locator 4: 1-1 (inpatient hospital); and 4-1 (Religious Nonmedical Health Care Facility - Hospital-inpatient), • Outpatient - Of the bills reported on the "All Claims" page, it shows on page 3 data on the number of CMS-1450s submitted by hospitals and SNFs for outpatient services with the following two-digit classification codes in Form Locator 4: 1-3 (hospital-outpatient); 2-3 (SNF-outpatient); 4-3 (Religious Nonmedical Health
Care Facility - Hospital-outpatient); 5-3 (Religious Nonmedical Health Care Facility - SNF-outpatient); and 8-3 (hospital-outpatient surgical procedures - ASC), • SNF - Of the bills reported on the "All Claims" page, it shows on page 4 data on the number of CMS-1450s with the following two-digit classification codes in Form Locator 4: 1-8 (hospital swing-bed); 2-1 (SNF-inpatient); 2-8 (SNF-swing- bed); and 5-1 (Religious Nonmedical Health Care Facility - SNF-inpatient), • HHA - Of the bills reported on the "All Claims" page, it shows on page 5 data on the number of CMS-1450s with the following two-digit classification codes in Form Locator 4: 3-2 (HHA-Part B visits and use of DME); 3-3 (HHA-Part A visits and DME); and 3-4 (HHA-other-Part B benefits), • Hospice - Of the bills reported on the "All Claims" page, it shows on page 6 data on the number of CMS-1450s with the following two-digit classification codes in Form Locator 4: 8-1 and 8-2 (Hospice), • CORF - Of the bills reported on the "All Claims" page, it shows on page 7 data on the number of CMS-1450s with the following two-digit classification codes in Form Locator 4: 7-4 (Other Rehabilitation Facility) and 7-5 (Comprehensive Outpatient Rehabilitation Facility), • ESRD - Of the bills reported on the "All Claims" page, it shows on page 8 data on the number of CMS-1450s with the following two-digit classification codes in Form Locator 4: 7-2 (hospital-based or independent renal dialysis facilities), • Lab (All referred outpatient diagnostic services) - Of the bills reported on the "All Claims" page, it shows on page 9 data on the number of CMS-1450s with the following two-digit classification codes in Form Locator 4: 1-4 (Hospital-Other- Part B benefits); and 2-4 (SNF-Other-Part B benefits), • Other - Of the bills reported on the "All Claims" page, it shows on page 10 data on the number of CMS-1450s not included in the previous eight bill categories, including provider and independent RHC bills, and • All Claims - On page 11 it includes all bills processed to completion during the reporting month. SECTION E(2): CLAIMS PROCESSING TIMELINESS - EMC CLAIMS AND ADJUSTMENTS FOR CPEP CPT CALCULATIONS Pages 12-21 of the CMS-1566 the intermediary includes data on the non-PIP bills paid during the month they were received via electronic media. The basic instructions and definitions that apply to pages 2-11 (see above) also apply to pages 12-21. For each bill type, it reports the following information:
• Column 1 - The intermediary reports the number of EMC claims that were included in column 2 (paid non-PIP clean) for the corresponding bill type on pages 2-11. • Column 2 - The intermediary reports the number of EMC claims that were included in column 3 (paid non-PIP other) for the corresponding bill type on pages 2-11. For each bill type on pages 12-21, it reports the following adjustments for CPEP CPT calculations: CWF - Claims that were beyond its control due to CWF. (See The Medicare Claims Processing Manual, Chapter 1, General Billing Requirements for definition of claims meeting this criteria.) A. The number of EMC non-PIP clean claims paid beyond the EMC ceiling. B. The number of paper non-PIP clean claims paid beyond the paper ceiling. C. The number of all claims processed beyond 60 days. WAIVER - Non-PIP claims paid under the claims payment floor for which the intermediary had a waiver from CMS. D. The number of EMC non-PIP clean claims paid under the EMC floor. E. The number of paper non-PIP clean claims paid under the paper floor. F. The number of EMC non-PIP claims (clean and other) paid under the EMC floor plus the number of paper non-PIP claims (clean and other) paid under the paper floor. 30.4 - Completing Page 22 of Intermediary Workload Report (Rev. 6, 08-30-02) A3-3894.4 30.5 - Heading (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3894.5 This page is referenced as Form W for CROWD. The intermediary submits the appropriate information for the reporting period for each office assigned a separate contractor number and BSI. 30.6 - Checking Reports (Rev. 6, 08-30-02) A3-3894.6 Before transmitting page 22 to CMS, the intermediary checks its completeness and arithmetical accuracy. It uses the following checklist:
• For each column, line 1 must equal the sum of lines 2-10. • For each column, line 11 must equal the sum of lines 12-20. • For each line, column 1 must equal the sum of columns 2-6. 30.7 - Body of Report (Rev. 175, Issued: 10-28-10, Effective: 04-01-11, Implementation: 04-04-11) SECTION F: INTEREST PAYMENT DATA The intermediary reports on Page 22 of the CMS-1566 data on the bills on which it paid interest because it paid the bills after the required payment date per §9311 of the Omnibus Budget Reconciliation Act of 1986. Counts of bills processed reflect their status as of the last workday of the reporting calendar month. The intermediary bases data shown on reliable counts of all bill processing activity and not on estimates. It reports data on initial bills only. Note that HH PPS RAPs with three-digit classification code 3- 2-2 or 3-3-2 with dates of service 10/01/2000 and greater are not subject to interest payment and should be excluded from this section. The intermediary includes all bills requiring interest payments in the month. It reports bills in the month the scheduled date of payment falls. See The Medicare Claims Processing, Chapter 1, General Billing Requirements, for a discussion of interest payments and the definition of scheduled payment date. It the report for each column as follows: • Column 1 - Total - It includes data for all bills for which interest payments were made in the reporting month. • Column 2 - Hospital - Of the bills reported in column 1, it shows in column 2 data for CMS-1450s submitted by hospitals for inpatient or outpatient services with the following two-digit classification codes in Form Locator 4: 1-1 (inpatient hospital) 1-2 (inpatient hospital - Part B benefits) 1-3 (outpatient hospital) 1-4 (hospital - other Part B benefits) 4-1 (Religious Nonmedical Health Care Hospital - inpatient) 4-2 (Religious Nonmedical Health Care Hospital - inpatient Part B benefits) 4-3 (Religious Nonmedical Health Care Hospital - outpatient) 4-4 (Religious Nonmedical Health Care Hospital - inpatient other) 8-3 (Outpatient hospital surgical procedures - ASC) • Column 3 - SNF--Of the bills reported in column 1, it shows in column 3 data for CMS- 1450s submitted with the following two-digit classification codes in Form Locator 4:
1-8 (hospital swing-bed) 2-1 (SNF - inpatient) 2-2 (SNF - inpatient Part B benefits) 2-3 (SNF - outpatient) 2-4 (SNF - other Part B benefits) 2-8 (SNF-swing-bed) 5-1 (Religious Nonmedical Health Care SNF - inpatient) 5-2 (Religious Nonmedical Health Care SNF - inpatient Part B benefits) 5-3 (Religious Nonmedical Health Care SNF - outpatient) 5-4 (Religious Nonmedical Health Care SNF - inpatient other) • Column 4 - HHA - Of the bills reported in column 1, it shows in column 4 data for CMS-1450s with the following two digit classification codes in Form Locator 4: 3-2, 3-3, and 3-4. • Column 5 - Hospice - Of the bills reported in column 1, it shows in column 5 data for CMS-1450s with the following two-digit classification codes in Form Locator 4: 8-1 and 8-2. • Column 6 - Remainder - Of the bills reported in column 1 it shows in column 6 data for all CMS-1450s not included in columns 2-5 (including provider and independent RHCs). On line 1, it shows the number of claims on which it paid interest in the reporting month. It reports on line 2 the number of claims included in line 1 for which it made payment one day after the required payment date (e.g., the required payment date is 25 days in FY 1999). Data for lines 3-10 are similar to those for line 2. It calculates the number of days late by subtracting the Julian date of receipt of the bill from the Julian scheduled payment date and then subtracting the required payment date (i.e., 25 in FY 1999). If the bill is paid in the year following the year of receipt, it adds 365 or 366 (if the year of receipt is a leap year) to the result, as appropriate. On line 11, it shows the amount paid in interest on the bills reported in line 1. See The Medicare Claims Processing Manual, Chapter 1, General Billing Requirements on how to calculate interest payments. On lines 12-20 it shows the amounts paid in interest for bills reported in lines 2-10, respectively. It shows payment amounts on lines 11-20 to the nearest penny, including the decimal point.
Exhibit 1 Form CMS 1566 - Medicare Program Intermediary Workload Report, Page 1 Intermediary Name: Reporting Period: Intermediary Number: Number of Working Days: SECTION A: INITIAL BILL PROCESSING TOTAL (1) INPATIENT (2) OUTPATIENT (3) SNF (4) HHA (5) OTHER (6) Opening Pending 1. Opening Pending 2. Adjustments (+ or -) 3. Adj Opening Pending Receipts 4. Received during Month 5. Electronic Media Clearances 6. Total CWF Bills 7. Payment Approved 8. No Payment Approved 9. Total Non-CWF Bills 10. Payment Approved 11. No Payment Approved 12. Total Processed Closing Pending 13. Pending End of Month 14. Longer than 1 Month 15. Longer than 2 Months
Exhibit 1 (Cont.) Form CMS 1566 - Medicare Program Intermediary Workload Report, Page 1 Intermediary Name: Reporting Period: Intermediary Number: Number of Working Days: SECTION A: INITIAL BILL PROCESSING TOTAL (1) INPATIENT (2) OUTPATIENT (3) SNF (4) HHA (5) OTHER (6) Bill Investigations 16. Investigations Init SECTION B: ADJUSTMENT BILLS CWF Clearances 17. Total CWF Processed 18. PRO Generated 19. Provider Generated 20. MSP 21. Other Non-CWF Clearances 22. Total Non-CWF Prcsd 23. PRO Generated 24. Provider Generated 25. MSP 26. Other
Exhibit 1 (Cont.) Form CMS 1566 - Medicare Program Intermediary Workload Report, Page 1 Intermediary Name: Reporting Period: Intermediary Number: Number of Working Days: SECTION B: ADJUSTMENT BILLS TOTAL (1) INPATIENT (2) OUT PATIENT (3) SNF (4) HHA (5) OTHER (6) Pending 27. Total Pending 28. PRO Generated 29. Provider Generated 30. MSP 31. Other SECTION C: MEDICAID CROSSOVER BILLS Clearances 32. Trans to St Agencies 33. Trans Electronically SECTION D: MISCELLANEOUS DATA TOTAL BENEFICIARY PROVIDER Inquiries 34. Total Inquiries 35. Telephone 36. Walk-In 37. Written
Exhibit 1 (Cont.) Form CMS 1566 - Medicare Program Intermediary Workload Report, Page 1 Intermediary Name: Reporting Period: Intermediary Number: Number of Working Days: SECTION D: MISCELLANEOUS DATA TOTAL (1) INPATIENT (2) OUTPATIENT (3) SNF (4) HHA (5) OTHER (6) OCR Bills 38. Total Received Bills Paid by HMOs 39. Total Processed Medicare Summary Notices 40. Total MSNs Mailed
Exhibit 2 SECTION E(1): CLAIMS PROCESSING TIMELINESS - ALL CLAIMS Form CMS 1566 - Medicare Program Intermediary Workload Report, Pages 2-11 Intermediary Number: Bill Type: Report Month: ****** ******** **PAID** ******** ***NOT PAID*** **Non-PIP** ***PIP**** DAYS TO PROCESS TOTAL (1) CLEAN (2) OTHER (3) CLEAN (4) OTHER (5) CLEAN (6) OTHER (7) EMC (8) 1.1 2. 2 3. 3 4. 4 5. 5 6. 6 7. 7 8. 8 9. 9 10. 10 11. 11 12. 12
Exhibit 2 (Cont.) SECTION E(1): CLAIMS PROCESSING TIMELINESS--ALL CLAIMS Form CMS 1566 - Medicare Program Intermediary Workload Report, Pages 2-11 Intermediary Number: Bill Type: Report Month: ******* ******* ***PAID*** NOT PAID **Non-PIP** ****PIP**** DAYS TO PROCESS TOTAL (1) CLEAN (2) OTHER (3) CLEAN (4) OTHER (5) CLEA N (6) OTHE R (7) EMC (8) 13. 13 14. 14 15. 15 16. 16 17. 17 18. 18 19. 19 20. 20 21. 21 22. 22 23. 23
Exhibit 2 (Cont.) SECTION E(1): CLAIMS PROCESSING TIMELINESS--ALL CLAIMS Form CMS 1566 - Medicare Program Intermediary Workload Report, Pages 2-11 Intermediary Number: Bill Type: Report Month: ******** ******* **PAID** *NOT PAID* **Non-PIP** ****PIP**** DAYS TO PROCESS TOTAL (1) CLEAN (2) OTHER (3) CLEAN (4) OTHER (5) CLEA N (6) OTHE R (7) EM C (8) 24. 24 25. 25 26. 26 27. 27 28. 28 29. 29 30. 30 31. 31 32. 32 33. 33
Exhibit 2 (Cont.) SECTION E(1): CLAIMS PROCESSING TIMELINESS--ALL CLAIMS Form CMS 1566 - Medicare Program Intermediary Workload Report, Pages 2-11 Intermediary Number: Bill Type: Report Month: ******* ****** **PAID** **NOT PAID** **Non-PIP** ****PIP**** DAYS TO PROCESS TOTAL (1) CLEAN (2) OTHER (3) CLEAN (4) OTHER (5) CLEA N (6) OTHE R (7) EMC (8) 34. 34-45 35. 46-60 36. 61-90 37. 91+ 38. Total 39. Mean PT
CMS-1566, Page Page number and bill type to be reported as follows: Page 2 - Inpatient Hospital (INP) Page 7 - CORF (COR) Page 3 - Outpatient (OUT) Page 8 - ESRD (ERD) Page 4 - SNF (SNF) Page 9 - Lab (LAB) Page 5 - HHA (HHA) Page 10 - Other (OTH) Page 6 - Hospice (HPC) Page 11 - Total (TOT)
EXHIBIT 3 SECTION F: INTEREST PAYMENT DATA Form CMS 1566 - Medicare Program Intermediary Workload Report, Page 22 Intermediary Number: Report Month: BILLS/PAYMENTS DAYS LATE TOTAL (1) HOSPITAL (2) SNF (3) HHA (4) HOSPICE (5) REMAINDER (6) 1. Total Bills 2. 1 3. 2 4. 3 5. 4 6. 5 7. 6-15 8. 16-30 9. 31-60 10. 61+ 11. Total Paid 12. 1 13. 2 14. 3 15. 4
Exhibit 3 (Cont.) SECTION F: INTEREST PAYMENT DATA Form CMS 1566 - Medicare Program Intermediary Workload Report, Page 22 Intermediary Number: Report Month: BILLS/PAYMENTS DAYS LATE TOTAL (1) HOSPITAL (2) SNF (3) HHA (4) HOSPICE (5) REMAINDER (6) 16. 5 17. 6-15 18. 16-30 19. 31-60 20. 61+
40 - Monthly PRO Adjustment Bill Report (Inactive) (Rev. 175, Issued: 10-28-10, Effective: 04-01-11, Implementation: 04-04-11) The intermediary prepares and submits to CMS, by the 10th of each month following the reporting month, a PRO Adjustment Bill Report using the CROWD system. It submits a total page showing contractor activity for all PROs in the contractor’s area. In addition, it submits a separate report for each PRO/State. For example, if the intermediary handles adjustment records for a PRO involving separate States, it should submit a separate report for each State. It reports all tape adjustment requests as well as hardcopy adjustment request records which the PRO has designated XXP (where XX is a two-digit numeric identifier) in accordance with the Medicare Claims Processing Manual, Chapter 4, Outpatient Billing. If the intermediary does not have activity for a certain PRO/State combination in a month, it shall not submit a report. 40.1 - Heading (Rev. 6, 08-30-02) A3-3895.1 The intermediary enters the contractor’s assigned 5-digit ID and the PRO's 5-digit ID number in the indicated spaces. It shows the 2-digit State abbreviation. For the total page show "Total" in the PRO space. In the space labeled "Report Month/Year" enter the calendar month and year reported, e.g., show 0692 for June 1992. 40.2 - Body of Report (Rev. 175, Issued: 10-28-10, Effective: 04-01-11, Implementation: 04-04-11) For all PRO adjustments, determine the appropriate column. Complete the report for each line as follows: • Line 1 - Opening Pending - The intermediary enters the total number of adjustment request records reported as pending at the end of the previous month. • Line 2 - Revisions to Opening Pending - The intermediary reports the net result of the number of request records that should not have been counted as adjustment request records pending at the end of the previous month (minus) and the number that were not counted but which should have been (plus). • Line 3 - Revised Opening Pending - The intermediary enters line 1 plus line 2. • Line 4 - Electronic Adjustment Request Records Received - The intermediary enters the number of electronic adjustment request records received from the PRO in the month. • Line 5 - Electronic Adjustment Request Records Rejected - The intermediary enters the number of electronic adjustment request records reported on line 4 that failed contractor front end edits.
• Line 6 - Electronic Adjustment Request Records Accepted - The intermediary enters the difference of line 4 minus line 5. • Line 7 - Hard Copy Adjustment Requests Received - The contractor shall enter the number of hard copy adjustment requests it received from its PRO(s). It shall count only hard copy requests the PRO has identified as 11P, 13P, 18P, 21P, or 83P. • Line 8 - Additional Bills to be Processed Due to Interim Bills-The intermediary enters the number of interim bills to be adjusted as a result of PRO electronic or hard adjustment requests. It does not count interim bills for which no change is needed. • Line 9 - Total Adjustment Bills to be Processed - The intermediary enters the total number of adjustment bills to be processed. This is the sum of lines 3, 6, 7, and 8. • Line 10 - Non-processable Adjustment Bills - Failed Batch/System Edits - The intermediary enters the number of bills it could not process due to batch/system edits. It includes any requests which conflict with its history; e.g., utilization. It counts any interim bill which edits out of its system. These bills will be identified as non-processable on the Revisions to the Monthly PRO Adjustment Bill Report. • Line 11 - Total Adjustment Bills Processed - The intermediary enters the total number of adjustment bills it has processed as a result of PRO adjustment requests (hard copy and electronic). It counts each bill when multiple bills are processed to satisfy one request. • Line 12 - Number Completed in 60 Days or Less - The intermediary enters the number of adjustment bills processed in 60 days or less from the date it received the adjustment request record. • Line 13 - Number Completed in 61-90 Days - The intermediary enters the number of adjustment bill processed in 61 to 90 days. • Line 14 - Number Completed in 91-120 Days - The intermediary enters the number of adjustment bills processed in 91 to 120 days. • Line 15 - Number Completed Over 120 Days - The intermediary enters the number of adjustment bills processed in 121 days or more. • Line 16 - Closing Pending - The intermediary enters the total number of adjustment request records pending at the end of the report month.
40.3 - Checking Reports (Rev. 6, 08-30-02) A3-3895.3 Before transmitting the report, the intermediary checks for completeness and arithmetical accuracy. The line item edits apply to all columns. It uses the following checklist: • Line 1 plus line 2 = line 3; • Line 5 plus line 6 = line 4; • Line 3 plus line 6 plus line 7 plus line 8 = line 9; • Line 9 minus line 10 minus line 11 = line 16; • Sum of lines 12 through 15 = line 11; • Column b plus column c = column a; • Sum of all PRO pages = Total pages; • Total page line 11 = line 17, column (i) of CMS-1566; and • Line 1 of current month's report must equal line 16 of previous month's report.
40.4 - Report Form (Rev. 6, 08-30-02) A3-3895.4 MONTHLY PRO ADJUSTMENT BILL REPORT INTERMEDIARY ID: PRO ID: STATE: MONTH/YEA R: TOTAL (A) INPATIENT (B) OUTPATIENT (C) 1.Opening Pending 2.Revisions to Opening Pending 3.Revises Opening Pending 4.Elec. Adj. Req. Rec. Received 5.Elec. Adj. Rec. Rec. Rejected 6.Elec. Adj. Rec. Received 7.Hard-Copy Adj. Req. Rec. Accepted 8.Addtl. Bills to be Proc. Due to Interim Bills 9.Total Adj. Bills to be Proc.
Report Form (Cont.) MONTHLY PRO ADJUSTMENT BILL REPORT INTERMEDIARY ID: PRO ID: STATE: MONTH/YEA R: TOTAL (A) INPATIENT (B) OUTPATIENT (C) 10.Nonprocessable Adjustment Bills-Failed Batch/System Edits 11.Total Adj. Bills Processed 12.No. Compl. in 60 Days or Less 13.No. Compl. in 61-90 Days 14.No. Compl. in 91-120 Days 15.No. Compl. Over 120 Days 16.Closing Pending
50 - Quarterly Supplement To Intermediary Workload Report (Form CMS-1566A) - General (Rev. 6, 08-30-02) A3-3896 In addition to the monthly workload report, prepare and transmit to CMS a Quarterly Supplement to the Intermediary Workload Report showing the status and disposition of selected workloads. Complete a separate report for each office assigned a separate intermediary number. 50.1 - Purpose and Scope (Rev. 6, 08-30-02) A3-3896.1 The Quarterly Supplement to the Intermediary Workload Report - Pages 1 and 2, supplies CMS with current data on the number of bills processed for each State for which you service one or more providers. The Quarterly Supplement to the Intermediary Workload Report - Page 3, provides data on denials, HHA visits and waivers of liability. 50.2 - Due Date (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3896.2 Transmit the Quarterly Supplement to CMS CO via PC or terminal as soon as possible after the reporting quarter but no later than the 15th of the following month. Use instructions in the CROWD User Guide available via the CMS Enterprise Portal. 60 - Completing Quarterly Supplement To The Intermediary Workload Report, CMS-1566A, Pages 1 And 2 (Rev. 6, 08-30-02) A3-3897 60.1 - Heading (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3897.1 These pages are referenced as Form C for CROWD. It submits the appropriate information for the reporting period for each office assigned a separate contractor number and BSI. 60.2 - Checking Reports (Rev. 6, 08-30-02) A3-3897.2
Before submitting Form C to CMS, check its completeness and arithmetical accuracy. Use the following checklist: • For each corresponding type of bill, line 1 (ALL) equals the sum of the number of bills processed reported on line 12 on the intermediary's monthly workload report (CROWD Form D) for the 3 months of the reporting period. • For each column, line 1 (ALL) equals the sum of the lines reported for each State. • For all lines of the report, column 1 (Total) equals the sum of the items in columns 2 + 3 + 4 + 5 + 6. • The State code must be the two-letter postal abbreviation. Use code FO for all foreign claims not originating from a state, territory, or the District of Columbia. 60.3 - Type of Bill (Rev. 10521; Issued: 12-16-20; Effective: 01-01-21; Implementation: 01-04-21) The A/B MAC (A) reports counts in total and by type of bill as shown below: Column (1) Total--All provider bills. Column (2) Inpatient Hospital--CMS-1450s submitted by hospitals for inpatient services, with the following two-digit classification codes in Form Locator 4: 1-1 (inpatient hospital); and 4-1 (Religious Nonmedical Health Care Hospital-inpatient). Column (3) Outpatient--CMS-1450s submitted by hospitals or SNFs for outpatient services with the following two-digit classification codes in Form Locator 4: 1-3 (hospital-outpatient); 2-3 (SNF-outpatient); 4-3 Religious Nonmedical Health Care Hospital- outpatient); 5-3 (Religious Nonmedical Health Care SNF-outpatient); and 8- 3 (hospital- outpatient surgical procedures - ASC) Column (4) SNF--CMS-1450s with the following two-digit classification codes in Form Locator 4: 1-8 (hospital-swing-bed); 2-1 (SNF-inpatient); 2-8 (SNF swing- bed); and 5-1 (Religious Nonmedical Health Care-SNF-inpatient). Column (5) HHA--CMS-1450s submitted by HHAs with the following two digit classification codes in Form Locator 4: 3-2 (HHA-Part B visits and use of DME); 3-3 (HHA-Part A visits and DME); 3-4 (HHA-other-Part B-benefits) Column (6) Other--CMS-1450s with the following two-digit classification codes in Form Locator 4: 1-2 (hospital inpatient-Part B benefits); 1-4 (hospital-other-Part B benefits); 2-2 (SNF-inpatient-Part B benefits); 2-4 (SNF-other-Part B benefits); 4-2 (Religious Nonmedical Health Care-inpatient-Part B benefits); 4-4 (Religious Nonmedical Health Care-inpatient-other); 5-2 (Religious Nonmedical Health Care-SNF inpatient-Part B benefits); 5-4 (Religious Nonmedical Health Care-SNF inpatient-other); 7-1, 7-2,
7-3, 7-4, 7-5 (Clinics - provider and independent RHCs, FQHCs, ESRD hospital- based or independent renal dialysis facilities, FQHCs, CMHCs, ORFs and CORFs); 8-1 and 8-2 (Hospices); and 8-7 (Opioid Treatment Programs) 60.4 - Body of Report (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3897.4 Section A: Bills Processed by State of Provider - The intermediary reports in this section the claims workload for each State for which you service one or more providers. Break out by State the number of initial bills (including demand and no-pay bills) reported as processed on line 12 of Form D (see §20.4) over the 3 months of the reporting quarter. NOTE: Categorize the information reported by the State of the individual provider, not the home office, if it is part of a chain organization. Line 1 - All - For each column 1 through 6, the system will sum the number of claims reported on the individual State lines completed below. The numbers so calculated by the system must equal the sum of the numbers reported on line 12 of Form D for the 3 months of the reporting quarter. State Lines - In the column just left of column (1), the intermediary reports the two-digit postal abbreviation of each State (or FO for foreign claims) which includes at least one provider for which you processed claims during the quarter. It reports opposite each listed State the number of initial bills processed during the reporting quarter for providers located in the State. It reports the data in total in column 1, and by type of bill in columns 2 through 6. 70 - Completing Quarterly Supplement To The Intermediary Workload Report, CMS-1566A, Page 3 (Rev. 6, 08-30-02) A3-3898 70.1 - Heading (Rev.) A3-3898.1 This page is referenced as Form I for CROWD. It submits the appropriate information for the reporting period for each office assigned a separate contractor number and BSI. 70.2 - Checking Reports (Rev. 6, 08-30-02)
A3-3898.2 Before submitting Form I to CMS, check for completeness and arithmetical accuracy. Use the following checklist: • For all columns, line 1 + line 7 + line 8 must be equal to or less than line 1 of Form C. • For all columns, line 1A + line 1B + line 1C must equal line 1. • For all columns, line 1D must be equal to or less than line 1C. • For all columns, line 2A must be equal to or less than line 1A. • For all columns, line 2A must be equal to or less than line 2. • For all columns, line 3A must be equal to or less than line 3. • For all columns, line 7A must be equal to or less than line 7. • For all columns, line 8B must be equal to or less than line 8. • For all columns, lines 3 and 3A must be rounded to whole dollars. NOTE: This may cause you to force column 1 to equal the sum of columns 2-6. • For lines 1 through 3A, lines 7 and 7A, and lines 8 and 8B, column 1 must equal the sum of columns 2-6. • For columns 4 and 5, line 4 must be equal to or greater than line 1 of Form C. • For columns 4 and 5, lines 5 through 6A must be equal to or greater than lines 1 through 2A, respectively (e.g., line 5 must be equal to or greater than line 1, line 5A must be equal to or greater than line 1A, etc.). • For columns 4 and 5, line 5A + 5B + 5C must equal line 5. • For columns 4 and 5, line 6A must be equal to or less than line 5A. • For columns 4 and 5, line 6A must be equal to or less than line 6. • For columns 4 and 5, line 7B must be equal to or greater than line 7A. • For columns 4 and 5, line 8A must be equal to or greater than line 8. • For columns 4 and 5, line 5 + line 7B + line 8A must be equal to or less than line 4.
70.3 - Type of Bill (Rev. 6, 08-30-02) A3-3898.3 The intermediary reports counts in total and by type of bill as outlined in §60.3 for Form C. 70.4 - Body of Report (Rev. 6, 08-30-02) A3-3898.4 Section B: Bill Denial Data Line 1: Bills Denied-Total - The intermediary reports all full and partial denial determinations that it made during the reporting period. It reports only denial determinations resulting in its preparing and sending a notice to the beneficiary. It counts a denial when it denies (either in full or in part) bills submitted as covered. It includes counts where it made a denial determination but found both the beneficiary and the provider to be without fault under §213 of Public Law 92-603 and, therefore, made a determination to waive liability in full. Also, it includes counts when it found only the provider to be at fault (i.e., it waived the beneficiary's liability). It does not count: • Denials of no-pay or demand bills even though the contractor sends a denial notice. • Denials of future services. • Denials made by PROs. Line 2: Bills Paid Under Waiver-Total - The intermediary reports the total number of bills on which you made a determination to waive the liability of both the beneficiary and the provider. Count determinations made at: • Initial bill processing, • Appeals process, and • Any other time such as when you reopen your initial decision. The intermediary does not count waiver determinations made by PROs. Line 2A: Initial Bills Paid Under Waiver - The intermediary reports the number of bills on which you made a decision to waive the liability of both the beneficiary and the provider during the initial adjudication of the bills.
Line 3: Amount Reimbursed Under Waiver - The intermediary reports the amounts paid (to the nearest dollar) under the waiver provision for the bills reported on line 2. Do not include coinsurance amounts, charges applied toward the deductible, or reimbursement for services not under consideration with respect to the waiver provision. Where all services on a bill are paid in full (excluding the applicable deductible and coinsurance) as a combination of covered services and noncovered services paid under waiver and the exact dollar amount of the waiver payment is not available without contacting the provider, it reports an approximation of the waiver payment. In calculating this approximation, apply to total charges the proportion of waiver days to total days included on the bill, and subtract any applicable deductible or coinsurance for the waiver period. Line 3A: Amount on Initial Bills - The intermediary reports the amounts paid (to the nearest dollar) under the waiver provision for the bills reported on line 2A. Section C: Day/Visit Data Line 4: Days/Visits Processed - The intermediary reports under column 4 the total number of days (both covered and noncovered) for SNF bills shown as processed in column 4, line 1 of Form C, for the same reporting period. It reports under column 5 the number of billed visits for HHA bills shown as processed in column 5, line 1 of Form C, for the same reporting period. Line 5: Days/Visits Denied-Total - The intermediary reports under column 4 the number of SNF days denied on the bills reported on line 1. It reports under column 5 the number of HHA visits denied on the bills reported on line 1. Denied days/visits are those billed as covered which you determine to be noncovered. Line 6: Days/Visits Paid Under Waiver of Liability - The intermediary reports under column 4 the number of SNF days on the bills reported on line 2 that were paid under the waiver provision. It reports under column 5 the number of HHA visits on the bills reported on line 2 that were paid under the waiver provision. Line 6A: Days/Visits Paid Under Waiver on Initial Bills - The intermediary reports under column 4 the number of SNF days on the bills reported on line 2A that were paid under the waiver provision. It reports under column 5 the number of HHA visits on the bills reported on line 2A that were paid under the waiver provision. Section D: Demand Bill Data Line 7: Total Demand Bills - The intermediary reports under the appropriate column bills which the provider determined to be for noncovered services but which the beneficiary or his representative requested be filed in order to obtain a Medicare decision. It reports only bills identified by condition code 20. (See The Medicare Claims
Processing Manual, Chapter 1, General Billing Requirements.) It reports the total number of bills processed during the reporting quarter, even if not manually reviewed. Line 7A: Full/Partial Reversals - The intermediary reports the number of demand bills on which you fully or partially reversed the provider's decision that the services were noncovered. Line 7B: Days/Visits on Reversals - The intermediary reports under column 4 the number of SNF days on the demand bills reported on line 7A. It reports under column 5 the number of HHA visits on the demand bills reported on line 7A (i.e., report days/visits for which you fully or partially reversed the provider's decision that they were noncovered). Section E: No-Pay Bill Data Line 8: Total No-Pay Bills - The intermediary reports under the appropriate column the total number of no-pay bills (excluding the demand bills reported on line 7 Section D) which are included in the total bills processed reported on line 1, page 1 of the Quarterly Supplement for the same reporting period. No-pay bills are those submitted by providers with no charges and/or covered days/visits. It does not report HHA bills where no utilization is chargeable and no payment has been made, but which you have requested only to facilitate recordkeeping processes. Line 8A: Days/Visits on No-Pay Bills - The intermediary reports under column 4 the number of SNF days on the no-pay bills reported on line 8. It reports under column 5 the number of HHA visits on the no-pay bills reported on line 8. Line 8B: MSP No-Pay Bills - The intermediary reports the number of no-pay bills included on line 8 where payment has been made in full by another insurer as primary payer. 70.5 – Completing Medicare Fraud Unit Quarterly Workload Status Report, CMS-1566B – General (Inactive) (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3898.5 The intermediary prepares and submits to CMS each quarter a report on the number of fraud workload items handled by your Medicare fraud unit. This information is required by CMS to budget for fraud and abuse activities, as well as to monitor the flow of work through the fraud units. Submit this form via CROWD no later than the 15th day following the close of the reporting quarter. 70.6 – Heading (Inactive) (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3898.6
This page is referenced as Form M in the CROWD system. Complete the ADD/UPDATE/DELETE DATA criteria screen with the appropriate information to bring the reporting format to your screen. 70.7 – Checking Reports (Inactive) (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3898.7 Before submitting Form M to CMS, check for completeness and arithmetical accuracy. Use the following checklist: • For all columns, line 1 must equal line 8 of Form M for the previous quarter. • For all columns, line 1 + line 2 = line 3. • For all columns, line 6 + line 7 = line 5. • For all columns, line 3 + line 4 – line 5 = line 8. • For all lines, column 1 = column 2 + column 3 + column 4. 70.8 – Type of Fraud Workload Item (Inactive) (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3898.8 The intermediary reports fraud workload items in the following columns for all lines of Form M: Column (1) – Total – All fraud workload items. Column (2) – Beneficiary Complaints – The intermediary reports the number of complaints received from, or on behalf of, beneficiaries alleging fraud. Do not include complaints filed with the Office of the Inspector General (OIG) Hotline. Column (3) – OIG Hotline – The intermediary reports the number of complaints received via the OIG Hotline. Column (4) – Referrals and Other – The intermediary reports referrals and any other workload received by the fraud unit (e.g., provider complaints, internally generated referrals from medical review, special requests from OIG or CMS). 70.9 – Body of Report (Inactive) (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24)
A3-3898.9 Line 1 – Opening Pending – The system will pre-fill the number pending from line 8 of the previous quarter’s report. Line 2 – Adjustments – If it is necessary to revise the pending figure for the close of the previous quarter because of inventories, reporting errors, etc., enter the adjustment on this line. Precede negative adjustments with a minus sign. Line 3 – Adjusted Pending – The system will sum line 1 + line 2 to calculate the adjusted opening pending. Line 4 – Workload Received – The intermediary reports the number of complaints and referrals received in the fraud unit during the reporting period. Line 5 – Total Cleared – The system will sum line 6 + line 7 to calculate the total number of complaints and referrals cleared by the fraud unit during the reporting period. Line 6 – Cleared by Contractor – The intermediary reports the number of complaints and referrals cleared by the fraud unit by means other than referral to the OIG or designated agency. Include those that were: • Closed as not substantive or not a fraud issue. • Closed as not a fraud issue but referred to another contractor component for their review or action. • Closed as not being a fraud issue but referred to an external component other than the OIG. Line 7 – Cleared by Referral – The intermediary reports the number of complaints and referrals that were incorporated into cases referred formally to the OIG or designated agency for action (e.g., sanctions or prosecution). Line 8 – Closing Pending – The system will calculate the closing pending for the quarter by adding line 3 to line 4 and subtracting line 5. 70.10 – Completing Quarterly Periodic Interim Payment (PIP) Report, CMS-1566C – General (Rev12894; Issued:10-17-24-Effective: 11-01-24; Implementation:11-01-24) A3-3898.10 The intermediary prepares and submits to CMS each quarter a report on the number of providers that you pay using the PIP method. This information is required so that CMS
can monitor the number of providers being paid using the PIP method at each intermediary and nationally. Submit the form via CROWD no later than the 15th day following the close of the reporting quarter. 70.11 – Heading (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3898.11 This page is referenced as Form Q for CROWD. It submits the appropriate information for the reporting period for each office assigned a separate contractor number and BSI. 70.12 - Checking Reports (Rev. 6, 08-30-02) A3-3898.12 Before submitting Form Q to CMS, check for completeness and arithmetical accuracy. Use the following checklist: • For all columns, line 1 + line 2 - line 3 = line 4. • For all lines, column 1 + column 2 + column 3 = column 4. 70.13 - PIP Items Reported - The intermediary reports the PIP workload items in the following lines for all columns of Form Q: (Rev. 6, 08-30-02) A3-3898.13 Line 1 - PIP Providers - Beginning of Quarter - The intermediary reports the number of PIP providers by type (hospital, SNF and HHA) and total at the beginning of the quarter. Line 2 - PIP Providers - Accretions - The intermediary reports the number of providers by type (hospital, SNF and HHA) and total who elected during the reporting quarter to be paid under PIP. Line 3 - PIP Providers - Deletions - The intermediary reports the number of providers by type (hospital, SNF and HHA) and total who elected during the reporting quarter to discontinue being reimbursed under the PIP method. Line 4 - PIP Providers - End of Quarter - The intermediary reports the number of PIP providers by type (hospital, SNF and HHA) and total at the end of the quarter.
70.14 - Quarterly Supplement to the Intermediary Workload Report - CMS-1566A, Pages 1,2,3 (Rev. 12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3898.14 QUARTERLY SUPPLEMENT TO INTERMEDIARY WORKLOAD REPORT HFCA-1566A, PAGES 1 & 2 (CROWD FORM C) INTERMEDIARY NUMBER_______ REPORT PERIOD_______ SECTION A: BILLS PROCESSED BY STATE OF PROVIDER TOTAL 1 INP HOSP 2 OUTPATIENT 3 SNF 4 HHA 5 OTHER 6 1 . TOTAL - ALL STATE CODE XXXXXXXXXXX XXXXXXXXX XXXXXXXXXXXX XXXX XXXXX XXXXXX
Quarterly Supplement To Intermediary Workload Report (Cont.) QUARTERLY SUPPLEMENT TO INTERMEDIARY WORKLOAD REPORT HFCA-1566A, PAGE 3 (CROWD FORM I) INTERMEDIARY NUMBER_______ REPORT PERIOD_______ TOTAL 1 INPATIENT 2 OUTPATIENT 3 SNF 4 HHA 5 OTHER 6 SECTION B: BILL DENIAL DATA XXXXXXX XXXXXXXXXX XXXXXXXXXXX XXXX XXXX XXXXX 1. BILLS DENIED - TOTAL 1A. MEDICAL - SUBJECT TO WAIVER XXXXXX XXXXXXXXXX XXXXXXXXXXX XXXXXX XXXXXX XXXXXX 1B. MEDICAL - NOT SUBJECT TO WAIVER XXXXXX XXXXXXXXXX XXXXXXXXXXX XXXXXX XXXXXX XXXXXX 1C. NONMEDICAL TOTAL XXXXXXX XXXXXXXXXX XXXXXXXXXXX XXXXXX XXXXXX XXXXXX 1D. NONMEDICAL MSP XXXXXXX XXXXXXXXXX XXXXXXXXXXX XXXXXX XXXXXX XXXXXX 2. BILLS PAID UNDER WAIVER TOTAL 2A. INITIAL BILLS PAID UNDER WAIVER
Quarterly Supplement To Intermediary Workload Report (Cont.) QUARTERLY SUPPLEMENT TO INTERMEDIARY WORKLOAD REPORT HFCA-1566A, PAGE 3 (CROWD FORM I) INTERMEDIARY NUMBER_______ REPORT PERIOD_______ TOTAL 1 INPATIENT 2 OUTPATIENT 3 SNF 4 HHA 5 OTHER 6 3. AMOUNT REIMBURSED UNDER WAIVER 3A. AMOUNT ON INITIAL BILLS SECTION C: DAY/VISIT DATA XXXXXXX XXXXXXXXXX XXXXXXXXXXX XXXX XXXX XXXXX 4. DAYS/VISITS PROCESSED XXXXXXX XXXXXXXXXX XXXXXXXXXXX XXXXX 5. DAYS/VISITS DENIED TOTAL NO-PAY BILLS XXXXXXX XXXXXXXXXX XXXXXXXXXXX XXXXX 5A. MEDICAL - SUBJECT TO WAIVER XXXXXXX XXXXXXXXXX XXXXXXXXXXX XXXXX 5B. MEDICAL - NOT SUBJECT TO WAIVER XXXXXXX XXXXXXXXXX XXXXXXXXXXX XXXXX 5C. NONMEDICALS XXXXXXX XXXXXXXXXX XXXXXXXXXXX XXXXX
Quarterly Supplement To Intermediary Workload Report (Cont.) QUARTERLY SUPPLEMENT TO INTERMEDIARY WORKLOAD REPORT HFCA-1566A, PAGE 3 (CROWD FORM I) INTERMEDIARY NUMBER_______ REPORT PERIOD_______ TOTAL 1 INPATIENT 2 OUTPATIENT 3 SNF 4 HHA 5 OTHER 6 6. DAYS/VISITS PAID UNDER WAIVER - TOTAL XXXXXXX XXXXXXXXXX XXXXXXXXXXX XXXXX 6A. DAYS/VISITS ON INITIAL BILLS XXXXXXX XXXXXXXXXX XXXXXXXXXXX XXXXX
Quarterly Supplement To Intermediary Workload Report (Cont.) QUARTERLY SUPPLEMENT TO INTERMEDIARY WORKLOAD REPORT HFCA-1566A, PAGE 3 (CROWD FORM I) INTERMEDIARY NUMBER_______ REPORT PERIOD_______ TOTAL 1 INPATIENT 2 OUTPATIENT 3 SNF 4 HHA 5 OTHER 6 SECTION D: DEMAND BILL DATA XXXXXXX XXXXXXXXXX XXXXXXXXXXX XXXX XXXX XXXXX 7. TOTAL DEMAND BILLS 7A. FULL/PARTIAL REVERSALS 7B. DAYS/VISITS ON REVERSALS XXXXXXX XXXXXXXXXX XXXXXXXXXXX XXXXX SECTION E: NO-PAY BILLS XXXXXXX XXXXXXXXXX XXXXXXXXXXX XXXX XXXX XXXXX 8. TOTAL NO-PAY BILLS 8A. DAYS/VISITS ON NO-PAY BILLS XXXXXXX XXXXXXXXXX XXXXXXXXXXX XXXXX 8B. MSP NO-PAY BILLS
70.15 - Medicare Fraud Unit Quarterly Workload Status Report - CMS-1566B (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3898.15 MEDICARE FRAUD UNIT QUARTERLY WORKLOAD STATUS REPORT HFCA-1566B (CROWD FORM M) INTERMEDIARY NUMBER_______ REPORT PERIOD_______ FRAUD WORKLOAD ITEM TOTAL 1 BENEFICIARY COMPLAINT 2 OIG HOTLINE 3 REFERRAL & OTHERS 4 1. OPENING PENDING 2. ADJUSTMENTS 3. ADJUSTED PENDING 4. WORKLOAD RECEIVED 5. TOTAL CLEARED 6. BY CONTRACTOR 7. BY REFERRAL 8. CLOSING PENDING
70.16 - Quarterly Periodic Interim Payment (PIP) Report - Form CMS-1566C (Rev. 6, 08-30-02) A3-3898.16 QUARTERLY PERIODIC INTERIM PAYMENT (PIP) REPORT FORM CMS-1566C (CROWD FORM Q) INTERMEDIARY NUMBER_______ REPORT PERIOD PIP PROVIDERS HOSP. (1) SNF (2) HHA (3) TOTAL (4) 1. BEGINNING OF QUARTER 2. ACCRETIONS 3. DELETIONS 4. END OF QUARTER
70.17 - Completing Quarterly Report on Provider Enrollment (Inactive) (Rev. 175, Issued: 10-28-10, Effective: 04-01-11, Implementation: 04-04-11) Each quarter, the intermediary prepares and submits to CMS a report on the number of provider enrollment applications received, processed, and pending during the quarter. Include in your counts of provider enrollment applications, any change of ownership (CHOW) notices handled by you. It submits this report via the Contractor Reporting of Operational and Workload Data (CROWD) system no later than the fifteenth day following the close of the reporting quarter. 70.18 - Heading (Inactive) (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3898.18 This report is referenced as Form 3 in the CROWD system. Complete the ADD/UPDATE/DELETE DATA criteria screen with the appropriate information to bring the reporting format to your screen. 70.19 - Checking Reports (Inactive) (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3898.19 Before submitting Form 3 to CMS, check for completeness and arithmetical accuracy. Use the following checklist: • For all lines, column 1 must equal the sum of columns 2-16. • For all columns, line 1 must equal line 11 from the previous quarter. • For all columns, line 3 must equal line 1 plus line 2. • For all columns, line 6 must equal line 4 plus line 5. • For all columns, line 10 must equal the sum of lines 7-9. • For all columns, line 11 must equal line 3 plus line 6 minus line 10. • For all columns, the sum of lines 12-17 must equal line 8. • For all columns, the sum of lines 18-22 must equal line 9. • For all columns, the sum of lines 23-26 must equal line 10. • For all columns, the sum of lines 27-31 must equal line 11.
• For all columns, line 32 must equal line 37 from the previous quarter. • For all columns, line 34 must equal line 32 plus line 33. • For all columns, line 37 must equal line 34 plus line 35 minus line 36. • For all columns, line 32 must be less than or equal to line 1. • For all columns, line 34 must be less than or equal to line 3. • For all columns, line 35 must be less than or equal to line 6. • For all columns, line 36 must be less than or equal to line 10. • For all columns, line 37 must be less than or equal to line 11. 70.20 - Type of Provider (Inactive) (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3898.20 The intermediary reports provider enrollment application data in the following columns for all lines on Form 3. Column (1) - Total - The sum of columns 2-16 for each line. Column (2) - Accredited Hospital - Provider applications indicating provider type as an accredited hospital. Column (3) - Non-Accredited Hospital - Provider applications indicating provider type as a non- accredited hospital. Column (4) - Religious Nonmedical Health Care Facility - Hospital - Provider applications indicating provider type as a Religious Nonmedical Health Care Facility - hospital. Column (5) - Rural Primary Care Hospital - Provider applications indicating provider type as a rural primary care hospital. Column (6) - SNF - Provider applications indicating provider type as a skilled nursing facility (i.e., long term care facility). Column (7) - HHA. - Provider applications indicating provider type as a home health agency. Column (8) - Hospice - Provider applications indicating provider type as a hospice facility. Column (9) - ESRD - Provider applications indicating provider type as an end stage renal disease dialysis facility.
Column (10) - CORF - Provider applications indicating provider type as a comprehensive outpatient rehabilitation facility. Column (11) - RHC - Provider applications indicating provider type as a rural health clinic. Column (12) - FQHC - Provider applications indicating provider type as a federally qualified health center. Column (13) - CMHC - Provider applications indicating provider type as a community mental health center. Column (14) - IHS - Provider applications indicating provider type as an Indian Health Service facility. Column (15) - Outp. Speech Path./Phy.Ther - Provider applications indicating provider type as either outpatient speech pathology or outpatient physical therapy facility. Column (16) - Other - Provider applications indicating provider type other than those defined for columns 1 through 15. 70.21 - Completing Lines One through Eleven - Workload Operations (Inactive) (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3898.21 Line 1 - Pending End of Last Quarter - The CROWD system will automatically enter the value from line 11 on the previous quarter’s report. Line 2 - Adjustments to Pending - If it is necessary to revise the pending figure for the close of the previous quarter because of inventories taken or reporting errors discovered, enter the adjustment here. Adjustments can be positive or negative values. If entering a negative value, precede the number with a minus (-) sign. Line 3 - Adjusted Opening Pending -The CROWD system will automatically sum the values on lines 1 and 2. Line 4 - New Applications Received - The intermediary enters the number of applications received for the first time during the reporting quarter. Line 5 - Returned Applications Resubmitted - The intermediary enters the number of applications received during the reporting quarter that had previously been received and returned to the applicant for correction/completion. Line 6 - Total Applications Received -The CROWD system will automatically sum the values and lines 4 and 5.
Line 7 - Applications Recommended for Approval - The intermediary enters the number of applications that you recommended for approval (i.e., Medicare number issued) during the reporting quarter. Line 8 - Applications Recommended for Denial - The intermediary enters the number of applications that you recommended for denial during the reporting quarter. Line 9 - Applications Returned - The intermediary enters the number of applications returned to the applicant for corrections/completion during the reporting quarter. Line 10 - Total Applications Processed -The CROWD system will automatically sum the values on lines 7, 8, and 9. Line 11 - Pending End of Quarter -The CROWD system will automatically compute the number of applications pending at the end of the reporting quarter by adding the value on line 3 to the value on line 6 and then subtracting the value on line 10. 70.22 - Completing Lines Twelve through Seventeen - Reason for Denial Recommendation (Inactive) (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3898.22 Line 12 - Sanctioned From Medicare - The intermediary enters the number of applications that you recommended for denial because the applicant is currently excluded/sanctioned from Medicare. Line 13 - Debarred/Excluded by Other Federal Agency - The intermediary enters the number of applications that you recommended for denial because the applicant had been disbarred, suspended, or excluded by any other Federal agency. Line 14 - Not Professionally Licensed - The intermediary enters the number of applications that you recommended for denial because the applicant was not professionally licensed. Line 15 - Business Address Invalid - The intermediary enters the number of applications that you recommended for denial because the applicant had an invalid business address. Line 16 - Business Location Not Licensed - The intermediary enters the number of applications that you recommended for denial because the applicant=s business location was not properly licensed. Line 17 - CMS Requirements Not Met - The intermediary enters the number of applications that you recommended for denial because the applicant did not meet all CMS requirements. 70.23 - Completing Lines Eighteen through Twenty-Two - Reason for Return (Inactive)
(Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3898.23 Line 18 - Incomplete - The intermediary enters the number of applications returned to the applicant because the application was incomplete. Line 19 - Unverifiable Information - The intermediary enters the number of applications returned to the applicant because the application included unverifiable information. Line 20 - Not Signed - The intermediary enters the number of applications returned to the applicant because the applicant did not sign the certification statement. Line 21 - Invalid Billing Agreement - The intermediary enters the number of applications returned to the applicant because the billing agreement did not meet CMS requirements. Line 22 - Other - The intermediary enters the number of applications returned to the applicant for any reason other than the ones indicated on lines 18 through 21. 70.24 - Completing Lines Twenty-Three through Twenty-Six - Application Processing Times (Inactive) (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3898.24 Line 23 - Number Under 21 Days - The intermediary enters the number of applications processed in less than 21 days from the date of receipt. Line 24 - Number in 21-30 Days - The intermediary enters the number of applications processed in 21 through 30 days from the date of receipt. Line 25 - Number in 31-40 Days - The intermediary enters the number of applications processed in 31 through 40 days from the date of receipt. Line 26 - Number Over 40 Days - The intermediary enters the number of applications processed in more than 40 days from the date of receipt. 70.25 - Completing Lines Twenty-Seven through Thirty-One - Age of Applications Pending (Inactive) (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3898.25 Line 27 - Number Under 11 Days Old - The intermediary enters the number of applications included in line 11 which are 1-10 days old. Line 28 - Number 11-20 Days Old - The intermediary enters the number of applications included in line 11 which are 11-20 days old.
Line 29 - Number 21-30 Days Old - The intermediary enters the number of applications included in line 11 which are 21-30 days old. Line 30 - Number 31-40 Days Old - The intermediary enters the number of applications included in line 11 which are 31-40 days old. Line 31 - Number Over 40 Days Old - The intermediary enters the number of applications included in line 11 which are over 40 days old. 70.26 - Completing Lines Thirty-Two through Thirty-Seven - CHOW Workloads (Inactive) (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3898.26 The intermediary reports in this section counts of your workloads dealing with CHOW notices included in lines 1, 2, 3, 6, 10, and 11. Line 32 - Pending End of Last Quarter - The CROWD system will automatically enter the value from line 37 on the previous quarter’s report. (This count represents the number of CHOWs included in line 1.) Line 33 - Adjustments to Pending - If it is necessary to revise the pending figure for the close of the previous quarter because of inventories taken or reporting errors discovered, enter the adjustment here. Adjustments can be positive or negative values. If entering a negative value, precede the number with a minus (-) sign. (This count represents the number of CHOWs included in line 2.) Line 34 - Adjusted Opening Pending -The CROWD system will automatically sum the values in lines 32 and 33. (This count represents the number of CHOWs included in line 3.) Line 35 - CHOWs Received - The intermediary enters the number of applications shown in line 6 that represents CHOWs received during the reporting quarter. Line 36 - CHOWs Processed - The intermediary enters the number of applications shown in line 10 that represents CHOWs processed during the reporting quarter. Line 37 - Pending End of Quarter -The CROWD system will automatically compute the number of CHOWs pending at end of the reporting quarter by adding the value on line 34 to the value on line 35 and then subtracting the value on line 36. (This count represents the number of CHOWs included in line 11.)
70.27 - Exhibits (Rev. 6, 08-30-02) A3-3898.27 Exhibit 1 - Screen 1 of Intermediary Provider Enrollment Quarterly Workload Report. INTERMEDIARY NAME: REPORT PERIOD: INTERMEDIARY NUMBER: CROWD FORM 3 Application Workloads Total (1) Accrued Hospital (2) Non- Accrued Hospital (3) Religious Nonmedical Health Care Hospital (4) Rural Prim Care Hospital (5) 1. Pending End of Last Quarter 2. Adjustments to Pending 3. Adjusted Opening Pending 4. New Applications Received 5. Returned Appls Resubmitted 6. Total Applications Received 7. Applications Approval Recmd 8. Applications Denial Recmd 9. Applications Returned 10. Total Applications Processed 11. Pending End of Quarter SCREEN 1
Exhibit 2 - Screen 2 of Intermediary Provider Enrollment Quarterly Workload Report. INTERMEDIARY NAME: REPORT PERIOD: INTERMEDIARY NUMBER: CROWD FORM 3 Application Workloads SNF (6) HHA (7) Hospice (8) ESRD (9) CORF (10) 1. Pending End of Last Quarter 2. Adjustments to Pending 3. Adjusted Opening Pending 4. New Applications Received 5. Returned Appls Resubmitted 6. Total Applications Received 7. Applications Approval Recmd 8. Applications Denial Recmd 9. Applications Returned 10. Total Applications Processed 11. Pending End of Quarter SCREEN 2
Exhibit 3 - Screen 3 of Intermediary Provider Enrollment Quarterly Workload Report. INTERMEDIARY NAME: REPORT PERIOD: INTERMEDIARY NUMBER: CROWD FORM 3 Application Workloads RHC (11) FQH C (12) CMHC (13) IHS (14) Outpatient Speech Pathology PhysicalTherapy (15) Other (16) 1. Pending End of Last Quarter 2. Adjustments to Pending 3. Adjusted Opening Pending 4. New Applications Received 5. Returned Appls Resubmitted 6. Total Applications Received 7. Applications Approval Recmd 8. Applications Denial Recmd 9. Applications Returned 10. Total Applications Processed 11. Pending End of Quarter SCREEN 3
Exhibit 4 - Screen 4 of Intermediary Provider Enrollment Quarterly Workload Report. INTERMEDIARY NAME: REPORT PERIOD: INTERMEDIARY NUMBER: CROWD FORM 3 Application Workloads Total (1) Accrued Hospital (2) Non- Accrued Hospital (3) Religious Nonmedical Health Care Hospital (4) Rural Prime Care Hospital (5) Reason for Denial Recommendation 12. Sanctioned from Medicare 13. Debarred/Excluded by Other Fed 14. Not Professionally Licensed 15. Business Address Invalid 16. Business Location Not Licensed 17. CMS Requirements Not Met Reason for Return 18. Incomplete 19. Unverifiable Information 20. Not Signed 21. Invalid Billing Agreement 22. Other SCREEN 4
Exhibit 5 - Screen 5 of Intermediary Provider Enrollment Quarterly Workload Report. INTERMEDIARY NAME: REPORT PERIOD: INTERMEDIARY NUMBER: CROWD FORM 3 Application SNF (6) HHA (7) Hospice (8) ESRD (9) CORF (10) Reason for Denial Recommendation 12. Sanctioned from Medicare 13. Debarred/Excluded by Other Fed 14. Not Professionally Licensed 15. Business Address Invalid 16. Business Location Not Licensed 17. CMS Requirements Not Met Reason for Return 18. Incomplete 19. Unverifiable Information 20. Not Signed 21. Invalid Billing Agreement 22. Other SCREEN 5
Exhibit 6 - Screen 6 of Intermediary Provider Enrollment Quarterly Workload Report. INTERMEDIARY NAME: REPORT PERIOD: INTERMEDIARY NUMBER: CROWD FORM 3 Application Workloads RHC (11) FQHC (12) CMHC (13) IHS (14) Outpatient Speech Pathology/ Physical Therapy (15) Other (16) Reasons for Denial Recommendation 12. Sanctioned from Medicare 13. Debarred/Excld by Other Fed 14. Not Professionally Licensed 15. Business Address Invalid 16. Business Location Not Licens 17. CMS Requirements Not Met Reason for Return 18. Incomplete 19. Unverifiable Information 20. Not Signed 21. Invalid Billing Agreement 22. Other SCREEN 6
Exhibit 7 - Screen 7 of Intermediary Provider Enrollment Quarterly Workload Report. INTERMEDIARY NAME: REPORT PERIOD: INTERMEDIARY NUMBER: CROWD FORM 3 Application Workloads Total (1) Accrued Hospital (2) Non- Accrued Hospital (3) Religious Nonmedical Health Care Hospital (4) Rural Prime Care Hospital (5) Application Processing Times 23. Number Under 21 Days 24. Number in 21-30 Days 25. Number in 31-40 Days 26. Number Over 40 Days Age of Applications Pending 27. Number Under 11 Days Old 28. Number 11-20 Days Old 29. Number 21-30 Days Old 30. Number 31-40 Days Old 31. Number Over 40 Days Old SCREEN 7
Exhibit 8 - Screen 8 of Intermediary Provider Enrollment Quarterly Workload Report. INTERMEDIARY NAME: REPORT PERIOD: INTERMEDIARY NUMBER: CROWD FORM 3 Application Workloads SNF (6) HHA (7) Hospice (8) ESRD (9) CORF (10) Application Processing Times 23. Number Under 21 Days 24. Number in 21-30 Days 25. Number in 31-40 Days 26. Number Over 40 Days Age of Applications Pending 27. Number Under 11 Days Old 28. Number 11-20 Days Old 29. Number 21-30 Days Old 30. Number 31-40 Days Old 31. Number Over 40 Days Old SCREEN 8
Exhibit 9 - Screen 9 of Intermediary Provider Enrollment Quarterly Workload Report. INTERMEDIARY NAME: REPORT PERIOD: INTERMEDIARY NUMBER: CROWD FORM 3 Application Workloads RHC (11) FQHC (12) CMHC (13) IHS (14) Outpatient Speech Pathology/ Physical Therapy (15) Other (16) Application Processing Times 23. Number Under 21 Days 24. Number in 21-30 Days 25. Number in 31-40 Days 26. Number Over 40 Days Age of Applications Pending 27. Number Under 11 Days Old 28. Number 11-20 Days Old 29. Number 21-30 Days Old 30. Number 31-40 Days Old 31. Number Over 40 Days Old SCREEN 9
Exhibit 10 - Screens 10 and 11 of Intermediary Provider Enrollment Quarterly Workload Report. SCREEN 10 INTERMEDIARY NAME: REPORT PERIOD: INTERMEDIARY NUMBER: CROWD FORM 3 CHOW Workloads Total (1) Accrued Hospital (2) Non- Accrued Hospital (3) Religious Nonmedical Health Care Hospital (4) Rural Prime Care Hospital (5) 32. Pending End of Last Quarter 33. Adjustments to Pending 34. Adjusted Opening Pending 35. CHOWs Received 36. CHOWs Processed 37. Pending End of Quarter
Exhibit 10 (Cont.) Exhibit 10 - Screens 10 and 11 of Intermediary Provider Enrollment Quarterly Workload Report. SCREEN 11 INTERMEDIARY NAME: REPORT PERIOD: INTERMEDIARY NUMBER: CROWD FORM 3 CHOW Workloads SNF (6) HHA (7) Hospice (8) ESRD (9) CORF (10) 32. Pending End of Last Quarter 33. Adjustments to Pending 34. Adjusted Opening Pending 35. CHOWs Received 36. CHOWs Processed 37. Pending End of Quarter
Exhibit 11 - Screen 12 of Intermediary Provider Enrollment Quarterly Workload Report. INTERMEDIARY NAME: REPORT PERIOD: INTERMEDIARY NUMBER: CROWD FORM 3 CHOW Workloads RHC (11) FQHC (12) CMHC (13) IHS (14) Outpatient Speech Pathology/Physica l Therapy (15) Other (16) 32. Pending End of Last Quarter 33. Adjustments to Pending 34. Adjusted Opening Pending 35. CHOWs Received 36. CHOWs Processed 37. Pending End of Quarter SCREEN 12
80 - Monthly Intermediary Report On Medicare Secondary Payer Savings (Form CMS-1563) (Rev. 6, 08-30-02) A3-3899 80.1 - General (Rev. 188, Issued: 04-22-11, Effective: 07-01-11, Implementation: 07-05-11) NOTE: For MSP reporting effective April 2005, refer to the manual instructions located within Publication 100-05, Chapter 5, Section 60 (MSP Reports). Each month the intermediary electronically transmits to CO a Monthly Intermediary Report on Medicare Secondary Payer Savings (CMS-1563) via the IBM PC. It continues to use existing dialup instructions and the RLINK software sent to it. (See §80.9). Hardcopy reports are not required. It transmits a separate report for each office assigned a separate intermediary number and also, for each State for which it have been designated the servicing intermediary for one or more providers. It is not required to complete an individual State report for those States in which it has had no MSP activity during the month (reports that would show zeros in every category, including pending). 80.2 - Purpose and Scope (Rev. 6, 08-30-02) A3-3899.2 The Monthly Intermediary Report on Medicare Secondary Payer Savings supplies CMS with current data on MSP savings and MSP pending workloads. 80.3 - Due Date (Rev. 6, 08-30-02) A3-3899.3 Form CMS-1563 is due in CO as soon as possible after the end of the month being reported, but not later than the 15th of the following month. Nonreceipt of the report by the 15th will result in a telephone contact with the intermediary to obtain required information. 80.4 - Form Heading (Rev. 6, 08-30-02) A3-3899.4 The intermediary enters its name, assigned number and the State in which the provider is located. In the space labeled "Reporting Period", it enters the numeric designation for month and year for which the report is being prepared, e.g., it shows 01/02 for January 2002. 80.5 - Savings Calculations (Rev. 6, 08-30-02) A3-3899.5
A. Reporting Dollar Values - The intermediary rounds all values to nearest whole dollar. This includes all amounts shown on lines 2, 4, 6, 8 and 80. B. Checking Reports - Before mailing the reports, it checks their completeness and arithmetical accuracy as follows: • Lines 1 + 3 + 5 = line 7 for all columns. • Lines 2 + 4 + 6 = line 8 for all columns. • Line 10 should be equal to, or greater than, line 9 for all columns, unless line 9 is equal to "0" in any column; in that case, line 10 should also be equal to "0" for the same column. • For each line of the report column "i" (TOTAL), must equal the sum of the items in columns "ii" + "iii" + "iv" + "v" + "vi." 80.6 - Recording Savings (Rev. 315, Issued: 05-17-19, Effective: 06-18- 19, Implementation: 06-18-19) The term Medicare beneficiary identifier (Mbi) is a general term describing a beneficiary's Medicare identification number. For purposes of this manual, Medicare beneficiary identifier references both the Health Insurance Claim Number (HICN) and the Medicare Beneficiary Identifier (MBI) during the new Medicare card transition period and after for certain business areas that will continue to use the HICN as part of their processes. The intermediary controls all claims from which it extracts MSP savings and is able to verify all amounts recorded on the CMS-1563. A. MSP Savings File - It retains claims specific key identifying information on each claim counted as savings on the CMS-1563. At a minimum, it records the beneficiary's name, Medicare beneficiary identifier, type/dates of service, claim control number, billed charges and savings amounts reported. B. Savings Data From Non-Medicare Sources - If it records savings from data it obtained from its "private side" records or any other "outside" source, it must be able to extract the same claims specific information noted above, i.e., it must verify that Medicare covered services are involved and be able to calculate "what Medicare would have paid." In addition, it must compare this data with the data contained in its MSP savings file to ensure that savings have not previously been recorded for the same claims. If savings have not previously been taken for the claim, it counts them as savings on the CMS-1563 and enters them into its MSP savings file. 80.7 - Source of Savings - The intermediary reports data by total and by source as shown below: (Rev. 6, 08-30-02) A3-3899.7 Column (i) Total--All MSP savings regardless of source.
Column (ii) Workers' Compensation, Black Lung, and VA - It includes data related to all MSP savings resulting from medical benefits provided by the WC Plans of the 50 States, the District of Columbia, Guam and Puerto Rico. It also includes Federal WC provided under the Federal Employee's Compensation Act, the U. S. Longshoremens' and Harborworkers' Compensation Act and its extensions, the Federal Coal Mine Health and Safety Act of 1969 as amended (the Federal BL Program), and any fee-for-service medical care paid for by the VA. It keeps separate records for each distinct category (WC, BL or VA) as this may become a reporting requirement in the future. Column (iii) Working Aged - It includes data related to all MSP savings resulting from benefits payable under an EGHP for beneficiaries aged 65 and older who are covered by reason of their own employment or the employment of a spouse of any age. Section 3491 further defines the working aged provisions. Column (iv) ESRD - It includes data related to all MSP savings resulting from benefits payable under an EGHP for individuals who are entitled to Medicare benefits solely on the basis of ESRD during a period of up to 12 months. The period during which Medicare pays secondary benefits is defined in the Medicare Claims Processing Manual, Chapter 29, Coordination with Medigap insurers. Column (v) Auto Medical, No Fault and Liability Insurance - It includes data related to all MSP savings resulting from: • Automobile Medical or No Fault Insurance - Insurance coverage (including a self-insured plan) that pays for all, or part, of the medical expenses for injuries sustained in the use of, or occupancy of, an automobile, regardless of who may have been responsible for the accident. (This insurance is sometimes called "personal injury protection," "medical payments coverage" or "medical expense coverage.") • Liability Insurance - Insurance (including a self-insured plan) that provides payment based on legal liability for injury, illness or damage to property. It includes, but is not limited to, automobile liability insurance, uninsured motorist insurance, homeowners' liability insurance, malpractice insurance, product liability insurance, and general casualty insurance. It does not include situations where a beneficiary receives medical payment under his or her own homeowners' insurance. Column (vi) Disabled - It includes data related to all MSP savings resulting from situations where Medicare is the secondary payer for disabled beneficiaries under age 65 (except ESRD beneficiaries) who elect to be covered by a large group health plan (LGHP) as a current employee or
family member of such employee. A LGHP is any health plan that covers employees of at least one employer who normally employs 100 or more employees. The disabled provisions apply to items and services furnished on or after January l, 1987 and before January l, 1992 80.8 - Type of Savings - The intermediary reports data by type of savings as shown below (Rev. 6, 08-30-02) A3-3899.8 Unpaid (Cost Avoided) MSP Claims Unpaid (cost avoided) claims are those that the intermediary has returned without payment because it has strong evidence that another insurer is the primary payer and there is no indication that payment has been requested from that payer. The information indicating MSP involvement may be contained in the intermediary’s files, on the query reply, or on the claim itself. In addition, any information it obtains from a non-Medicare source and uses as the basis for claiming cost avoidance savings must meet the criteria in §80.6B. Information considered adequate for claiming cost avoidance savings includes statements on the claim noting "automobile accident," "collision", or the name of the automobile insurer. Another example would be previous information obtained showing EGHP coverage exits. The intermediary does not count claims it develops as "possible" MSP situations based on routine edits as cost avoidance savings unless it has previous information that another payer has primary responsibility. For example, "trauma code" edits are not, by themselves, considered strong evidence that Medicare is the secondary payer. Line 1 - Number - The intermediary reports the total number of cost avoided claims from which it is recording savings on the report. Line 2 - Dollar Value - The intermediary reports the total dollar value of the potential Medicare payments calculated for the claims on Line 1 that will be saved if the primary payer makes a payment which relieves Medicare of all payment liability. It shows as the amount cost avoided what Medicare would have paid. It does not count total charges as cost avoided savings. The cost avoided amount is the "Medicare payment rate" or the "current Medicare interim reimbursement amount" less any co-insurance amount applicable. It reduces Part B services subject to coinsurance for the coinsurance amount or it may use a "coinsurance reduction factor" of 19 percent to calculate coinsurance charges for all Part B services. It does not have to query for deductible status, but may assume that the deductible has been met. Tracking/Adjusting Cost Avoidance Savings Cost avoidance savings may not duplicate savings reported as full or partial recoveries and may not be shown where Medicare ultimately makes primary payment. To prevent duplicate counting, the intermediary suspends all claims it returns unpaid. It sets up a control on each claim returned for development. It maintains this control for 75 days, unless it receives further information before
that time which allows it to process the claim. If no further information on the claim is received, it may deny the claim after 75 days. It is not required to continue tracking the claim, but retains the key identifying information on the claim, as described in §80.6A. CMS prefers the intermediary to show cost avoidance savings only after 75 days have elapsed. However, it has the option of counting the savings when the claim is initially suspended or at any time during the suspension period. If it chooses the latter alternative, it must adjust its cost avoidance savings if the claim is resubmitted during the suspension period with information showing it is not a legitimate cost avoidance. The following situations require special consideration if cost avoidance savings are counted before the 75 day suspense period has ended: • A claim returned (and counted as cost avoided) is paid in part by another payer and the provider resubmits it for secondary payment. • A claim returned (and counted as cost avoided) is denied by the other payer and the provider resubmits it for primary payment. • A claim returned (and counted as cost avoided) is paid in full by the other payer and the provider submits a no-payment bill. The intermediary shows "full recovery" savings and not cost avoidance. In these situations, it adjusts its cost avoidance savings figures by deducting or "backing out" the applicable amounts. It makes the adjustments in the reporting month in which a final determination is rendered. The following chart outlines the correct reporting of savings in each situation.
ADJUSTMENTS TO REPORTED MSP COST AVOIDANCE SAVINGS CLAIMS PROCESSING ACTIONS MSP SAVINGS REPORTED Cost Avoidance Partial Recoveries Full Recoveries I. Partial Recovery Adjustment o MSP situation indicated. Medicare payment calculated to be $1200 if Medicare was primary payer. Claim is returned to provider. $ 1,200 o Provider resubmits the claim showing $900 paid by the other insurer. Medicare secondary payment of $300 is made. $ (1,200) * $ 900 II. "Other Payer Denial" Adjustment • MSP situation indicated - Medicare "primary" payment, $2,000. Claim is returned to provider. $ 2,000 • Other payer denies claim. Medicare found to be primary and Medicare payment of $2,000 is made. $ (2,000) * III. Full Recovery Adjustment • MSP situation indicated - Medicare "primary" payment, $900. Claim is returned to provider. $ 900 • Provider submits a "no-payment" bill showing full payment by the other payer. $ (900) * $ 900 *Amounts "backed out" of cost avoidance savings figures. Full Recoveries Line 3 - Number - The intermediary reports the number of full recoveries made during the month. Line 4 - Dollar Value - The intermediary reports the dollar value of full recoveries made during the month.
Full Recoveries are claims where the primary payer made a payment that relieved Medicare of all payment liability. Full recoveries can be either prepayment or postpayment. The intermediary counts full recoveries in the month in which it recovers the full payment or receives a no-payment bill for prepayment full recovery cases. Where the "full recovery" is paid in installments, it counts the claim as pending until all monies have been received. Instructions for processing full recovery claims are in the Medicare Claims Processing Manual, Chapter 29, Coordination with Medigap insurers. A. Prepayment Full Recovery - A prepayment full recovery occurs when a primary payer makes full payment on a charge before Medicare makes any payment. EXAMPLE: A hospital identifies an EGHP as the primary payer, submits its charge to that insurer, and the EGHP pays the hospital's full cost. The intermediary subsequently receive a "no pay" bill in accordance with the Medicare Claims Processing Manual, Chapter 29, Coordination with Medigap insurers. It determines what it would have paid if the EGHP had not made payment and records that total as a full recovery savings. B. Postpayment Full Recovery - A postpayment full recovery occurs when a primary payer makes full payment on a charge after Medicare has paid. EXAMPLE: Medicare paid a hospital bill for charges incurred as a result of an automobile accident. Subsequently, an auto liability insurer reimburses the Medicare beneficiary for the full amount of the medical expenses and the beneficiary refunds that amount to the program. The intermediary counts the amount of Medicare's initial payment as a postpayment full recovery. The intermediary records as savings, that portion of a full recovery paid to an attorney or other agent as Medicare's share of the recovery cost. Consequently, there may be instances where it has made a full recovery but does not get back the full amount paid. When it refers a case to the RO for recovery action, however, it does not record any savings at that point. Savings from a compromise or "subrogation" case may be recorded only after a final determination. The intermediary does not count these cases for CPEP credit prior to final settlement. EXAMPLE: A beneficiary incurs a $1,000 physician's bill and a $5,000 hospital bill as a result of injuries sustained in an automobile accident. Assuming that all deductibles are satisfied, Part B pays $800 toward the physician's charges, and Part A covers the hospital bill in full. After litigation, a liability insurer agrees to pay $6,000 for the beneficiary's medical expenses from which the attorney takes a fee. (If the attorney's fee were 33 percent, the dollar recovery would be $4,000.) The Part B contractor can record $800 in Full Recovery savings. The intermediary is also allowed to count its payment as a Full Recovery savings even though the amount recovered, due to attorney's fees, does not equal what was paid. Partial Recoveries Line 5 - Number - The intermediary reports the number of partial recoveries made during the month. Line 6 - Dollar Value - The intermediary reports the dollar value of partial recoveries made during the month.
Partial recoveries are those savings realized when a primary payer makes a payment which covers only a part of the Medicare allowable charge, leaving Medicare with a balance to pay. The intermediary uses the following formula in computing the savings from a partial recovery: • The dollar amount of Medicare benefits available for the services or supplies (calculated as if Medicare were the primary payer) less the Medicare benefits paid for the services or supplies, equals the partial recovery savings. (Primary Payment -Actual Payment = Partial Recovery Savings) The intermediary counts partial recoveries in the month when it takes final action on the claim (either making a payment supplemental to that of the primary payer or making a partial recovery from a payment by the primary payer). Instructions for processing partial recovery claims are in the Medicare Claims Processing Manual, Chapter 29, Coordination with Medigap insurers. It records as savings, that portion of a partial recovery paid to an attorney or other agent as Medicare's share of the recovery cost. When it refers a case to the RO for recovery action, however, It does not record any savings at that point. Savings from a compromise or "subrogation" case may be recorded only after a final determination. These cases may not be counted for CPEP credit prior to final settlement. Totals In this part of the report (lines 7 and 8), the intermediary reports data on the totals of unpaid claims plus full and partial recoveries. Line 7 - Claims - The intermediary reports the total number of MSP claims handled during the month. Line 8 - Dollar Value - The intermediary reports the total dollar value associated with MSP claims during the month. Pending Claims/Cases Line 9 - Number - The intermediary reports the number of pending claims/cases as of the close of the reporting month. It includes claims/cases for which "Full Recovery" is expected but all money due has not been received. Line 10 - Estimated Value - The intermediary reports the gross charges for all claims/cases reported as pending on line 9. Where "Full Recovery or Partial Recovery" has been determined, but all monies have not been received, it reports the gross charges until it receives the full amount due or it is reasonable not to expect further payments. A case is defined as one or more claims filed on behalf of an individual and related to one specific occurrence that necessitated medical care. When recording data for column 1 concerning WC and Auto Liability, and No Fault Insurance, the intermediary counts only cases. For Working Aged (column iii), ESRD (column iv), and Disabled (column vi), it counts each individual claim.
A case/claim is pending only after it has been developed to the point where it is determined to be an MSP claim and no final resolution has been made. A partial or interim payment is not sufficient to remove a case/claim from the pending rolls. Final resolution occurs when there is no longer a practical expectation of further reimbursement. Remarks - The intermediary enters any comments relevant to the interpretation and analysis of the report. Signature - The report is signed by the individual responsible for its compilation. Date - The intermediary enters the Date that the report is completed and signed. 80.9 - Electronic Submission (Rev. 6, 08-30-02) A3-3899.9 A. Keying CMS-1563 • The intermediary uses existing RLINK dialup instructions. • The intermediary keys the letter "L" to bring up blank CMS-1563. • The intermediary enters a valid 5 digit intermediary number. It uses the tab key to move from column to column. • The intermediary enters the reporting period using numeric designation month and year, e.g., 0102 for January 2002. • The intermediary enters two-position alpha State code. • The intermediary completes each column of data. Fields with zero need not be keyed. The system will presume all blank fields to be zero. • The intermediary does not key dollar signs or commas in money fields. It keys only whole dollar amounts. • After completing the form, the intermediary keys F1. The system will edit and print any error messages on the line above "contractor number." The intermediary tabs to the incorrect field and rekeys a correct entry. When the form passes all edits, the line will read "record has been written." The intermediary keys F4 to return to the menu. • To abort at any time without writing a record, the intermediary keys F3 and refers to CICS instructions. • To verify that a report has been written, the intermediary returns to the main menu (F4) and keys "L" to bring up a blank form. It keys in contractor number, reporting period and State code. It keys F7. The completed report appears on the screen.
B. Edits for CMS-1563 • A valid 5-digit intermediary number is required. • The default value for areas not keyed is zero. • Appropriate reporting period (MMYY) is required. • Two-position alpha State code is required. • Lines 1 + 3 + 5 must equal line 7 for all columns. • Lines 2 + 4 + 6 must equal line 8 for all columns. • Line 10 must be equal to or greater than line 9 for all columns unless line 9 is zero. In that case line 10 must also be zero. • For each line of the report column i must equal the sum of columns ii + iii + iv + v + vi. 90 – Monthly Intermediary Part A and Part B Appeals Report (Form CMS-2591) (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) At the end of each month, prepare and transmit to CMS a report summarizing activity on Part A reconsiderations, Part A Administrative Law Judge (ALJ) hearings, Part B reviews, and Part B hearings during the month. Complete a separate report for each office assigned a separate intermediary number. Form CMS-2591 is subject to the Paperwork Reduction Act and requires approval by the Office of Management and Budget (OMB). OMB approval has been requested. 90.1 – Purpose and Scope (Rev. 45, 05-28-04) The CMS-2591 (see §3890 - Exhibits 1 thru 6) enables CMS to tabulate data for administrative purposes on the following information: • The number of reconsiderations, reviews and hearings requested, completed, and pending; • The number of reconsiderations, reviews and hearings resulting in affirmations or reversals of previous determinations; • The number of reconsiderations, reviews and hearings involving waiver of liability determinations, and dollar amount of charges allowed; • Data on timeliness; and • The number of Part A and Part B reopenings.
90.2 – Due Date (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) Transmit the CMS-2591 to CO via PC or terminal. Use instructions in the CROWD User Guide available via the CMS Enterprise Portal. The report is due as soon as possible after the end of the reporting month but no later than the 15th of the month following the end of the reporting month. 100 – Completion of Items on Form CMS-2591 (Rev. 45, 05-28-04) 100.1 – Heading (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) This report is referenced as Form J for CROWD. It submits the appropriate information for the reporting period for each office assigned a separate contractor number and BSI. 100.2 – Section A – Intermediary Appeal Requests (Rev. 45, 05-28-04) This part concerns data from Part A and Part B appeals processes. The number of appeals requested (received), completed, and pending reflects the status of the workload as of the last day of the reporting month. Base data on actual counts of each activity and not on sampling or other estimating techniques. Appeals fall into the following categories: 1. Part A Reconsideration.--This is the first level of appeal following denial of a Part A claim. It is a re-evaluation of the facts and findings of a claim to determine whether the initial decision was correct. (See §3781.) Do not count duplicate reconsideration requests or reconsideration requests received before you have made an initial determination on a claim. Do not count telephone requests for reconsiderations or inquiries. Count one reconsideration per request received. With the exception of line 7 of the CMS-2591, do not count the number of claims or beneficiaries involved in the requests. 2. Part B Review.--This is the first formal level of appeal following denial of a Part B claim. It is a second look by a different employee at the claim and supporting evidence. (See §§3792 ff.) 3. Part B Hearing.--This is an independent determination resulting from an appeal of your review decision. This independent determination is rendered by a Hearing Officer (HO) you assigned. The amount in controversy must be at least $100. (See §§3794ff.) Definition of Columns:
Column (1) TOTAL--All Part A reconsiderations. Column 1 must equal the sum of columns 2, 3 and 4. Column (2) SNF.--All skilled nursing facility reconsiderations. Column (3) HHA/HOSPICE.--All home health agency and hospice reconsiderations. Column (4) OTHER.--All other Part A reconsiderations. Column (5) PART B REVIEWS.--Count one review per request received (i.e., Form CMS-1964 or equivalent written request). Do not count duplicate review requests or review requests received before you have made an initial determination on a claim. With the exception of line 7 of the CMS-2591, do not count the number of claims or beneficiaries involved in the requests. (Report claim counts in line 7.) Column (6) PART B HEARINGS.--Count one hearing per request received (i.e., Form CMS- 1965 or equivalent written request). Include hearings requested that do not meet the minimum $100 requirements and are subsequently dismissed. With the exception of line 7 of the CMS-2591, do not count the number of claims or beneficiaries involved in the requests. (Report claim counts in line 7.) Do not count hearing requests that qualify for a Part B ALJ hearing. (Part B intermediary hearings are those Part B hearings that a hearing officer adjudicates, as opposed to an ALJ). See definition for Section C. Do not count requests for HO hearings received after you rendered an on-the-record (OTR) decision in lines 1-44 of the report. Count these cases only in lines 45, 46, 47, 48 and 50 as appropriate. Line 1. Opening Pending.--Show under columns 1-4, the number of reconsiderations reported on line 19 as the closing pending on the previous month's report. Show under column 5 the number of reviews reported on line 30 as the closing pending on the previous month's report. Show under column 6 the number of hearings reported on line 40 as the closing pending on the previous month's report. Line 2. Adjustments to Pending.--If it is necessary to revise the pending figure for the close of the previous month because of inventories or reporting errors, enter the adjustment. Report requests received near the end of the reporting month and placed under control in the subsequent month as received in the reporting month, not as requests received in the subsequent month. If some cases were not counted in the proper month's receipts, count them as adjustments to the opening pending in the subsequent month. If line 3 of the current month differs from the closing pending of the previous month, there must be an entry in line 2 for the current month. Precede the entry by a "+" or "-", as appropriate. Line 3. Adjusted Pending.--Enter the result of line 1 + line 2 (taking into account the "-" sign, if any). Line 4. Requests Received.--Show, under the appropriate columns, the number of requests for reconsiderations, reviews, and Part B intermediary hearings received during the reporting month.
Include requests transferred to you by other intermediaries if you incur administrative costs for processing the appeals and you report the cost on the Interim Expenditure Report (Form CMS- 1523). If an appellant submits one request involving several different claims (and several different beneficiaries), count it as one request. If an appellant submits more than one request (for different claims) at different times, count each request. NOTE: See definition of column (6) for instructions on hearings requested subsequent to OTR decisions. Line 4A. Medical Necessity Documentation Denials.--Show the number of requests included in line 4 that involved initial claim denials for lack of medical documentation. Line 5. Requests Transferred.--Show under columns 1 thru 5 the number of reconsiderations and review requests you transferred to other contractors because you did not process the original claim(s). Report under column 6 the number of Part B hearing requests transferred to other contractors because the claimant is not within your geographical area (See §3794.3B) or transferred to ROs because the issues are outside the HO's responsibilities. (See §3794.2.) For columns 1-6, if you have reported a reconsideration, review or Part B hearing as transferred, do not report any information regarding it on lines 6-51. The transfer is the final action. Line 6. Requests Cleared.--Show, under the appropriate columns, the total numbers of reconsiderations, reviews, and Part B hearings completed during the month. Report all completed appeals, regardless if final outcome was affirmation, reversal, withdrawal, or dismissal. Consider a reconsideration or review cleared when the final determination (EOMB or other notice, including dismissal) is printed or typed, or upon notification of withdrawal by the appellant. In the case of a reversal, consider the case cleared when you initiate the adjustment action. A Part B hearing may be considered cleared when the decision is signed, or the following conditions exist: o The claimant indicates that he/she is satisfied with the On-The-Record (OTR) decision; o The claimant indicates after the OTR decision that he/she wishes to proceed with an ALJ hearing (if the amount in controversy is $500 or more); o The HO dismisses the hearing request; or o The appellant withdraws the hearing request. Do not consider a hearing completed upon release of an OTR decision unless the appellant specifically requested an OTR hearing. Do not count the OTR hearing as completed until you have completed all follow-up actions as required in §3794.9. If as a result of the follow-up actions, the appellant requests an in-person or telephone hearing after release of the OTR decision, the OTR hearing and decision are not counted on the report with the exception noted below. If the appellant does not appear for the subsequent hearing, dismiss the hearing. (See §3794.3K.) For
processing time purposes, the case is completed when you dismiss it; however, the decision to record in lines 9-11 is the OTR decision. NOTE: If you close a reconsideration, review or hearing after the end of a reporting month but before the report is due on the fifteenth of the subsequent month, do not count it until the subsequent month's report. Line 7. No. of Claims Involved.--Show on line 6 the total number of claims involved in the appeals reported as cleared during the month. For example, if you process one HHA reconsideration decision which involves five claims, report five claims under column (3), or if you process decisions for two Part B hearings in the month, one of which involved three claims and the other seven, report 10 claims under column (6). Line 8. Amount in Controversy.--For Part B hearings reported as affirmed (line 9) or reversed (line 11) during the month, show the total dollar amount in controversy on the initial requests. The amount in controversy is the difference between the amount billed (less any reductions required by legislation, e.g., Gramm-Rudman-Hollings) and the amount you originally allowed less any unmet deductible and coinsurance amounts. In effect, the amount in controversy is the amount of payment that the claimant would receive if the denial(s) was fully reversed. Show results rounded to the nearest dollar. Line 9. Affirmations.--Under the appropriate columns, show the number of completed reconsiderations, reviews, and Part B hearings in which the previous determinations were completely upheld; i.e., no change was made. All parts of all claims in a case must be upheld in order for the case to be counted as an affirmation. An OTR hearing decision does not count as a previous decision if the appellant subsequently requests an in-person or telephone hearing. If the in-person/telephone hearing is dismissed because the appellant did not appear, or the request was withdrawn, use the OTR decision to determine if the case is counted here. (See line 11 for partial affirmations. Do not include them here.) If you uphold your original determination, but pay under limitation of liability, count the determination as an affirmation. Report the appropriate information in Section D of the CMS- 2591. Line 10. Dism./Withdr.--Report, under the appropriate column, the number of completed reconsiderations, reviews, and Part B hearings that were withdrawn by the appellant or dismissed (before determination) by you or the HO. Report here and in lines 4 and 6 an appeal that is requested and withdrawn or dismissed within the same month. If the appellant requests an in- person or telephone hearing after receiving an OTR decision, and you dismiss the hearing because the appellant failed to appear, the OTR decision is the final decision, not the dismissal. Similarly, for a withdrawal, use the OTR decision. A dismissal at the reconsideration or review level is done when written correspondence has been identified as an appeal request, but the claimant does not have the right to an appeal. Misrouted correspondence and duplicate requests are not dismissals. If you have incorrectly counted such correspondence as an appeal on a previous report, use line 2 (adjustments to pending) to correct the count. Do not count a duplicate request for appeal
anywhere on the report. Likewise, do not count on the report a request for appeal received before an initial claim determination has been rendered. (Consider the request an inquiry.) Line 11. Reversals (Full or Part).--Under the appropriate columns, show the total number of completed reconsiderations, reviews, and Part B hearings in which at least part of the prior determination was reversed. That is, a change was made and some or all of the new determination was in favor of the appellant. If a reconsideration, review, or Part B hearing involves several claims, and the initial determinations for some are affirmed and some are reversed, consider the decision a reversal. An OTR hearing decision does not count as a previous decision if the appellant subsequently requests an in-person or telephone hearing. If the in-person/telephone hearing is dismissed because the appellant did not appear, or the request was withdrawn, use the OTR decision to determine if the case is counted here. Line 12. Amount Awarded.--For cases included in line 11, show the amount of submitted charges for services where the determination was reversed. Show charges prior to application of the deductible and coinsurance. Round results to the nearest dollar. Processing and Pending Times.--This deals with processing and pending times for Part A and Part B appeals. Computing Time to Process Part A Reconsiderations and Part B Reviews for (Lines 13-18 and 25- 29) For lines 13-18 and 25-29, use the matrix below to determine the number of days from receipt to completion of reconsiderations and reviews. The date of receipt in all cases is the day the processing contractor received it in its corporate mailroom. Situation Date Completed • The appellant withdraws the request. The date you were notified of the withdrawal. • You dismiss the request or affirm the original determination. The date of the notice. • You process the request to a reversal. The date when you submit the claim to CWF if payment can be made without further development, or when you initiate development; e.g., when you must ascertain whether or not the provider has refunded payment to the beneficiary. Computing Time to Process Part B Hearings for Lines 35-39 For lines 35-39, use the matrix below to determine the number of days from receipt to completion of Part B hearings. The date of receipt, in all cases, is the day you receive the appeal request in its corporate mailroom. In out-of-area cases, it is the date that the second intermediary receives the request.
Situation Date Completed An OTR decision is made and the appellant accepts the decision or decided to go directly to an ALJ hearing. The date of the OTR decision. An OTR decision is made and the appellant chooses in a timely fashion to proceed with the in- person or telephone hearing. The date of the second decision. If the appellant appears, and you dismiss the hearing, use the date of notice of dismissal. An in-person or telephone hearing is held without an OTR decision. The date of the decision. The appellant withdraws the hearing request. The date you are notified of the withdrawal. The HO dismisses the hearing request. The date of the dismissal notice. RECONSIDERATIONS Line 13. Processing Time - Average.--Report under the appropriate columns the average number of days from receipt of the reconsideration to the date of completion. To compute the average number of days from request to completion, divide the total days elapsed for all requests cleared in the month by the number of requests cleared. Round results to the nearest day. Calculate the days elapsed for an individual request by subtracting the Julian date of receipt from the Julian date of completion. If the request is cleared in the year following the year of receipt, add 365 or 366 to the result, as appropriate. (Otherwise, you will get a negative number.) If a case is cleared the same day it is received, consider it to require 1 day. NOTE: Include all cases cleared, regardless of whether they were affirmed, reversed, dismissed, or withdrawn. Line 14. Reconsiderations Completed 1-45 Days.--Show the number of reconsiderations that required 1-45 days, to complete. If a case is cleared the same day it is received, consider it to require 1 day. Line 15. Reconsiderations Completed 46-60 Days.--Show the number of reconsiderations that required 46-60 days to complete. Line 16. Reconsiderations Completed 61-90 Days.--Show the number of reconsiderations that required 61-90 days to complete. Line 17. Reconsiderations Completed 91-120 Days.--Show the number of reconsiderations that required 91-120 days to complete. Line 18. Reconsiderations Completed over 120 Days.--Show the number of reconsiderations that required more than 120 days to complete.
Line 19. Closing Pending Reconsiderations.--Show, under the appropriate columns, the total number of reconsiderations that have not been completed by the end of the reporting month. Line 20. Reconsiderations Pending 1-45 Days.--Show the number of reconsiderations included in line 19 that have been pending 1-45 days, inclusive, at the end of the reporting month. Line 21. Reconsiderations Pending 46-60 Days.--Show the number of reconsiderations included in line 19 that have been pending 46-60 days, inclusive, at the end of the reporting month. Line 22. Reconsiderations Pending 61-90 Days.--Show the number of reconsiderations included in line 19 that have been pending 61-90 days, inclusive, at the end of the reporting month. Line 23. Reconsiderations Pending 91-120 Days.--Show the number of reconsiderations included in line 19 which have been pending 91-120 days, inclusive, at the end of the reporting month. Line 24. Reconsiderations Pending Over 120 Days.--Show the number of reconsiderations included in line 19 which have been pending more than 120 days at the end of the reporting month. REVIEWS Line 25. Processing Time - Average.--Report here the average number of days from the receipt of the review to the date of completion. To compute the average number of days from request to completion, divide the total days elapsed for all requests cleared in the month by the number of requests cleared. Round results to the nearest day. Calculate the days elapsed for an individual request by subtracting the Julian date of receipt from the Julian date of completion. If the request is cleared in the year following the year of receipt, add 365 or 366 to the result, as appropriate. (Otherwise, you will get a negative number.) If a case is cleared the same day it is received, consider it to require 1 day. NOTE: Include all cases cleared, regardless of whether they were affirmed, reversed, dismissed, or withdrawn. Line 26. Reviews Completed in 1-30 Days.--Show the number of cases that required 1-30 days to complete. If a case is cleared the same day it is received, consider it to require 1 day. Line 27. Reviews Completed in 31-45 Days.--Show the number of reviews that required 31-45 days to complete. Line 28. Reviews Completed in 46-60 Days.--Show the number of reviews that required 46-60 days to complete. Line 29. Reviews Completed in 61+ Days.--Show the number of reviews that required more than 60 days to complete. Line 30. Closing Pending-Reviews.--Show the total number of reviews that have not been completed by the end of the reporting month.
Line 31. Reviews Pending 1-30 Days.--Show the number of reviews included in line 30 that have been pending 1-30 days, inclusive, at the end of the reporting month. Line 32. Reviews Pending 31-45 Days.--Show the number of reviews included in line 30 that have been pending 31-45 days, inclusive, at the end of the reporting month. Line 33. Reviews Pending 46-60 Days.--Show the number of reviews included in line 30 that have been pending 46-60 days, inclusive, at the end of the reporting month. Line 34. Reviews Pending Over 60 Days.--Show the number of reviews included in line 30 that have been pending more than 60 days at the end of the reporting month. PART B HEARINGS Line 35. Hearing Processing Time - Average.--Report the average number of days from receipt of the hearing request to date of completion. See methodology under line 25. Line 36. Hearings Completed in 60 Days.--Show the number of hearings that required 1-60 days to complete. If a case is cleared the same day it is received, consider it to require 1 day. Line 37. Hearings Completed in 61-90 Days.--Show the number of hearings that required 61-90 days to complete. Line 38. Hearings Completed 91-120 Days.--Show the number of hearings that required 91-120 days to complete. Line 39. Hearings Completed Over 120 Days.--Show the number of hearings that required more than 120 days to complete. Line 40. Closing Pending-Hearings.--Show the total number of hearings that have not been completed by the end of the reporting month. You may not consider a hearing completed upon release of an OTR decision unless the appellant specifically requested an OTR hearing. See definition for line 6. Line 41. Hearings Pending 1-60 Days.--Show the number of hearings included in line 40 that have been pending 1-60 days, inclusive, at the end of the reporting month. Line 42. Hearings Pending 61-90 Days.--Show the number of hearings included in line 40 which have been pending 61-90 days, inclusive, at the end of the reporting month. Line 43. Hearings Pending 91-120 Days.--Show the number of hearings included in line 40 which have been pending 91-120 days, inclusive, at the end of the reporting month. Line 44. Hearings Pending Over 120 Days.--Show the number of hearings included in line 40 that have been pending more than 120 days at the end of the reporting month. 100.3 – Section B – Part B Hearing Results
(Rev. 45, 05-28-04) Section B deals with data on Part B hearings completed during the month. Base data shown on actual counts of each activity and not derived from sampling or other estimating techniques. HEARINGS FALL INTO THE FOLLOWING CATEGORIES: Column (1) On-the-Record with No Subsequent Hearing.--Include in column 1 hearings held where the appellant originally requested an OTR hearing, indicates that he/she is satisfied with the OTR decision, that he/she wishes to proceed with an ALJ hearing (if the amount in controversy is $500 or more), or fails to respond to the OTR within the required time frame. In addition, if the appellant requests an in-person or telephone hearing subsequent to an OTR decision, but the hearing is dismissed or withdrawn, include it here and not in columns (2) or (3). Column (2) All Telephone.--Include in column 2, hearings where the appellant requested and had a telephone hearing subsequent to an OTR hearing decision, or a telephone hearing was held without a prior OTR decision. Count all telephone hearings including those where the appellant did not follow-up timely to the OTR notice, but later requested a telephone hearing. Column (3) All In-Person.--Include in column 3 hearings where the appellant requested and had an in-person hearing subsequent to an OTR hearing decision, or an in- person hearing was held without a prior OTR decision. Count all in-person hearings including those where the appellant did not follow-up timely to the OTR notice but later requested an in-person hearing. Column (4) Number in 120 Days.--For the total cases included in line 47, columns 2 and 3, (e.g., the sum) show for lines 49-51 the numbers that were completed within 120 days of receipt. Use the methodology shown above the explanation for line 13 to determine the completion date. Where an OTR decision is made and the appellant chooses to not follow-up timely and later requests either an in- person or telephone hearing, completion time for this second reported hearing is measured from the date of receipt of original request to the date of the second decision. If the appellant does not appear, dismiss the hearing in accordance with §3794.3k, and use the date of notice of dismissal as your date completed. Line 45. Reversals.--Under the appropriate columns, show the number of OTR, telephone, and in- person hearings completed in the month in which at least part of the review determination was reversed i.e., a change was made and some, or all, of the new determination was in favor of the appellant. (See the definition for line 11.) Line 46. Affirmations.--Under the appropriate columns, show the number of OTR, telephone, and in-person hearings completed in the month in which the review determination was completely upheld, i.e., no change was made. All parts of all claims must be upheld in order for the case to be counted as an affirmation. (See the definition for line 9.)
Line 47. Total Decisions.--Show the total number of hearing decisions completed during the month that resulted in a reversal or affirmation, excluding dismissals and withdrawals. Line 48. Number in 120 Days.--For cases included in line 47, show the number that were completed within 120 days of receipt. See methodology for column 4 to determine the completion date. Line 49. No Previous OTR Held.--For cases included in line 47, columns (2) and (3), report the number where you held the telephone or in-person hearing without first making an OTR decision, i.e., the OTR hearing was bypassed. In column (4), report the number of cases included in either column (2) or (3) which were completed within 120 days. Line 50. Previous OTR Counted.--For the cases included in line 47, columns (2) and (3), report the number where you included the OTR count on a previous report. In column (4), report the number of cases included in either column (2) or (3) that were completed within 120 days. Cases reported in line 50 are those where an OTR decision was made and the appellant either accepted the OTR decision, did not respond timely, or decided to go directly from the OTR decision to an ALJ hearing. Then, subsequent to this OTR decision "acceptance," the appellant changed his/her mind and decided that he/she wanted a telephone or in-person hearing. Do not include these cases in line 6. Line 51. Previous OTR Not Counted.--For cases included in line 47, columns (2) and (3), report the number where you did not include the OTR count on a previous report. These are cases where you made the OTR decision first, and the appellant indicated in a timely fashion (see §3794.9) that he/she wanted a telephone or in-person hearing. In column (4), report the number of cases included in either column (2) or (3) that were completed within 120 days. 100.4 – Section C – Part A and Part B ALJ Hearings (Rev. 45, 05-28-04) Use Section C to report requests for ALJ hearings, including those expected to be dismissed for failure to meet the amount in controversy requirement or for any other reason, such as the lack of a fair hearing in Part B cases. ALJ HEARINGS FALL INTO THE FOLLOWING CATEGORIES: Column (1) TOTAL.--All Part A ALJ hearing requests as originally filed. Column 1 must equal the sum of columns 2, 3 and 4. Column (2) SNF.--All skilled nursing facility (SNF) hearings. Column (3) HHA/HOSPICE.--All home health agency (HHA) and hospice hearings. Column (4) OTHER.--All other hearings.
Column (5) PART B.--All Part B ALJ hearings. Line 52. Opening Pending.--Show the number of ALJ hearings reported on Line 67 as the closing pending on the previous month's report. Line 53. Adjustments to Pending.--See definition for line 2. If line 54 of the current month differs from data in line 67 of the previous month, there must be an entry in line 53 for the current month. Precede the entry by a "+" or "-" as appropriate. Line 54. Adjusted Pending.--Show the result of line 52 + line 53 (taking into account the "-" sign, if any). Line 55. Requests Received.--Show the number of ALJ hearings requested during the month. (See §3797) Line 56. Requests Forwarded to ALJ.--Show the number of ALJ hearing requests forwarded to ALJs during the month. Consider the case forwarded when all necessary material has been mailed to the ALJ. Line 57. No. of Claims Involved.--Show the number of claims involved in the ALJ hearing requests forwarded to ALJs as reported on line 56. Line 58. In 1-7 Calendar Days.--Show the number of ALJ hearing requests forwarded to ALJs within 7 calendar days from receipt of the request in the corporate mailroom to mailing of the necessary information. Show data for all cases mailed during the month. The number must be less than, or equal to, the number shown in line 56. Line 59. In 1-14 Calendar Days.--Show the number of ALJ hearing requests forwarded to ALJs within 14 calendar days from receipt of the request in the corporate mailroom to mailing of the necessary information to the ALJ. Show data for all cases mailed during the month. Note that the number in this line must be less than or equal to the number shown in line 56. Line 60. Average Time to Forward.--Report the average number of calendar days from receipt of the ALJ request to the date of mailing of the necessary information. Use the methodology discussed in §3888.2 for line 13. Line 61. Completed.--Show the number of ALJ hearing requests completed during the month. Consider a case completed when you have received the completed decision from the ALJ for all parts of the case. Line 62. Amount in Controversy.--For ALJ hearings reported as affirmed (line 63) or reversed (line 65), during the month, show the total dollar amount in controversy according to the initial ALJ hearing request. This should be the amount remaining after previous appeals decisions. Round results to the nearest dollar. Line 63. Affirmations.--Show the number of completed ALJ hearings in which the previous determination was completely upheld, i.e., no change was made. All parts of all claims in a case must be upheld in order for the case to be counted as an affirmation. See line 65 for partial affirmations. (Do not include partial affirmations on this line.)
If the prior determination was upheld, but payment was made under limitation of liability, count the ALJ hearing determination as an affirmation. Report the appropriate information in lines 77 and 78. Line 64. Dismissals/Withdrawals.--Show the number of completed hearings that were withdrawn by the appellant or dismissed (before determination) by the ALJ. Report an appeal that was requested and withdrawn or dismissed within the same month here and in lines 55, 56, and 61. Line 65. Reversals (Full or Part).--Show the total number of completed ALJ hearings in which at least part of the prior determination was reversed; i.e., a change was made and some or all of the new determination was in favor of the appellant. For example, if an ALJ hearing involved several claims, and the initial determinations for some were affirmed and some were reversed, consider the decision to be a reversal. Line 66. Amount Awarded.--For cases included in line 65, show the amount of submitted charges for services where the determination was reversed. Show charges prior to application of the deductible and coinsurance. Round results to the nearest dollar. Line 67. Closing Pending.--Show the total number of ALJ hearing requests that were not completed by the end of the reporting month. Consider a case transferred to an ALJ as pending until you have received the completed decision from the ALJ for all parts of the case. ALJ DISPOSITIONS Line 68. Number of Dispositions.--Report the number of dispositions rendered by the ALJ(s) in cases reported as cleared for the month in Line 61. There will usually be more ALJ dispositions than cases counted in line 61. Do not count a case in line 61 until the ALJ has cleared all of the claims included in the request for hearing. EXAMPLE: You forwarded one request to an ALJ involving 20 claims. The ALJ dismisses 10 claims at once. A month later, the ALJ decides to affirm the original decision on 5 others as one group. The other five claims receive separate determinations. This would be counted as seven dispositions. Line 69. Affirmations.--Of those dispositions shown in line 68, report the number of decisions rendered by the ALJ(s) that were completely upheld. Line 70. Dismissals/Withdrawals.--Of those dispositions shown in line 68, report the number of dismissals and withdrawals issued by the ALJ(s). Line 71. Reversals.--Of those dispositions shown in line 68, report the number of decisions rendered by the ALJ (s) in which at least part of the prior determination was reversed. EFFECTUATION OF ALJ DECISIONS Line 72. Total Effectuations.--Show the number of ALJ hearing decisions for which you initiated effectuation during the month. Consider effectuation of a decision to be initiated when you:
o Submit the claim to CWF if payment can be made without further development; or o Initiate development, e.g., when you must determine whether or not the provider has refunded payment to the beneficiary. Line 73. Number 1-7 Days.--Show the number of cases where you effectuated the decision within 7 days. Effectuation days include day of receipt of the decision in your corporate mailroom. Line 74. Number 8-15 Days.--Show the number of cases where you effectuated the decision within 8-15 days. Line 75. Number 16-30 Days.--Show the number of cases where you effectuated the decision within 16-30 days. Line 76. Number Over 30 Days.--Show the number of cases where you effectuated the decision in more than 30 days. LIMITATION OF LIABILITY DETERMINATION IN ALJ CASES Line 77. No. Waived - Ben. and Prov..--Show the number of claims in ALJ hearings during the reporting month where the liability of both the beneficiary and provider was limited. Line 78. Amount Awarded.--For claims included in line 77, show the amount of the submitted charges for services where the liability was limited (including non-covered services where the liability of the beneficiary and provider are limited.) Show charges prior to application of the deductible and coinsurance. Round results to the nearest dollar. 100.5 – Section D – Limitation of Liability (Rev. 45, 05-28-04) Section D concerns requests involving limitation of liability determinations in Part A reconsiderations, Part B reviews and Part B hearings. To include a claim in lines 79-82, you must have originally denied it or reduced it for medical necessity or custodial care reasons. Lines 80-82 are mutually exclusive; i.e., a claim meeting the above conditions may be counted on only one of three lines. Therefore, ensure that the sum of the number of the claims recorded on each of these lines equals the total number of claims considered for limitation of liability during the period as reported on line 79. The counts in lines 79-82 reflect counts of claims. Report cases corresponding to the claims counted in Section A, as appropriate. If a claim is considered for limitation of liability at the initial claim level, do not count it at the review or hearing level unless you change the limitation of liability decision. Categorize claims for the columns shown in Section D according to the adjudication level at which limitation of liability is considered or granted. If you make several different limitation of liability decisions on the same claim, use the highest numbered line (out of 80-82) on the report that applies to that claim. Count the claim only once.
For example, if you waive both the beneficiary and provider liability on any part of the claim, count the claim on line 82. Line 79. Total Number Considered.--Show, under the appropriate columns, the number of claims, meeting the conditions above, for which limitation of liability was considered during the month. Line 80. No. Considered - Not Waived.--Show, under the appropriate columns the number of claims that meet the conditions above, on which limitation of liability was considered, but was not granted to the beneficiary. This also includes cases where only provider liability is waived. Line 81. No. Waived - Ben. Only.--Show, under the appropriate columns, the numbers of claims that meet the conditions above, where the liability of only the beneficiary was limited. Line 82. No. Waived - Ben. and Prov.--Show, under the appropriate columns, the numbers of claims where the liability of both the beneficiary and provider was limited. Line 83. Amount Awarded.--For cases included in line 82, show the amount of the submitted charges for services where liability was limited (including noncovered services where liability of the beneficiary and provider are limited). Show charges prior to application of the deductible and coinsurance. Round results to nearest dollar. 100.6 – Section E – Part A and Part B Reopenings (Rev. 45, 05-28-04) Report the number of Part A and Part B claims involved in reopenings completed during the month. See §3795 for discussion of what constitutes a reopening. Include reopenings which do not result in revisions. Claims review, reconsideration, Part B hearings, and ALJ hearings undertaken as part of the appeal process are not reopenings. PART A REOPENINGS FALL INTO THE FOLLOWING CATEGORIES: Column (1) Total.--All reopenings completed. Column (2) Pre-Recon.--All reopenings of initial claim determinations. If a claim has been through a reconsideration, do not count it here. Column (3) Post-Recon.--All reopenings of reconsideration determinations. If a claim has been through any type of hearing, do not count it here. Column (4) Post-ALJ Hearing.--All reopenings of ALJ hearing determinations. Once a claim has been through an ALJ hearing, count it here if it is reopened. Line 84. Total Number.--Show the number of claims in which the reopening of a claim, reconsideration, or hearing determination was completed, whether or not the determination was revised. Line 85. Unfavorable to Claimant.--Of the claims shown in line 84, show the number which resulted in a revision of a previously favorable decision.
Line 86. No Change.--Of the claims shown in line 84, show the number of claims that you reopened, but on which you did not change the initial determination. Line 87. Favorable to Claimant.--Of the claims shown in line 84, show the number which resulted in a favorable revision of a previously unfavorable decision. Line 88. Amount Awarded.--For cases included in line 87, show the amount of the submitted charges for services which involved a revision of a previously unfavorable decision. Show charges prior to application of the deductible and coinsurance. Round results to the nearest dollar. PART B REOPENINGS FALL INTO THE FOLLOWING CATEGORIES: Column (1) Total.--All reopenings completed. Column (2) Pre-Review.--All reopenings of initial claim determinations. If a claim has been through a review, or any type of hearing, do not count it here. Column (3) Post-Review.--All reopenings of review determinations. If a claim has been through any type of hearing, do not count it here. Column (4) Post-Hearing.--All reopenings of hearing determinations, regardless of the type of hearing; e.g., intermediary HO or ALJ. Once a claim has been through a hearing, count it here if it is reopened. Line 89. Total Number.--Show the number of claims in which the reopening of a claim, review or hearing determination was completed, whether or not the determination was revised. Line 90. Unfavorable to Claimant.--Of the claims shown in lines 89, show the number which resulted in an unfavorable revision of a previously favorable decision. Line 91. No Change.--Of the claims shown in line 89, show the number of claims that you reopened, but on which you did not change the initial determination. Line 92. Favorable to Claimant.--Of the claims shown in line 89, show the number which resulted in a favorable revision of a previously unfavorable decision. Line 93. Amount Awarded.--For cases included in line 92, show the amount of the submitted charges for services that involved a revision of a previously unfavorable decision. Show charges prior to application of the deductible and coinsurance. Round results to the nearest dollar. 110 – Checking Reports (Rev. 45, 05-28-04) Before you send the report to CMS, check for completeness and arithmetical accuracy. Use the following checklist for an arithmetical check for each column:
o Column 1 = Column 2 + Column 3 + Column 4 for lines 1-7, 9-12, 14-24, 52-59, and 61-93. o Line 1 for columns 1-4 must be equal to line 19 of the previous month. o Line 1 Column 5 must be equal to line 30 of the previous month. o Line 1 Column 6 must be equal to line 40 of the previous month. o Line 1 + line 2 = line 3. o Line 3 + line 4 - line 5 - line 6 = line 19 for columns 1-4. o Line 3 + line 4 - line 5 - line 6 for column 5 = line 30. o Line 3 + line 4 - line 5 - line 6 for column 6 = line 40. o Line 4A must be less than or equal to line 4. o Line 6 = line 9 + line 10 + line 11. o Line 6 = line 14 + line 15 + line 16 + line 17 + line 18 for column 1-4. o Line 6, column 5 = line 26 + line 27 + line 28 + line 29. o Line 6, column 6 = line 36 + line 37 + line 38 + line 39. o Line 7 must be greater than or equal to line 6. o Line 9 + line 11 for column 6 must be less than or equal to the sum of columns 1, 2, and 3 for line 47. o Line 19 = line 20 + line 21 + line 22 + line 23 + line 24. o Line 30 = line 31 + line 32 + line 33 + line 34. o Line 40 = line 41 + line 42 + line 43 + line 44. o Line 47 = line 45 + line 46 for columns 1-3. o Line 47 = line 49 + line 50 + line 51 for columns 2 and 3 only. o Line 48 must be less than or equal to line 47 for columns 1, 2, and 3. o Line 49 (column 4) must be less than or equal to line 49 (column 2) + line 49 (column 3). o Line 50 (column 4) must be less than or equal to the sum of line 50 (column 2) + line 50 (column 3).
o Line 51 (column 4) must be less than or equal to the sum of line 51 (column 2) + line 51 (column 3). o Line 52 must be equal to line 67 of the previous month. o Line 54 = line 52 + line 53. o Line 54 + line 55 - line 61 = line 67. o Line 57 must be greater than or equal to line 56. o Line 58 must be less than or equal to line 56. o Line 59 must be less than or equal to line 56. o Line 59 must be greater than or equal to line 58. o Line 61 = line 63 + line 64 + line 65. o Line 62 must be greater than or equal to 500 times the sum of lines 63 and 65 in Column (5) only (each case must involve at least $500 per case). o Line 66 must be greater than or equal to line 65 (must award at least $1 per case). o Line 68 = line 69 + line 70 + line 71. o Line 72 = line 73 + line 74 + line 75 + line 76. o Line 78 = must be greater than or equal to line 77 (at least $1 per claim). o Line 79 = line 80 + line 81 + line 82. o Line 83, must be greater than or equal to line 82 (at least $1 per claim). o Line 84 = line 85 + line 86 + line 87. o Line 88 must be greater than or equal to line 87 (at least $1 per claim). o Line 89 = line 90 + line 91 + line 92. o Line 93 must be greater than or equal to line 92 (at least $1 per claim). Public reporting burden for this collection of information is estimated to average 2 hours per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden to Office of Financial Management, CMS, P.O. Box 26684, Baltimore, MD 21207; and to the Office of Management and Budget, Paperwork Reduction Project Washington, DC 20503.
110.1 – Exhibit 1 (Rev. 45, 05-28-04) Medicare Program - Intermediary Part A and Part B Appeals Report - Form CMS-2591, Screen 1. INTERMEDIARY APPEALS REPORT INTERMEDIARY ID REPORTING PERIOD PART A RECONSIDERATIONS PART B A. INTERMEDIARY APPEAL REQUESTS TOT AL (1) SNF (2) HHA/ HOSPIC E (3) OTHE R (4) REVIE WS (5) HEARIN GS (6) 1. OPENING PENDING 2. ADJUSTMENTS TO PENDING 3. ADJUSTED PENDING 4. REQUESTS RECEIVED 4A. MED. NEC. DOC. DENIALS 5. REQUESTS TRANSFERRED 6. REQUESTS CLEARED 7. NO. OF CLAIMS INVOLVED 8. AMOUNT IN CONTROVERSY 9. AFFIRMATIONS 10. DISMISSAL/WITHDRAWALS 11. REVERSALS (FULL OR PART) 12. AMOUNT AWARDED Form CMS-2591 Screen 1
110.2 – Exhibit 2 (Rev. 45, 05-28-04) Medicare Program - Intermediary Part A and Part B Appeals Report - Form CMS-2591, Screen 2. INTERMEDIARY APPEALS REPORT INTERMEDIARY ID REPORTING PERIOD A. INTERMEDIARY APPEAL REQUESTS PART A RECONSIDERATIONS TOTAL SNF HHA/HOSPI CE OTHER (1) (2) (3) (4) PROCESSING TIMES 13. AVERAGE 14. NO. COMPLETED 1-45 DAYS 15. NO. COMPLETED 46-60 DAYS 16. NO. COMPLETED 61-90 DAYS 17. NO. COMPLETED 91-120 DAYS 18. NO. COMPLETED OVER 120 DAYS PENDING TIMES 19. CLOSING PENDING 20. NO. PENDING 1-45 DAYS 21. NO. PENDING 46-60 DAYS 22. NO. PENDING 61-90 DAYS 23. NO. PENDING 91-120 DAYS
24. NO. PENDING OVER 120 DAYS Form CMS-2591 Screen 2 110.3 – Exhibit 3 (Rev. 45, 05-28-04) Medicare Program - Intermediary Part A and Part B Appeals Report - Form CMS-2591, Screen 3 INTERMEDIARY APPEALS REPORT INTERMEDIARY ID REPORTING PERIOD A. INTERMEDIARY APPEAL REQUESTS REVIEWS PART B APPEALS Reviews Hearings (1) HEARINGS (2) PROCESSING TIMES PROCESSING TIMES 25. AVERAGE 35. AVERAGE 26. NO. 1-30 DAYS 36. NO. 1-60 DAYS 27. NO. 31-45 DAYS 37. NO. 61-90 DAYS 28. NO. 46-60 DAYS 38. NO. 91-120 DAYS 29. NO. OVER 60 DAYS 39. NO. OVER 120 DAYS PENDING TIMES PENDING TIMES 30. CLOSING PENDING 40. AVERAGE 31. NO. 1-30 DAYS 41. NO. 1-60 DAYS 32. NO. 31-45 DAYS 42. NO. 61-90 DAYS 33. NO. 46-60 DAYS 43. NO. 91-120 DAYS 34. NO. OVER 60 DAYS 44. NO. OVER 120 DAYS B. PART B OTR All All
HEARING RESULTS With No Subsequent (1) Telephone Hearings (2) In-Person Hearings (3) Number In 120 Days (4) 45. REVERSALS 46. AFFIRMATIONS 47. TOTAL DECISIONS 48. NBR IN 120 DAYS 49. NO PREV. OTR HELD 50. PREV. OTR COUNTED 51. PREV. OTR NOT CNTD Form CMS-2591 Screen 3 110.4 – Exhibit 4 (Rev. 45, 05-28-04) Medicare Program - Intermediary Part A and Part B Appeals Report - Form CMS-2591, Screen 4 INTERMEDIARY APPEALS REPORT INTERMEDIARY ID REPORT PERIOD C. PART A AND B ALJ HEARINGS PART A Total (1) SNF (2) HHA/Hospice (3) Other (4) Part B (5) 52. OPENING PENDING 53. ADJUSTMENTS TO PENDING 54. ADJUSTED OPENING PENDING 55. REQUESTS RECEIVED
56. REQUESTS FRWD. TO ALJ 57. NO. OF CLAIMS INVOLVED 58. NO. IN 7 CALENDAR DAYS 59. NO. IN 14 CALENDR DAYS 60. AVG. TIME TO FORWARD 61. COMPLETED 62. AMT. IN CONTROVERSY 63. AFFIRMATIONS 64. DISMISSALS/WITHDRAWALS 65. REVERSALS (FULL/PART) 66. AMOUNT AWARDED 67. CLOSING PENDING Form CMS-2591 Screen 4 110.5 – Exhibit 5 (Rev. 45, 05-28-04) Medicare Program - Intermediary Part A and Part B Appeals Report - Form CMS-2591, Screen 5 INTERMEDIARY APPEALS REPORT INTERMEDIARY ID REPORT PERIOD PART A C. PART A AND B ALJ HEARINGS Total (1) SNF (2) HHA/Hospice (3) Other (4) PART B (5)
DISPOSITIONS 68. NUMBER OF DISPOSITIONS 69. AFFIRMATIONS 70. DISMISSALS/WITHDRAWALS 71. REVERSALS (FULL OR PART) EFFECTUATIONS 72. TOTAL EFFECTUATIONS 73. NO. 1-7 DAYS 74. NO. 8-15 DAYS 75. NO. 16-30 DAYS 76. NO. OVER 30 DAYS LIMITATION OF LIABILITY 77. WAIVED - BEN & PROV. 78. AMOUNT AWARDED D. LIMITATION OF LIABILITY (CLAIM COUNTS) PART A RECONSIDERATIONS PART B Total (1) SNF (2) HHA/ Hospice (3) Other (4) Reviews (5) Hearings (6) 79. TOTAL NUMBER CONSIDERED 80. CONSIDERED - NOT WAIVED 81. WAIVED - BEN. ONLY 82. WAIVED - BEN. & PROV.
83. AMOUNT AWARDED Form CMS-2591 Screen 5 110.6 - Exhibit 6 (Rev. 45, 05-28-04) Medicare Program - Intermediary Part A and Part B Appeals Report - Form CMS-2591, Screen 6 INTERMEDIARY APPEALS REPORT INTERMEDIARY ID REPORT PERIOD E. REOPENINGS (Claims Count) PART A TOTAL (1) PRE- Recon (2) Post- Recon (3) Post-ALJ Hearing (4) 84. TOTAL 85. UNFAVORABLE TO CLAIMANT 86. NO CHANGE 87. FAVORABLE TO CLAIMANT 88. AMOUNT AWARDED PART B TOTAL Pre- Review Post- Review Post- Hearing 89. TOTAL 90. UNFAVORABLE TO CLAIMANT 91. NO CHANGE 92. FAVORABLE TO CLAIMANT 93. AMOUNT AWARDED
Form CMS-2591 Screen 6 120 - Completing Page One of the Carrier Performance Report (Rev. 6, 08-30-02) B3-13301 120.1 - Classification of Claims for Counting (Rev. 175, Issued: 10-28-10, Effective: 04-01-11, Implementation: 04-04-11) All claims data entered on page one of the performance report must represent counts of claims (real and replicate) as defined in the Medicare Claims Processing, Chapter 1, General Billing Requirements. The carrier includes in column (i) the following types of claims: CMS-1500s, CMS-1490s, and CMS-1491s. Of these claims forms, it reports the assigned in column (ii) and the unassigned in column (iii). It includes any claims where processing has been suspended due to CMS directives since they are still part of its claims workload. NOTE: It does not count assigned claims received from physicians/suppliers if they are incomplete, incorrect, or inconsistent and consequently returned for clarification. It does not have to control such claims. Throughout its process, it includes the date material is received on all claims (real and replicate). It shows identifying numbers or codes on all replicate claims through the processing system so that they can be counted and reported separately in Part A. The carrier reports claims as received in the month the claim is received in its mailroom with the following exceptions: • Additional real claims resulting from a split; and • Claims identified as replicates. Split and replicate claims, although carrying the dates the materials were originally received, are to be counted as receipts for the month in which they are recognized by the carrier's system as created (i.e., split or identified as replicate) for purposes of this report. EXAMPLE: The carrier splits a claim received in the reporting month into two claims because the total number of line items exceeds its system's line item limitation. If it can recognize this split when it occurs, it reports two claims in "Total Claims Received During Month" and in "Net Number of Claims Received" (lines 4 and 6, respectively) in Part A of the report. It reports both claims in Part A. After processing the split (replicate) claim, it reports it in Part A under "Replicate Claims Processed" (line 16), as well as under "Total Claims Processed" (line 15). If its system does not indicate when the split occurs, it counts the new claim as a receipt for the month in which the system allows it to be recognized, although the date claims materials were originally received must be carried forward and remain unchanged.
The carrier counts claims received near the end of the reporting month but placed under computer control in the following month as received in the reporting month. It obtains this count by a physical inventory or by computer count. 130 - Completion of Items on Page One of Form CMS-1565 (Rev. 6, 08-30-02) B3-13302 130.1 - Heading (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) B3-13302.1 This report is referenced as Form B for CROWD. The carrier submits the appropriate information for the reporting period for each office assigned a separate contractor number and BSI. It reports the number of working days scheduled for the reporting period, less any days where no claims were processed as a result of a strike, snowstorm, etc. It does not count Saturdays, Sundays, or holidays. 130.2 - Part A - Monthly Workload Operations (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) This part of the report presents data on carrier claims processing activity during the reporting period. Counts of claims (real and replicate) processed, total claims (real and replicate) pending, or pending from prior months must reflect the actual status of claims (real or replicate) workloads as of the last day of the reporting calendar month. Data shown must be based on reliable counts of all claims (real or replicate) processing activity and the entire "in-house" pending workload. This data may not be derived from estimates. If a single claim is split into two or more real claims, or into one real claim and one or more replicate claims, the carrier considers each split (real and replicate) as a separate, distinct claim for purposes of counting claims. The original real claim is a receipt for the month in which it was received. It counts a claim split from the original, or identified as a replicate, as a receipt for the month in which it is actually created or in which its system recognizes it as a separate claim. To determine the age of pending claims, the carrier considers the receipt date as the date the original claim was received and not the date it was split from another claim. It reports, in Part A, only data relating to initial claims (real and replicate) actions. It does not report data on requests for, or dispositions of, reviews, hearings, or reopenings of initial claim actions. Opening Pending Line 1. Claims Pending End of Last Month - The system will pre-fill the number pending from line 17 on the previous month's report. Line 2. Adjustments - If it is necessary to revise the pending figure for the close of the previous month, the carrier reports the adjustment, preceded by a minus sign for negative adjustments, as appropriate. Adjustments normally result from:
• Private claims incorrectly counted as Medicare claims; • Beneficiary inquiries or other correspondence incorrectly counted as Medicare claims; and • Claims consisting of one or more continuation forms incorrectly counted as more than one Medicare claim. The carrier reports claims received near the end of the reporting month, and placed under computer control sometime after the reporting month, as claims received in the reporting month. It does not count them as claims received in the following month. If some claims have not been counted in the proper month's receipts, it counts them as adjustments to the opening pending in the subsequent month. Line 3. Adjusted Opening Pending - The system will sum line 1 + line 2 to calculate the adjusted opening pending. Receipts Line 4. Total Claims Received During Month - The carrier reports all real claims received during the month and all split and replicate claims generated (recognized) during the month. (See the Medicare Claims Processing Manual for a discussion of what constitutes a claim.) Claims received include all claims received in its mailroom during the reporting month even though some of them were placed under computer control in the following month. (See §120.1 for counting receipts.) The carrier counts claims submitted electronically after they have passed its consistency edits. Prior to that time, it may return these bills or the entire tape (where magnetic tape is the medium of submission), as necessary, without counting them as received. However, once the claims or tapes have passed consistency edits and are counted as received, it uses the actual receipt date, not the date the edits are passed, in calculating pending and processing times. Line 5. Transferred to Other Carriers - The carrier reports the number of claims received, but transferred to other carriers or Part A intermediaries, during the month because the claimant submitted the claim to the wrong contractor. It includes claims transferred in their entirety or split off from other claims because they contained services from physicians/suppliers outside of their carrier jurisdiction. Line 6. Net Number of Claims Received - The carrier shows the net number of claims (real and replicate) received after subtracting those transferred. Line 7. Electronic Media Claims Received - The carrier reports the net number of claims included in line 6 which were received in paperless form via electronic media from providers or their billing agencies and read directly into its claims processing system. It does not count on this line claims that it received in hardcopy and entered using an Optical Character Recognition (OCR) device. It does not count any claims received in hardcopy and transformed into electronic media by any entity working for it directly or under subcontract. It counts claims which are split automatically by computer, without manual intervention, as electronic media claims. This includes "required" splits
only. (See the Medicare Claims Processing Manual. It excludes replicate claims). Claims Processed Line 8. Total CWF Claims - The carrier reports the number of initial claims (described in lines 9, 10 and 11 below) processed through Common Working File (CWF) and posted to CWF history. It does not include claims sent to CWF and rejected, unless they were resubmitted and posted to CWF history in the reporting month. The counts entered in lines 9, 10 and 11 are exclusive of each other and represent the total number of CWF claims (real or replicate) processed during the month. On page 1, it reports these claims in the month it move the claim to a processed location in its system after receipt of the host's response to pay, apply entirely toward the deductible or deny in full. For pages 2-9, it reports these claims as processed in the month during which the scheduled payment date falls, which may be in a subsequent reporting period. Line 9. Claims Paid - The carrier reports the number of initial CWF claims (real or replicate) that it approved for payment and for which the CWF host responded by accepting its determination during the month. It reports only claims which are completely processed. If payment is made on part of a claim and the remainder of the claim requires no payment or is denied for any reason, it reports the claim as paid. It reports claims that have been fully adjudicated, with a response having been received from the CWF host, and that are being held only due to the payment floor. Line 10. Claims Applied Towards Deductible - The carrier reports the number of CWF claims (real or replicate) for which no payment was made because the deductible had not been met. It includes claims for which all charges were applied toward the deductible, as well as those for which some charges were denied. Line 11 Claims Denied - The carrier reports the number of CWF claims (real or replicate) for which all services were denied because, for example, the beneficiary was not eligible for Part B benefits, the filing limitation was exceeded, or services were not covered. Line 12. Total Non-CWF Claims - The carrier reports the number of initial claims (real or replicate) processed outside CWF. Non-CWF claims are those either rejected by or not submitted to CWF which it finally adjudicates outside of CWF and are, therefore, not posted to its history in the reporting month. It reports these claims as non-CWF, even if it plans to submit an informational record in the future. Also, it reports these claims in the month in which it made the determination as to their final disposition. Line 13. Claims Approved - Of those claims reported on line 12 as not processed through CWF, the carrier reports the number approved for payment or with all charges applied toward the deductible. Line 14. Claims Denied - Of those claims reported on line 12, the carrier reports the number on which all services were denied. Line 15. Total Claims Processed - The carrier reports the sum of lines 8 and 12. Line 16. Replicate Claims Processed - The carrier reports the number of replicate claims included under Total Claims Processed, line 15, column (1).
Replicate claims are those claims split off from original (real) claim. Replicate claims are generally created because of computer line item limitations, the carrier is making partial payments, or it is carving out individual specialty types of services. (See the Medicare Claims Processing Manual, Publication 100-04, Chapter 1, Section 70.2.). Closing Pending Line 17. Claims Pending at End of Month - The system calculates the number of bills pending at the end of the month by adding line 3 (adjusted opening pending) to line 6 (net receipts) and subtracting line 15 (total processed). It does not report as pending those bills that the carrier has moved to a processed location after being accepted by the host and are holding only due to the payment floor. It reports such bills as processed on line 17. Distribution by Days Elapsed Since Receipt Line 18. 1-15 Days - The carrier reports the number of claims, by type, included in line 17 which are 1-15 days old. Line 19. 16-30 Days - The carrier reports the number of claims, by type, included in line 17 which are 16-30 days old. Line 20. 31-60 Days - The carrier reports the number of claims, by type, included in line 17 which are 31-60 days old. Line 21. 61-90 Days - The carrier reports the number of claims, by type, included in line 17 which are 61-90 days old. Line 22. Over 90 Days - The carrier reports the number of claims, by type, included in line 17 which are over 90 days old. Claim Investigations Line 23. Number of Claims Investigated During Month - The carrier reports the number of claims (real and replicate) that required contact during the month by telephone, correspondence, or automatic inquiry with physician, beneficiary, supplier, or social security office, or other entities outside the carrier for missing, incorrect, or inconsistent information. It counts only the number of claims investigated, not the number of contacts made. 130.3 - Part B – Inquiries (Inactive) (Rev. 248, Issued: 12-19-14, Effective: 01-23-15, Implementation: 01-23-15) The carrier reports the number of responses it processed as a result of inquiries from, or on behalf of, Medicare beneficiaries or providers during the reporting month. It reports only inquiries processed related to the Medicare program. It excludes inquiries addressing its private line of business. It bases the data on actual counts, not on estimates or samples. The carrier counts inquiries as follows:
Beneficiary - It counts one inquiry per contact (telephone, written, walk-in), regardless of how many claims the beneficiary inquires about. For example, if a beneficiary writes it about the status of two claims, it counts the response as one beneficiary written inquiry. It counts responses to re- contacts made by that beneficiary as an additional inquiry. It counts any inquiry made by a beneficiary, or by anyone on behalf of the beneficiary, except a provider. Provider - It counts one inquiry per contact. For example, if a provider calls or writes it regarding the status of 10 claims, it counts the response as one provider-written or phone inquiry. It counts any inquiry made by a provider, or anyone on behalf of the provider, except a beneficiary. It counts inquiries regardless of whether they relate to assigned or unassigned claims. • It counts beneficiary and provider inquiries as follows: • It counts Medicare inquiries directed to it for a response if they are requests for information from beneficiaries or providers (physicians/suppliers) or their representatives. • It does not count, as inquiries, professional relations activities and contacts (i.e., its training programs for providers on new requirements). • It counts voice inquiries captured electronically as telephone inquiries, and electronic mail inquiries as written inquiries. It does not count electronic inquiries if the provider can access the carrier system to determine claim status without its involvement. • It does not count inquiries related specifically to the physician fee freeze or MSP. (This is to achieve comparability with the CMS-1524 budget form, where all costs related to the fee freeze and MSP are reported on separate lines.) • It counts congressional inquiries in the appropriate category (i.e., as a beneficiary inquiry if made on behalf of a beneficiary, and as a provider inquiry if made on behalf of a provider). • It counts inquiries made by the RO or the SSA DO in the appropriate category if the inquiries are on behalf of a beneficiary or a provider and relate to a specific claim. It does not count the inquiries if they are of a general nature (i.e., ongoing liaison necessary during monitoring of day-to-day operations). • It does not count Part A inquiries if it handles all Part A inquiries for an intermediary on a routine basis. In this case, it charges the related costs to the intermediary. It does not include the volume of work on the CMS-1565. • It counts misdirected telephone inquiries (i.e., those that must be referred to another source for response) as processed telephone inquiries. It does not count misdirected written inquiries. • It does not count requests for reviews or hearings as inquiries. (See The Medicare Claims Processing, Beneficiary Correspondence and Administrative Appeals, for definitions of reviews and hearings.) It reports reviews and hearings on the CMS-2590, not on the CMS- 1565.
130.4 - Part C - Miscellaneous Claims Data (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) Medicaid Crossover Claims - This part of the report represents data on the volume of Medicaid crossover claims. Line 28 Number Transferred to State Agencies - The carrier reports the total number of Medicaid crossover claims transferred to State agencies or their fiscal agents in the reporting month. Line 29 Number Transferred Electronically - The carrier reports the total number of Medicaid crossover claims reported in line 28 which were transferred in the reporting month to State agencies, or their fiscal agents, via electronic media. Optical Character Recognition Claims Line 30 Total Claims - The carrier reports the number of claims received in hardcopy and entered using an OCR device. It does not count these claims as EMC claims on line 7, page 1, or in column 6, pages 2-9. Medicare Summary Notices (MSNs) Line 31 Total MSNs Mailed - The carrier reports the number of MSNs mailed to beneficiaries during the reporting month. 140 - Completing Pages Two through Eleven of the Carrier Performance Report (Rev. 6, 08-30-02) B3-13305 140.1 - Heading (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) B3-13305.1 These pages are referenced as Form T (pages 2-9) and Form E (pages 10-11) for CROWD. It submits the appropriate information for the reporting period for each office assigned a separate contractor number and BSI. 150 - Part D (1) - Claims Processing Timeliness - All Claims (Rev. 12456; Issued:01-11-24; Effective: 07-01-24; Implementation:07-01-24) Pages 2-9 of the CMS-1565 include data on its activity in processing all claims to completion during the reporting period. A claim is counted as processed to completion on the scheduled payment date, which is the date the check is mailed, deposited in the provider’s account, or transferred electronically. For non-paid claims, the date of completion is the date the MSN or other notice of final action on the claim is mailed. Data shown must be based on reliable counts of all claims (real and replicate) processing activity. The A/B MAC (B) does not estimate claim
counts. It reports only data relating to initial claims (real and replicate) actions. It does not report data on requests for, or dispositions of, reviews, hearings, or reopenings of initial claim actions. "Clean" claims are defined as those that do not require investigation or development external to the A/B MAC (B)’s operation on a prepayment basis. Claims which do not meet the definition of "clean" are "other" claims. Claims paid are those for which some payment was made (i.e., payment greater than zero). Claims not paid are those for which no payment was made (i.e., claim charges applied completely toward deductible or fully denied). On pages 2-9, the A/B MAC (B) reports: • In column 1, the total number of claims processed to completion; • In column 2, the number of "clean" claims paid; • In column 3, the number of "other" claims paid; • In column 4, the number of "clean" claims not paid; • In column 5, the number of "other" claims not paid; and • In column 6, the number of "clean" or "other" claims processed to completion, which were received via electronic media from providers or their billing agencies and read directly into the A/B MAC (B)’s claims processing system. The A/B MAC (B) does not count on this line claims that it received in hardcopy and entered using an OCR device. It does not count any claims received in hardcopy and transformed into electronic media by any entity working for it directly or under subcontract. The data in lines 1 through 37 of pages 2 through 9 represent the number of claims processed in the number of days shown on that line, counting from the date of receipt. Line 38 represents the sum of lines 1-37. The date of receipt is defined for hard-copy and magnetic tape claims as the date of receipt in the mailroom. For EMC billed via terminal or equivalent, it is the date the claim passes all front-end edits. For split claims, whether required or replicate, the date of receipt is the date of receipt of the original claim material, not the date of the split. To calculate the processing time for a claim, the A/B MAC (B) subtracts the Julian receipt date from the processed to completion Julian date. When the processed to completion date falls in the year following the year of receipt, it adds 365 to the Julian date of completion (or 366 if the year of receipt is a leap year). If a claim is processed to completion on the same day it is received, the processing time is 1 day. This definition applies to all lines of the report, including line 39. On line 39, the A/B MAC (B) reports the mean processing time (PT) to one decimal place for each column. To calculate the mean PT, it adds the processing times for the claims shown in line 38 of that column, and divides by the number in line 38. It does not use the categories on the report to calculate the mean PT. Because of the aggregation of claims in lines 34-37, it uses the processing times for individual claims, as explained below, to make this calculation. Mean PT Calculation for All Claims - To determine the mean PT for all claims: • Subtract the Julian date of receipt from the Julian date of payment or equivalent action for those not paid for each claim. • Accumulate the result to cell counter for number of days for all claims.
• Divide this result by the total number of claims. • Round to one decimal place. EXAMPLE: Claim Julian Date Receipt Paid Counter by Days Counter by Claims A 87103 87133 30 1 B 87105 87206 101 2 C 87115 87177 62 3 D 87120 87213 93 4 E 87122 87215 93 5 F 87130 87223 93 6 Total Days = 30 + 101 + 62 + 93 + 93 + 93 = 472 Mean = 472/6 = 78.6666 = 78.7 The A/B MAC (B) completes the report for each of the following claim types: Page 2. Assigned Physician - It shows the number of assigned claims included on page 9 which involved services billed by physicians. Physicians are identified by specialty codes 01-14, 16-30, 33-41, 44, 46, 48, 66, 70, 72, 76-79, 81-86, 90-94, 98, 99, C0, or C3, C5, C6, C7, C8, C9, D3 D4, D7, D8, E1, E2, E3, E4, E5, E6, E7, E9, F1, F2, F3, F4, F5, F6. Page 3. Assigned DME - It shows the number of assigned claims included on page 9 which involved services billed by DME suppliers. Page 4. Assigned Lab - It shows the number of assigned claims included on page 9 which involved services billed by an independent laboratory. Independent laboratories are identified by specialty code 69. Page 5. Assigned Ambulance - It shows the number of assigned claims included on page 9 which involved services billed by ambulance service suppliers. Ambulance service suppliers are identified by specialty code 59. Page 6. Assigned Other - It shows the number of assigned non-physician claims included on page 9 but not represented on pages 3, 4, or 5. Page 7. Unassigned - It shows the number of unassigned claims (real and replicate) included on page 9. Page 8. Participating Physician - It shows the number of claims included on page 9 involving services rendered by physicians enrolled in the Medicare Physician/Supplier Participation Program. Page 9. All Claims - It shows the total number of claims (real and replicate) processed during the month. 160 - Part D(2) - Claims Processing Timeliness - EMC Claims and Adjustments for CPEP CPT Calculations (Rev. 6, 08-30-02) B3-13307
Pages 10-11 of the CMS-1565 include data bills paid or denied during the month that were received via electronic media. The basic instructions and definitions that apply to pages 2-9 (see §150) also apply to pages 10-11. The carrier reports the following information for Participating Physician EMC claims (page 10) and all EMC claims (page 11): • Column 1 - the number of EMC claims that were included in column 2 (paid clean) for the corresponding claim type on page 8 or 9, as appropriate. • Column 2 - the number of EMC claims that were included in column 3 (paid other) for the corresponding claim type on page 8 or 9, as appropriate. • Column 3 - the number of EMC claims that were included in column 4 (not paid clean) for the corresponding claim type on page 8 or 9, as appropriate. For each claim type (PAR and TOT), the carrier reports the following adjustments for CPEP CPT calculations: CWF - Claims which were beyond carrier control due to CWF. A. The number of EMC clean claims processed beyond the EMC ceiling. B. The number of paper clean claims processed beyond the paper ceiling. C. The number of all claims processed beyond 60 days. WAIVER - Claims paid under the floor for which the carrier had a waiver from CMS. D. The number of EMC clean claims paid under the EMC floor. E. The number of paper clean claims paid under the paper floor. F. The number of all EMC claims paid under the EMC floor plus the number of all paper claims paid under the paper floor. 170 - Completing Page 12 of the Carrier Performance Report (Rev. 6, 08-30-02) B3-13308 170.1 - Classification of Claims for Counting (Rev. 6, 08-30-02) B3-13308.1 Claims data entered on page 12 of the performance report represent counts of claims (real and replicate) as defined in Ref. 170.2 - Heading (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) B3-13308.2 This page is referenced as Form V for CROWD. The carrier submits the appropriate information for the reporting period for each office assigned a separate contractor number and BSI.
170.3 - Part E - Interest Payment Data (Rev. 12456; Issued:01-11-24; Effective: 07-01-24; Implementation:07-01-24) The A/B MAC (B) reports on Page 12 of the CMS-1565 data on the claims on which it paid interest because it paid the claims after the required payment date per §9311 of the Omnibus Reconciliation Act of 1986 (OBRA 1986). It bases data shown on reliable counts of all claims processing activity, not on estimates. It reports data on initial claims only. It includes in the report all claims requiring interest payments in the month. It reports claims in the month the date of payment falls. (For a discussion of interest payments refer to the Medicare Claims Processing Manual, Publication 100-04, chapter 1, sections 80.2.2 and 80.2.2.1). The A/B MAC (B) completes the report for each column as follows: Column 1. Total - Data for all claims (real and replicate) for which interest payments were made during the month. Column 2. Assigned Physician - Data for the assigned claims included in column 1 which involved services billed by physicians. Physicians are identified by specialty codes 01-14, 16-30, 33-41, 44, 46, 48, 66, 70, 72, 76-79, 81-86, 90-94, 98, 99, C0, C3, C5, C6, C7, C8, C9, D3, D4, D7, D8, E1, E2, E3, E4, E5, E6, E7, E9, F1, F2, F3, F4, F5, F6. Column 3. Assigned DME - Data for the assigned claims included in column 1 that involved services billed by DME suppliers. Column 4. Assigned Lab - Data for the assigned claims included in column 1 that involved services billed by an independent laboratory. Independent laboratories are identified by specialty code 69. Column 5. Assigned Ambulance - Data for the assigned claims included in column 1 that involved services billed by ambulance service suppliers. Ambulance service suppliers are identified by specialty code 59. Column 6. Assigned Other - Data for the assigned non-physician claims included in column 1 but not represented in columns 3, 4, or 5. Column 7. Unassigned - Data for the unassigned claims included in column 1. Column 8. Participating Physician - Data for claims involving services rendered by physicians enrolled in the Medicare Physician/Supplier Participation Program. On line 1, the A/B MAC (B) shows the number of claims on which it paid interest in the reporting month. It reports on line 2 the number of claims included in line 1 for which it made payment 1 day after the required payment date (e.g., the required payment date is 17 days after receipt for participating physician claims received in FY 1992.) (See §9311 of OBRA 1986.) Data for lines 3-10 are similar to those for line 2. The A/B MAC (B) calculates the number of days late by subtracting the Julian date of the required payment date from the Julian date of payment. On line 11, it shows the amount paid in interest for claims reported in line 1. On lines 12-20, it shows the amount paid in interest for claims reported in lines 2-10, respectively. It shows dollar amounts on lines 11-20 to the nearest penny, and includes the decimal point.
180 - Completing Page Thirteen of the Carrier Performance Report (Inactive) (Rev. 175, Issued: 10-28-10, Effective: 04-01-11, Implementation: 04-04-11) 180.1 - Instructions for Completing the Carrier Performance Report - All Trunks Busy (ATB) (Rev. 175, Issued: 10-28-10, Effective: 04-01-11, Implementation: 04-04-11) Each month the carrier prepares and submits to CMS Central Office (CO) page 13 of the Carrier Performance Report - ATB. This report contains the monthly data for ATB, for both local and toll free calls, the number of beneficiary calls answered in 120 seconds, and the total number of beneficiary calls received. It reports these statistics electronically by the 15th of the month following the reporting month using the Medicare Contractor Reporting of Operational and Workload Data (CROWD) System at the CMS Data Center (CDC). It enters data on the ATB report screen for each office that has been assigned a separate carrier number. 180.2 - Heading (Rev. 6, 08-30-02) B3-13309.2 This page is referenced as Form R in the CROWD system. The carrier completes the ADD/UPDATE/DELETE DATA criteria screen with the appropriate information to bring the reporting format to its screen. 180.3 - Part F-ATB Data (Rev. 6, 08-30-02) B3-13309.3 The carrier completes the report for each line as follows: Line 1, column 1 - percent, rounded to the nearest tenth, of all trunks busy (ATB) for local calls. Line 1, column 2 - percent, rounded to the nearest tenth, of all trunks busy (ATB) for toll free calls. Line 2, column 1 - number of local beneficiary calls answered in 120 seconds. Line 2, column 2 - number of toll free beneficiary calls answered in 120 seconds. Line 3, column 1 - number of local beneficiary calls received. Line 3, column 2 - number of toll free beneficiary calls received. Line 4, column 1 - percent, rounded to the nearest tenth, of local beneficiary calls answered in 120 seconds.
Line 4, column 2 -, rounded to the nearest tenth, of toll free beneficiary calls answered in 120 seconds. EXPLANATION OF FAILURES: When the carrier fails the ATB level percentage standard or the timeliness standard for responding to telephone inquiries, it enters an explanation in this section. It makes the narrative as brief as possible. Refer to MCM-2, §5261.7 regarding the standards. 190 - Checking Reports Prior to Submittal to CMS (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) B3-13310 Prior to transmitting performance reports to CMS the carrier checks for the following: • Completeness; • Accuracy; and • Internal consistency. It uses the following checklists to assure accuracy and consistency: A. Page One of Report (CROWD Form B) • Line 1 of current report must be equal to line 17 of previous report for all columns; Line 1 + Line 2 = Line 3 for all columns; • Line 4 - Line 5 = Line 6 for all columns; • Line 7 should be equal to or less than Line 6 for all columns; • Line 9 + Line 10 + Line 11 = Line 8 for all columns; • Line 13 + Line 14 = Line 12 for all columns; • Line 8 + Line 12 = Line 15 for all columns; • Line 3 + Line 6 - Line 15 = Line 17 for all columns; • For each line of this page (except for lines 16, 28, 29 and 30), column 1 must equal the sum of columns 2 and 3; • Line 16 should be equal to or less than Line 15 for column 1; • Lines 18 + 19 + 20 + 21 + 22 = Line 17 for all columns; • Lines 25 + 26 + 27 = Line 24 for all columns; and • Line 29 should be equal to or less than line 28. B. Pages Two through Eleven (CROWD Forms T and E) • For each of lines 1-38 on pages 2-9, column 1 = column 2 + 3 + 4 + 5; • For each of lines 1-38 on pages 2-9, column 6 must be equal to or less than column 1; • The sum of lines 1-37 must be equal to line 38 for all columns; • Each data item on page 9, lines 1-38 = the sum of the corresponding data items on pages 2- 7; • Each data item on page 8, lines 1-38, must be equal to or less than the corresponding data item on page 2; • For each of lines 1-38 on pages 10 and 11, column 1 must be less than or equal to column 2 on pages 8 and 9, respectively;
• For each of lines 1-38 on pages 10 and 11, column 2 must be less than or equal to column 3 on pages 8 and 9, respectively; and • For each of lines 1-38 on pages 10 and 11, column 3 must be less than or equal to column 4 on pages 8 and 9, respectively. C. Page Twelve (CROWD Form V) - • For each line, column 1 = the sum of columns 2 - 7; • For each column, line 1 = the sum of lines 2 - 10; • For each column, line 11 = the sum of lines 12 - 20; and • For each line, column 8 must be equal to or less than column 2. D. Page Thirteen (CROWD Form R) (Inactive) (Line 2 divided by line 3) times 100 = line 4 for all columns. 200 - Exhibits (Rev. 126; Issued: 07-13-07; Effective: 01-01-08; Implementation: 01-07-08) Exhibit 1 - Medicare Program Carrier Performance Report- Page 1 MEDICARE PROGRAM CARRIER PERFORMANCE REPORT- Page 1 Carrier Number Report Period ( Month/Yr) Working Days Number and Type of Claim Reporting Item Total (1) Assigned (2) Unassigned (3) A. Monthly Workload Operations OPENING PENDING 1. Claims Pndg End of Last Mo. 2. Adjustments (Show + or -) 3. Adjusted Opening Pending RECEIPTS 4. Tot. Clms. Rcvd. During Mo. 5. Transferred to Other Carrier 6. Net Number of Claims Received 7. Electronic Media Claims Recvd. CLAIMS PROCESSED
8. Total CWF Claims 9. Claims Paid 10. Claims Applied To Deductible 11. Claims Denied 12. Total Non-CWF Claims 13. Claims Approved 14. Claims Denied 15. Total Claims Processed 16. Replicate Claims Processed Exhibit 1 (Cont.) MEDICARE PROGRAM CARRIER PERFORMANCE REPORT- Page 1 (cont) Carrier Number Report Period ( Month/Yr) Working Days Number and Type of Claim Reporting Item Total (1) Assigned (2) Unassigned (3) CLOSING PENDING 17. Claims Pending at End of Month DISTRIBUTION OF DAYS ELAPSED SINCE RECEIPT 18. 1 - 15 Days 19. 16 - 30 Days 20. 31 - 60 Days 21. 61 - 90 Days 22. Over 90 Days CLAIMS INVESTIGATIONS 23. No. of Clms. Invest. During Mo. B. INQUIRIES TOTAL BENEFICIARY PROVIDER
24. Tot. No. Processed During Mo. 25. Telephone 26. Walk-In Contact 27. Written C. MISCELLANEOUS CLAIMS DATA MEDICAID CROSSOVER CLAIMS 28. No. Transferred to St. Agencies 29. No. Transferred Electronically Exhibit 1 (Cont.) MEDICARE PROGRAM CARRIER PERFORMANCE REPORT- Page 1 (cont) Carrier Number Report Period ( Month/Yr) Working Days Number and Type of Claim Reporting Item Total (1) Assigned (2) Unassigned (3) OPTICAL CHARACTER RECOGNITION CLMS. 30. Total Claims MEDICARE SUMMARY NOTICES 31. Total MSNs Mailed Form CMS-1565
Exhibit 2 - Medicare Program Carrier Performance Report - Form CMS-1565, Pages 2-9 MEDICARE PROGRAM CARRIER PERFORMANCE REPORT - FORM CMS-1565, Pages 2-9 CARRIER WORKLOAD REPORT - PAGE __*__ PART - D (1) CLAIMS PROCESSING TIMELINESS - ALL CLAIMS CARRIER ID________ TYPE OF CLAIM______*_____ REPORT MO.___ PAID NOT PAID LINE NO./DAYS TOTAL (1) CLEAN (2) OTHER (3) CLEAN (4) OTHER (5) EMC (6) 1 1 2 2 3 3 4 4 5 5 6 6 7 7 8 8 9 9 10 10 11 11 12 12 13 13 14 14 15 15 16 16 17 17 18 18 19 19
20 20 21 21 22 22 23 23 24 24 25 25 26 26 27 27 28 28 29 29
Exhibit 2 (Cont.) PAID NOT PAID LINE NO./DAYS TOTAL (1) CLEAN (2) OTHER (3) CLEAN (4) OTHER (5) EMC (6) 30 30 31 31 32 32 33 33 34 34-45 35 46-60 36 61-90 37 91+ 38 Tot 1-37 39 Mean Pt CMS-1565 Page _*_ * PAGE NUMBER AND TYPE OF CLAIM ARE TO BE REPORTED AS FOLLOWS: Page 2-Assigned Physician Page 3-Assigned DME Page 4-Assigned Lab Page 5-Assigned Ambulance Page 6-Assigned Other Page 7-Unassigned Page 8-Participating Physician Page 9-All Claim
Exhibit 3 - Adjustments for CPEP CPT EMC PAID EMC NOT PAID ADJUSTMENTS FOR CPEP CPT LINE NO./DAYS CLEAN (1) OTHER (2) CLEAN (3) CALCULATIONS: 1 1 CWF Claims which were beyond carrier control due to CWF. 2 2 3 3 4 4 5 5 A. EMC clean claims Processed beyond EMC 6 6 7 7 8 8 B. Paper clean claims Processed beyond Paper ceiling 9 9 10 10 11 11 C. All claims processed Beyond 60 days ____ 12 12 13 13 WAIVER Claims paid under the floor For which the carrier had a waiver from CMS. 14 14 15 15 16 16 17 17 D. EMC clean claims Paid under EMC floor _________ 18 18 19 19 20 20 E. Paper clean claims Paid under paper floor ________ 21 21 22 22 23 23 F. All EMC claims paid under EMC floor and all paper claims paid under paper floor __________ 24 24 25 25 26 26 27 27 28 28 29 29 30 30 31 31 32 32 33 33
Exhibit 3 (Cont.) EMC PAID EMC NOT PAID LINE NO./DAYS CLEAN (1) OTHER (2) CLEAN (3) CALCULATIONS: 34 34-45 35 46-60 36 61-90 37 91+ 38 Tot 1-37 39 Mean Pt CMS-1565 Page _*_ * PAGE NUMBER AND TYPE OF CLAIM ARE TO BE REPORTED AS FOLLOWS: Page 10-Participating Physician (PAR) Page 11-Total (TOT)
Exhibit 4 - Carrier Workload Report - Part-E - Interest Payment Data CARRIER WORKLOAD REPORT - PAGE __*__ PART-E - INTEREST PAYMENT DATA CARRIER ID REPORT MONTH LINE NO CLAIM/PAYMENT LATE DAYS TOTAL (1) ASTD PHYS (2) ASTD DME (3) ASTD LAB (4) ASTD AMB (5) ASTD OTHER (6) UNASTD (7) PARTIC. PHYS (8) 1. No. of Claims 2. 1 Day late 3. 2 Days Late 4. 3 Days Late 5. 4 Days Late 6. 5 Days Late 7. 6-15 A Late 8. 16-30 A Late 9. 31-60 A Late 10. 61+ A Late 11. Amount paid 12. 1 Day late 13. 2 Days Late 14. 3 Days Late 15. 4 Days Late 16. 5 Days Late 17. 6-15 A Late 18. 16-30 A Late 19. 31-60 A Late 20. 61+ A Late CMS-1565 Page 12
Exhibit 5 - Carrier Workload Report - Part F - All Trunks Busy (ATB) CARRIER WORKLOAD REPORT PART F - ALL TRUNKS BUSY (ATB) ALL TRUNKS BUSY CARRIER ID___________ REPORT MONTH________ LOCAL CALLS (1) TOLL FREE CALLS (2) 1. PERCENT OF ATB 2. NUMBER OF BENEFICIARY CALLS ANSWERED IN 120 SECONDS 3. TOTAL NUMBER OF BENEFICIARY CALLS RECEIVED 4. % OF BENEFICIARY CALLS ANSWERED IN 120 SECONDS EXPLANATION FOR FAILURES: CMS-1565 Page 13
210 - Monthly DMEPOS State Report - General (Inactive) (Rev. 175, Issued: 10-28-10, Effective: 04-01-11, Implementation: 04-04-11) If the carrier is a Durable Medical Equipment Regional Carrier (DMERC), it prepares and submits a report each month for its region (either A, B, C, or D - see §210.3 for exhibits) to CMS summarizing its performance in processing DMEPOS claims. It transmits the DMEPOS report as soon as possible after the end of the reporting month, but no later than the 10th day of the following month using the instructions contained in the CROWD User's Guide. It is also required to submit all pages of the CMS-1565 report for its total DMEPOS workload. It must also submit data on forms CMS-2174, CMS-2590, CMS-1564, CMS-1565A, and CMS-1565C via CROWD for its total DMEPOS workload. 210.1 - Completion of Items on the DMEPOS State Report (Rev. 6, 08-30-02) B3-13312.1 Heading - The carrier enters its assigned carrier number in the indicated space. In the space labeled, "Reporting Period", it enters the numerical month and year for which the report is prepared, e.g., it shows 1001 for the month October 2001. For each of the 8 pages of the report, the "Type" of claim is pre-entered by the CROWD system. Page 1 will be labeled "PEN" and be used to report PEN claims (HCPCS codes B0000-B9999; J0000-J9999). The remaining pages (2 thru 8) will be labeled and defined as follows: PAGE TYPE HCPCS Codes 2 OXY (oxygen) E0400-E0499; E1351-E1499 3 NOE (non-oxygen equipment) E0000-E0399; E0500-E1350 4 DIA (dialysis supplies) A4650-A4927; E1500-E1649 5 NDS (non-dialysis supplies) A4200-A4640; A5051-A9999 6 PRO (prosthetics and orthotics) L0000-L9999; V0000-V9999 7 OTH (other than the previous types above) An example would be regional-wide code 8 TOT (total DMEPOS claims) If a claim contains more than one category type, the carrier reports the claim under each type identified. For example, it reports a claim including services for oxygen (OXY), non-oxygen equipment (NOE), and dialysis supplies (DIA) under page 2 (OXY), under page 3 (NOE), and under page 4 (DIA). As a result, this claim will end up being counted as 3 claims under page 8 (TOT). For each of these types (pages 1 through 8), it enters data for lines and columns as follows: Lines - data reflecting the total of all States and territories in its jurisdiction (region). On subsequent lines (2 and greater), enter data for each State and territory in its region. Columns Column 1, State Code - A code for the total of all States and an alpha code for each State and territory is pre-entered by the CROWD system.
Total Claims Processed for Type Indicated Column 2, Number - total number of DMEPOS claims processed for type indicated during the month for all States and territories in its region. The carrier reports claims in the month the payment date or other final adjudication occurs. See MCM-2, §5240, functional standard 11, for definition of payment date for all claims, including those fully denied or having charges applied completely towards the deductible. The total number of claims for all States (line 1) must be equal to or greater than the number reported on page 9, line 38, column 1 of the CMS-1565 that the carrier submits for the same month. Column 3, In 1-60 Days - total number of DMEPOS claims in type indicated processed within 60 days during the month for all States and territories in its region. To calculate the processing time for a claim, the carrier subtracts the Julian receipt date from the processed to completion Julian date. The total number of claims processed for all States must be equal to or greater than the number reported on page 9, lines 1-35, of column 1 of the CMS-1565 submitted by the carrier for the same month. Column 4, In 61-90 Days - total number of DMEPOS claims in type indicated processed in 61-90 days during the month for all States and territories in its region. The total number of claims processed for all States (line 1) must be equal to or greater than the number reported on page 9, line 36, column 1 of the CMS-1565 submitted by the carrier for the same month. Column 5, Mean Processing Time - mean processing time for number of DMEPOS claims for type indicated processed during the month for all States and territories in its region. See §140.2 for an explanation on calculating the mean processing time. The carrier enters data to one decimal place. Column 6, EMC - number of DMEPOS claims for type indicated processed to completion that were received via electronic media for all States and territories in its region. It does not include claims that the carrier receives in hardcopy and transfers to electronic media via character recognition devices. The total number of claims processed for all States (line 1) must be equal to or greater than the number reported on page 9, line 38, column 6 of the CMS-1565 that the carrier submits for the same month. Clean Claims Processed for Type Indicated Column 7, Number - total number of clean DMEPOS claims for type indicated processed during the month for all States and territories in its region. "Clean" claims are those that do not require an investigation or development external to the carrier operation on a prepayment basis. See MCM- 2, §5240, functional standard 11, for definition of clean claims. The total number of "clean" claims processed for all States (line 1) must be equal to or greater than the number reported on page 9, line 38, column 2 + 4 of the CMS-1565, the carrier submits for the same month. Column 8, In 1-30 Days - number of clean DMEPOS claims for type indicated processed 1-30 days for all States and territories in its region.
210.2 - Checking Report (Rev. 6, 08-30-02) B3-13312.2 Before transmitting the report to CMS CO, the carrier checks it for completeness and arithmetical accuracy. It uses the following checklist: • Total All States, line 1, equals the sum of lines 2-20 for columns 2, 3, 4, 6, 7, and 8. • For all lines, column 3 must be equal to or less than column 2. • For all lines, column 4 must be equal to or less than column 2. • For all lines, column 6 must be equal to or less than column 2. • For all lines, column 7 must be equal to or less than column 2. • For all lines, column 8 must be equal to or less than column 7. • Line 1, column 2, page 8 must be greater than or equal to line 38, column 1, page 9 of the CMS-1565 submitted by the carrier for the same month. • Line 1, column 3, page 8 must be greater than or equal to the sum of lines 1-35, column 1, page 9 of the CMS-1565 that the carrier submit for the same month. • Line 1, column 4, page 8 must be greater than or equal to line 36, column 1, page 9 of the CMS-1565 that the carrier submit for the same month. • Line 1, column 6, page 8 must be greater than or equal to line 38, column 6, page 9 of the CMS-1565 that the carrier submit for the same month. • Line 1, column 7, page 8 must be greater than or equal to line 38, column 2 plus column 4, page 9 of the CMS-1565 that the carrier submit for the same month.
210.3 - Exhibits B3-13312.3 Exhibit 1 - DMEPOS State Report - REGION A DMEPOS State Report - REGION A Carrier No._______ Report Period_______ Type_______ Total Claims Processed for Type Indicated Clean Claims Processed for Type Indicated State Code (1) Number (2) In 1-60 Days (3) In 61-90 Days (4) Mean Proc. Time (5) EMC (6) Number (7) In 1-30 Days (8) 1-Tot. All States 02 CT 03 DE 04 MA 05 ME 06 NH 07 NJ 08 NY 09 PA 10 RI 11 VT 12 13 14 15 16 17 18 19 20 TYPE Page 1-PEN Page 2-Oxygen Page 3-Non-Oxygen Equipment Page 4-Dialysis Supplies Page 5-Non-Dialysis Supplies
Page 6-Prosthetics and Orthotics Page 7-Other Page 8-Total
Exhibit 2 - DMEPOS State Report - REGION B DMEPOS State Report - REGION B Carrier No._______ Report Period_______ Type_______ Total Claims Processed for Type Indicated Clean Claims Processed for Type Indicated State Code (1) Number (2) In 1-60 Days (3) In 61-90 Days (4) Mean Proc. Time (5) EMC (6) Number (7) In 1-30 Days (8) 1-Tot. All States 02 DC 03 IL 04 IN 05 MD 06 MI 07 MN 08 OH 09 VA 10 WI 11 WV 12 13 14 15 16 17 18 19 20 TYPE Page 1-PEN Page 2-Oxygen Page 3-Non-Oxygen Equipment Page 4-Dialysis Supplies Page 5-Non-Dialysis Supplies Page 6-Prosthetics and Orthotics Page 7-Other Page 8-Total
Exhibit 3 - DMEPOS State Report - REGION C DMEPOS State Report - REGION C Carrier No._______ Report Period_______ Type_______ Total Claims Processed for Type Indicated Clean Claims Processed for Type Indicated State Code (1) Number (2) In 1-60 Days (3) In 61-90 Days (4) Mean Proc. Time (5) EMC (6) Number (7) In 1-30 Days (8) 1-Tot. All States 02 AL 03 AR 04 CO 05 FL 06 GA 07 KY 08 LA 09 MS 10 NC 11 NM 12 OK2 13 PR2 14 SC2 15 TN2 16 TX2 17 VI2 18 19 20
TYPE Page 1-PEN Page 2-Oxygen Page 3-Non-Oxygen Equipment Page 4-Dialysis Supplies Page 5-Non-Dialysis Supplies Page 6-Prosthetics and Orthotics Page 7-Other Page 8-Total
Exhibit 4 - DMEPOS State Report - REGION D DMEPOS State Report - REGION D Carrier No._______ Report Period_______ Type_______ Total Claims Processed for Type Indicated Clean Claims Processed for Type Indicated State Code (1) Number (2) In 1-60 Days (3) In 61-90 Days (4) Mean Proc. Time (5) EMC (6) Number (7) In 1-30 Days (8) 1-Tot. All States 02 AK 03 AZ 04 CA 05 CM 06 GU 07 HI 08 IA 09 ID 10 KS 11 MO 12 MT 13 ND 14 NE 15 NV 16 OR 17 SD 18 UT 19 WA 20 WY TYPE Page 1-PEN
Page 2-Oxygen Page 3-Non-Oxygen Equipment Page 4-Dialysis Supplies Page 5-Non-Dialysis Supplies Page 6-Prosthetics and Orthotics Page 7-Other Page 8-Total
220 - Quarterly Supplements to Carrier Performance Report (Forms CMS- 1565A, CMS-1565B, CMS-1565C, CMS-1565D, and CMS-1565E) - General (Rev. 6, 08-30-02) B3-13320 In addition to the monthly workload report, the carrier prepares and transmits to CMS a Quarterly Supplement to the Carrier Performance Report showing the status and disposition of selected workloads. It prepares a separate report for each office/State that has been assigned a separate carrier number. 220.1 - Purpose and Scope (Rev. 6, 08-30-02) B3-13320.1 The Quarterly Supplements to the Carrier Performance Report (Forms CMS-1565A, CMS-1565B, CMS-1565C, CMS-1565D, and CMS-1565E) are the sources of current information on key aspects of carrier Medicare operations. The data, together with information from other sources, are used by CMS for: • Identifying problem areas for resolution; • Measuring trends in reasonable charge reductions, denial rates, and provider participation; Monitoring the workload handled by the carrier’s Medicare Fraud and Abuse unit; • Monitoring activity related to the carrier’s Comprehensive Limiting Charge Compliance Program; and • Monitoring activities dealing with the carrier’s review of incentive payments made to physicians who render covered Medicare services in a rural or urban Health Professional Shortage Area (HPSA). Carrier Instructions 220.2 - Due Date (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) B3-13320.2 The carrier transmits Forms CMS-1565A, CMS-1565B, CMS-1565C, and CMS-1565D to CO via PC or terminal as soon as possible after the end of the reporting quarter, but no later than the 15th of the following month, using instructions in the CROWD User Guide available via the CMS Enterprise Portal. With the exception of the due date, it applies these same instructions to Form CMS-1565E. The due date for the CMS-1565E is 75 days following the reporting quarter. The carrier does not submit hardcopies of the reports. 230 - Completing Form CMS-1565A (Rev. 6, 08-30-02)
B3-13321 230.1 - Classification of Claims for Counting (Rev. 175, Issued: 10-28-10, Effective: 04-01-11, Implementation: 04-04-11) Claims data entered on the performance report represent counts of claims (real and replicate). (See the Medicare Claims Processing Manual, Publication 100-04, Chapter 1, Section 70.8.2, for a definition of replicate claims). It includes in column (1) both assigned and unassigned claims. The carrier reports assigned claims in column (2) and unassigned claims in column (3). 240 - Completion of Items on Form CMS-1565A (Rev. 6, 08-30-02) B3-13322 240.1 - Heading (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) B3-13322.1 This report is referenced as Form A for CROWD. The carrier submits the appropriate information for the reporting period for each office assigned a separate contractor number and BSI. 240.2 - Part A - Claims Reduced and Denied (Rev. 6, 08-30-02) B3-13322.2 This part of the report provides CMS with: • Current quarterly data on the results of carrier activity in determining reasonable charges; • Information on the extent to which claims (real and replicate) are being denied or partially denied; • The amount of charges disallowed as a result of carrier claims screening operations; and • Information on the reasons items are denied and the savings realized. The carrier reports only data relating to initial claims (real and replicate) actions in Part A of the report. It does not report data on disposition of informal reviews, hearings, or reopenings of an initial claim action in Part A. In order to be included in lines 1-7, the allowed amount on a service must be greater than $0. A claim must be reflected on more than one of lines 2-6 if appropriate. For example, if one service on a claim is reduced due to a fee schedule, and two services are reduced due to medical necessity, the carrier counts the claim once on line 2 and once on line 4. It reports the appropriate dollar amounts on lines 3 and 5. Covered Charges Line 1. Total Covered Charges for All Claims - total amount (rounded to the nearest dollar) of billed charges for covered services on all claims (real and replicate) paid or applied toward the
deductible during the quarter. Claims paid or applied toward deductible are those reported in lines 9, 10, and 13 of the monthly CMS-1565 (CROWD Form B). For those claims in which reasonable charge/fee schedule reductions are made, the carrier reports the total covered charges prior to such reductions. It does not include charges for otherwise covered services that are duplicates of previously submitted services, or should have been included in previously submitted services (e.g., global fee/rebundling situations). Reasonable Charge/Fee Schedule Reductions Line 2. Number of Claims With Reasonable Charge/Fee Schedule Reductions - number of claims (real and replicate) reported as paid (claims included under line 9 of the monthly Form B, applied toward the deductible (claims included under line 10 of the monthly Form B), or approved outside of Common Working File (CWF) (claims included under line 13 of the monthly Form B) in which the charges were reduced as a result of reasonable charge determinations or comparisons to fee schedules. For provider-based physician claims, the separation of charges for physicians' services and charges for provider component (institutional) services according to some schedule of charges is not a reasonable charge reduction. The carrier counts a claim of this type as a reduced claim only if the submitted charge exceeds the provider billing agreement. Line 3. Amount of Reduction (in dollars) - total amount (rounded to the nearest whole dollar) by which the claims (real and replicate) reported in line 2 were reduced as a result of reasonable charge determinations or fee schedules. Medical Necessity Reductions Line 4. Number of Claims with Medical Necessity Reductions - number of claims (real or replicate) where the carrier reduced the billed charges because of a determination that the level of service was not medically necessary (i.e., a lower level of service would have sufficed). It includes cases where the service was reduced because medical review determined that a lesser service was actually performed. Line 5. Amount of Reduction (in dollars) - the difference (rounded to the nearest dollar) between the billed and allowed charges for those covered services included on line 4. Global Fee/Rebundling Reductions Line 6. Number of Claims with Global Fee/Rebundling Reductions - the number of claims (real or replicate) where the charges were reduced because one or more of the services in a global fee was previously paid. It does not include claims with services denied because they should have been included in a previously submitted global fee. The carrier reports such claims in line 17. (See MCM-3, §4630.) Line 7. Amount of Reduction (in dollars) - the difference (rounded to the nearest dollar) between the billed and allowed charges for those covered services included on line 6.
Denials In this section, the carrier reports data for claims (real and replicate) totally or partially denied. Claims totally denied are claims where it determines the allowed amount to be $0 for all services billed. Claims partially denied are claims where it determines the allowed amount to be $0 for some, but not all services. The carrier does not report transfers of claims to other carriers or Part A intermediaries since these are not denials. It does not include claims returned to physicians or suppliers because they were lacking necessary information. (Returns are cases where no attempt was made to develop the claim.) It does not report reductions in billed charges where the fee is deemed to have been included in a global fee, such as postsurgical care. It includes such services only if the allowed amount is $0 (i.e., the service is denied). It reports data for such services reduced to an amount greater than $0 on lines 6 and 7 above. Line 8. Claims Denied in Full or in Part - the sum of (l) those claims (real and replicate) reported as denied in full on lines 11 and 14 of the Form B submitted for the three months of the reporting calendar quarter, plus (2) those claims (real and replicate) reported as paid or applied toward the deductible in which some charges, but not all, were denied. Claims paid or applied toward deductible are those reported on lines 9, 10 and 13 of the monthly Form B. Line 9. Amount Disallowed (in dollars) - the total amount (rounded to the nearest dollar) of charges disallowed (billed charges for denied services) on the claims (real and replicate) reported on line 8. Reason for Denial - On lines 10-18 the carrier enters the number of items denied (column 1), the amount (rounded to the nearest dollar) disallowed (column 2), and the number of claims disallowed (column 3). The items reported in column 1 of this section represent the number of separate items coded by the carrier which were denied. These items usually relate to a single service, but may also represent more than one service when multiple occasions of the same type of service are coded as a single item. Line 19 for column 1 should contain the total number of items denied. Since more than one item on a claim may be denied, the total on line 19 for items denied (column 1) will usually be larger than the total number of claims denied in full or in part shown on line 8, column 1. However, the total money shown in column 2 on line 19 for amount disallowed must equal the total amount disallowed shown on line 9, column 1. The carrier shows a claim that contains multiple services, but is denied for only one reason, only once in column 3 under that reason for denial. However, if a claim is denied for more than one reason, it shows it under each reason for denial. Therefore, line 19, for the total number of claims disallowed (column 3), will usually be larger than the number of claims denied in part or full on line 8 (column 1). Line 10. Claimant Ineligible - the number of items denied, the related amount (in rounded dollars) of total charges disallowed, and the number of claims denied because the recipient of
services was ineligible for Part B benefits, or because the services billed were rendered before the beneficiary's coverage for Part B benefits began, or after coverage was terminated. Line 11. Filing Limitation Exceeded - the number of items denied, the related amounts (in rounded dollars) of total charges disallowed, and the number of claims denied because the claim was filed later than the time limitation on filing claims. (See MCM-3, §3004.) Line 12. Duplicate Claim - the number of items denied, the related amount (in rounded dollars) of total charges disallowed, and the number of claims denied because the services billed duplicated those from previously filed claims. The only denials reported on line 12 are actual duplicate charges for the same item or service. The carrier does not report denials for duplicate medical equipment (see line 14) or charges for services which are deemed to be included in a global fee (see line 17). Line 13. Services Not Covered - the number of items denied, the related amount (in rounded dollars) of charges disallowed and the number of claims denied because the services billed are determined to be excluded from coverage under the SMI program for reasons other than a finding that the services were not medically necessary. Some examples of services not covered are: • Services with charges above 62.5 percent of psychiatric charges; • Services with charges over $1,375 annual psychiatric expenses; • Services with charges over $100.00 annual therapist expenses; • First three pints of blood; • Equipment or services not ordered or prescribed by a physician; • Manipulation of spine when no X-ray is submitted; • Services by noncertified labs, nonapproved ambulance services or supplies; • Nonambulance transportation; • Services provided by relative/household member; • Services provided where there is no legal obligation to pay; • Routine physical check up, immunization shots, prescription drugs, personal comfort items, eyeglasses, hearing aids, etc.; • Care outside United States; • Rental or purchase of DME for inpatients of hospitals or SNFs; • Service date is before provider's participation effective date or after provider's termination date;
• Services, supplies, or rental of equipment not needed during a period when the beneficiary was hospitalized; or • Ambulance beyond nearest appropriate facility. Line 14. Services Not Medically Necessary - the number of items denied, the related amount (in rounded dollars) of charges disallowed and the number of claims denied because it was determined that the services billed were not medically necessary. Some examples are: • Ambulance not medically necessary, e.g., transfers between similar hospitals for reasons other than medical necessity; • Care for same illness by another attending physician; • Medical equipment which is not needed for the patient's condition or which continues to be used after medical necessity has ceased; • Duplicate medical equipment; • Services not substantiated as necessary by medical review; • Vitamins or other injections not considered necessary for patient's diagnosis; • More than one nursing home visit per month by physician unless medical need is documented; and • Manipulation of spine when subluxation is not verified by X-ray. Line 15. MSP - the number of items denied, the amount (in rounded dollars) of charges disallowed, and the number of claims denied because it was determined that Medicare should have been secondary to another payer. (See MCM-3, §§3330-3340.) Line 16. Missing Information - the number of items denied, the amount (in rounded dollars) of charges disallowed, and the number of claims denied because the claimant failed to provide information necessary to process the claim. Line 17. Global Fee/Rebundling - the number of items denied, the amount (in rounded dollars) of charges disallowed, and the number of claims denied because the fee was deemed to have been included in a previously allowed global fee, or a charge for a rebundled set of codes. Line 18. Other - the number of items denied, the related amount (in rounded dollars) of charges disallowed, and the number of claims denied for reasons other than those specified on lines 10-16. Some examples of items to be reported here are: • Services or rental is billed in advance; and • Representative payee's form not on file.
Line 19. Total - the total number of items denied, the related amount (in rounded dollars) disallowed and the number of denied claims reported on lines 10-18. 240.3 - Checking Form A Prior to Submittal to CMS (Rev. 6, 08-30-02) B3-13322.3 Prior to submitting Form A to CMS, the carrier checks for completeness, accuracy, and internal consistency. It uses the following checklist to assure accuracy and consistency: • For lines 1 through 9 and 20 and 21, column 1 must equal the sum of columns 2 and 3; • Each of lines 2, 4, and 6 must be less than or equal to the total sum of lines 9, 10 and 13 on the Form B submitted for the three months in the quarter; • The sum of lines 3, 5, and 7 must be less than or equal to line 1 for each column; • Line 8 should be at least equal to, but in most cases greater than, the accumulated total for lines 11 and 14 on the Form B submitted for the three months in the quarter; • Lines 10 + 11 + 12 + 13 + 14 + 15 + 16 + 17 + 18 = line 19 for all columns; • The total number of items denied as reported on line 19, column 1 should be at least equal to, but in most cases greater than, the total number of claims denied in full or in part as reported on line 8 column 1; • The dollar amount disallowed reported in the first column of line 9 and the second column of line 19 must be equal; and • The total number of claims denied reported on line 19, column 3 must be at least equal to, but in most cases greater than the total number of claims denied in full or in part as reported on line 8, column 1. 250 - Completing Medicare Fraud Unit Quarterly Workload Status Report, CMS-1565B - General (Inactive) (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) B3-13323 The carrier prepares and submits to CMS each quarter a report on the number of fraud workload items handled by its Medicare fraud unit. This information is required by CMS to budget for fraud and abuse activities, as well as to monitor the flow of work through the fraud units. It submits this form via CROWD no later than the fifteenth day following the close of the reporting quarter. 250.1 - Heading
(Rev. 6, 08-30-02) B3-13323.1 This report is referenced as Form M in the CROWD system. The carrier completes the ADD/UPDATE/DELETE DATA criteria screen with the appropriate information to bring the reporting format to its screen. 250.2 - Checking Reports (Rev. 6, 08-30-02) B3-13323.2 Before submitting Form M to CMS, the carrier checks for completeness and arithmetical accuracy. It uses the following checklist: • For all columns, line 1 must equal line 8 of Form M for the previous quarter. • For all columns, line 1 + line 2 = line 3. • For all columns, line 6 + line 7 = line 5. • For all columns, line 3 + line 4 - line 5 = line 8. • For all lines, column 1 = column 2 + column 3 + column 4. 250.3 - Type of Fraud Workload Item (Rev. 6, 08-30-02) B3-13323.3 The carrier reports fraud workload items in the following columns for all lines of Form M: Column (1) - Total - All fraud workload items. Column (2) - Beneficiary Complaints - The number of complaints received from, or on behalf of, beneficiaries alleging fraud. The carrier does not include complaints filed with the Office of the Inspector General (OIG) Hotline. Column (3) - OIG Hotline - The number of complaints received via the OIG Hotline. Column (4) - Referrals and Other - Referrals and any other workload received by the fraud unit (e.g., provider complaints, internally generated referrals from medical review, special requests from OIG or CMS). 250.4 - Body of Report (Rev. 6, 08-30-02) B3-13323.4 Line 1. Opening Pending - The system will pre-fill the number pending from line 8 of the previous quarter's report. Line 2. Adjustments - If it is necessary to revise the pending figure for the close of the previous quarter because of inventories, reporting errors, etc., the carrier enters the adjustment on this line. It precedes negative adjustments with a minus sign.
Line 3. Adjusted Pending - The system will sum line 1 + line 2 to calculate the adjusted opening pending. Line 4. Workload Received - The number of complaints and referrals received in the fraud unit during the reporting period. Line 5. Total Cleared - The system will sum line 6 + line 7 to calculate the total number of complaints and referrals cleared by the fraud unit during the reporting period. Line 6. Cleared by Contractor - The number of complaints and referrals cleared by the fraud unit by means other than referral to the OIG or designated agency. The carrier includes those that were: • Closed as not substantive or not a fraud issue. • Closed as not a fraud issue, but referred to another contractor component for their review or action. • Closed as not being a fraud issue, but referred to an external component other than the OIG. Line 7. Cleared by Referral - The number of complaints and referrals that were incorporated into cases referred formally to the OIG or designated agency for action (e.g., sanctions or prosecution). Line 8. Closing Pending - The system will calculate the closing pending for the quarter by adding line 3 to line 4, and subtracting line 5. 260 - Completing Form CMS-1565C (Rev. 6, 08-30-02) B3-13324 260.1 - Classification of Claims for Counting (Rev. 12456; Issued:01-11-24; Effective: 07-01-24; Implementation:07-01-24) The A/B MAC (B) reports on Page 12 of the CMS-1565 data on the claims on which it paid interest because it paid the claims after the required payment date per §9311 of the Omnibus Reconciliation Act of 1986 (OBRA 1986). It bases data shown on reliable counts of all claims processing activity, not on estimates. It reports data on initial claims only. It includes in the report all claims requiring interest payments in the month. It reports claims in the month the date of payment falls. (For a discussion of interest payments refer to the Medicare Claims Processing Manual, Publication 100-04, chapter 1, sections 80.2.2 and 80.2.2.1). The A/B MAC (B) completes the report for each column as follows: Column 1. Total - Data for all claims (real and replicate) for which interest payments were made during the month.
Column 2. Assigned Physician - Data for the assigned claims included in column 1 which involved services billed by physicians. Physicians are identified by specialty codes 01-14, 16-30, 33-41, 44, 46, 48, 66, 70, 72, 76-79, 81-86, 90-94, 98, 99, C0, C3, C5, C6, C7, C8, C9, D3, D4, D7, D8, E1, E2, E3, E4, E5, E6, E7, E9, F1, F2, F3, F4, F5, F6. Column 3. Assigned DME - Data for the assigned claims included in column 1 that involved services billed by DME suppliers. Column 4. Assigned Lab - Data for the assigned claims included in column 1 that involved services billed by an independent laboratory. Independent laboratories are identified by specialty code 69. Column 5. Assigned Ambulance - Data for the assigned claims included in column 1 that involved services billed by ambulance service suppliers. Ambulance service suppliers are identified by specialty code 59. Column 6. Assigned Other - Data for the assigned non-physician claims included in column 1 but not represented in columns 3, 4, or 5. Column 7. Unassigned - Data for the unassigned claims included in column 1. Column 8. Participating Physician - Data for claims involving services rendered by physicians enrolled in the Medicare Physician/Supplier Participation Program. On line 1, the A/B MAC (B) shows the number of claims on which it paid interest in the reporting month. It reports on line 2 the number of claims included in line 1 for which it made payment 1 day after the required payment date (e.g., the required payment date is 17 days after receipt for participating physician claims received in FY 1992.) (See §9311 of OBRA 1986.) Data for lines 3-10 are similar to those for line 2. The A/B MAC (B) calculates the number of days late by subtracting the Julian date of the required payment date from the Julian date of payment. On line 11, it shows the amount paid in interest for claims reported in line 1. On lines 12-20, it shows the amount paid in interest for claims reported in lines 2-10, respectively. It shows dollar amounts on lines 11-20 to the nearest penny, and includes the decimal point. 270 - Completion of Items on Form CMS-1565C (Rev. 6, 08-30-02) B3-13325 270.1 - Heading (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) B3-13325.1 This report is referenced as Form G for CROWD. The carrier submits the appropriate information for the reporting period for each office assigned a separate contractor number and BSI. It must submit Form A for the reporting quarter before the system will allow it to submit Form G for the same quarter. 270.2 - Part D - Selected Claim Data by Participation Status (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24)
This part provides CMS with current quarterly workload data on the results of carrier activity in processing claims for physician and non-physician services according to the participation status of the physician/supplier. It also provides important related information on reasonable charge determinations, the extent to which claims for such services are being denied, and the amount of charges disallowed. The carrier reports only data relating to initial claims (real and replicate) actions. It does not report data on the disposition of reviews, hearings, or reopenings of initial claim actions. It reports data for lines 1-34 for each column (participation/assignment status) as defined in the Medicare Claims Processing Manual, Publication 100-04, Chapter 1, Section 30. unless otherwise stated. Specialty codes for physicians and non-physicians are listed in the Medicare Claims Processing Manual, Chapter 26, Sections 10.8.2 and 10.8.3. Line 1. Number of Claims Approved - total number of claims, processed to completion during the quarter, which were paid or applied to the deductible. Claims paid or applied toward the deductible are those reported in lines 9, 10, and 13 of Form B. The system will pre-fill columns 1 and 3 based on the total of these lines from the monthly reports. Line 2. Physician Only - number of claims included in line 1 involving physician services only. Line 3. Physician and Non-Physician - number of claims included in line 1 involving both physician and non-physician services on the same claim. The carrier shows all claims in this category under the "Non-Participant-Unassigned" column 3. Therefore, the numbers for columns 1 and 3 should be equal. Line 4. Non-Physician Only - number of claims included in line 1 involving non-physician services only. Line 5. Number of Covered Services - total number of covered services on the claims approved as shown on line 1. The carrier does not include services for which charges were completely disallowed. Line 6. Physician - number of physician services included in line 5. The carrier includes in this count the covered services from the claims shown in line 2 plus the covered physician services from the claims shown in line 3. Line 7. Non-Physician - number of non-physician services included in line 5. The carrier includes in this count the covered services from the claims shown in line 4 plus the covered non- physician services from the claims shown in line 3. Line 8. Amount of Covered Charges - total amount (rounded to the nearest dollar) of billed charges for the covered services shown in line 5. For those services in which any charges were reduced as a result of reasonable charge, medical necessity, or global fee/rebundling determinations, the carrier reports the total covered charges prior to such reductions. The system will pre-fill columns 1 and 3 with the data reported in the respective columns on line 1 of Form A for the same quarter.
Line 9. Physician - total amount (rounded to the nearest dollar) of billed charges for the covered physician services shown in line 6. For those services in which any charges were reduced as a result of reasonable charge, medical necessity, or global fee/rebundling determinations, the carrier reports the total covered charges prior to such reductions. Line 10. Non-Physician - total amount (rounded to the nearest dollar) of billed charges for the covered non-physician services shown in line 7. For those services in which any charges were reduced as a result of reasonable charge, medical necessity, or global fee/rebundling determinations, the carrier reports the total covered charges prior to such reductions. Line 11. Number of Claims Where Billed Charges Were Reduced - number of claims (real and replicate) reported on line 1 as approved in which any charges were reduced as a result of reasonable charge/fee schedule, medical necessity, or global fee/rebundling determinations. The carrier counts a claim only once, regardless of the number of services reduced or the different categories of reductions that apply. Some examples of such reductions are: a. Charges over allowed rental limits b. Tests included in a battery of tests, c. Fee covered in basic allowance or surgical allowance, d. Service included in office charge or surgery fee. Line 12. Physician Only - number of claims included in line 11 involving physician services only. Line 13. Physician and Non-Physician - number of claims included in line 11 involving both physician and non-physician services on the same claim. The carrier shows all claims in this category under the "Non-Participant-Unassigned" column 3. Therefore, the numbers for columns 1 and 3 should be equal. Line 14. Non-Physician Only - number of claims included in line 11 involving non-physician services only. Line 15. Number of Covered Services Where Charges Were Reduced - From the claims shown in line 11, the carrier reports the number of covered services in which any charges were reduced as a result of reasonable charge determinations, medical necessity reductions, or global fee/rebundling reductions. It includes services where a fee is deemed to have been included in a global fee, such as postsurgical care. (See examples given for line 11.) Line 16. Physician - number of covered physician services included in line 15. This count includes those services where charges were reduced on the claims shown in line 12, plus the physician services where charges were reduced on the claims shown in line 13. Line 17. Non-Physician - number of covered non-physician services included in line 15. This count includes those services where charges were reduced on the claims shown in line 14, plus the non-physician services where charges were reduced on the claims shown in line 13. Line 18. Total Amount of Reduction - total amount (rounded to the nearest dollar) by which the services reported in line 15 were reduced as a result of reasonable charge, medical necessity, or
global fee/rebundling determinations. The system will pre-fill columns 1 and 3 with the sum of the data reported in the respective columns on lines 3, 5, and 7 of Form A for the same quarter. Line 19. Physician - total amount (rounded to the nearest dollar) by which charges for physician services reported in line 16 were reduced as a result of reasonable charge, medical necessity, or global fee/rebundling determinations. Line 20. Non-Physician - total amount (rounded to the nearest dollar) by which charges for non- physician services reported in line 17 were reduced as a result of reasonable charges, medical necessity, or global fee/rebundling determinations. Line 21. Number of Claims Denied in Full - total number of claims, processed to completion during the quarter, in which charges for all services were completely disallowed. This number must equal the sum of the numbers reported in lines 11 and 14 of Form B for the three months of the quarter. The system will pre-fill columns 1 and 3 based on the total of these lines from the monthly reports. Line 22. Physician Only - number of claims included in line 21 involving physician services only. Line 23. Physician and Non-Physician - number of claims included in line 21 involving both physician and non-physician services on the same claim. The carrier shows all claims in this category under the "Non-Participant- Unassigned" column 3. Therefore, the numbers for columns 1 and 3 should be equal. Line 24. Non-Physician Only - number of claims included in line 21 involving non-physician services only. Line 25. Number of Claims Denied in Full or in Part - sum of (1) those claims (real and replicate) reported as denied in full in line 21, plus (2) those claims (real and replicate) reported as approved on line 1 in which some services, but not all, were denied. The system will pre-fill columns 1 and 3 with the data reported in the respective columns on line 8 of Form A for the same quarter. Line 26. Physician Only - number of claims included in line 25 involving physician services only. Line 27. Physician and Non-Physician - number of claims included in line 25 involving both physician and non-physician services on the same claim. The carrier shows all claims in this category under the "Non-Participant-Unassigned" column 3. Therefore, the numbers for columns 1 and 3 should be equal. Line 28. Non-Physician Only - number of claims included in line 25 involving non-physician services only. Line 29. Number of Denied Services - number of services for which charges were fully or partially denied on the claims shown in line 25.
Line 30. Physician - number of denied physician services included in line 29. The carrier includes in this count the denied services from the claims shown in line 26 plus the denied physician services from the claims shown in line 27. Line 31. Non-Physician - number of denied non-physician services included in line 29. The carrier includes in this count the denied services from the claims shown in line 28, plus the denied non-physician services from the claims shown in line 27. Line 32. Amount Disallowed - total amount (rounded to the nearest dollar) of charges disallowed on the services shown in line 29. The system will pre-fill columns 1 and 3 with the data reported in the respective columns on line 9 of Form A for the same quarter. Line 33. Physician - total amount (rounded to the nearest dollar) included in line 32 as disallowed which represented physician services as reported in line 30. Line 34. Non-Physician - total amount (rounded to the nearest dollar) included in line 32 as disallowed which represented non-physician services as reported in line 31. 270.3 - Checking Form G Prior to Submittal to CMS (Rev. 6, 08-30-02) B3-13325.3 Prior to submitting Form G to CMS, the carrier checks for completeness, accuracy and internal consistency. It uses the following checklist to assure accuracy and consistency: 1. For all lines, column 1 must equal the sum of columns 2 through 4, 2. Line 1 should equal the sum of lines 2 through 4 for all columns, 3. Line 5 should be greater than or equal to line 1 for all columns, 4. Line 5 should equal the sum of lines 6 and 7 for all columns, 5. Line 8 should be greater than or equal to line 5 for all columns, 6. Line 8 should equal the sum of lines 9 and 10 for all columns, 7. Line 9 should be greater than or equal to line 6 for all columns, 8. Line 10 should be greater than or equal to line 7 for all columns. 9. Line 11 should be less than or equal to line 1 for all columns, 10. Line 11 should equal the sum of lines 12-14 for all columns, 11. Line 12 should be less than or equal to line 2 for all columns, 12. Line 13 should be less than or equal to line 3 for all columns, 13. Line 14 should be less than or equal to line 4 for all columns, 14. Line 15 should be greater than or equal to line 11 for all columns, 15. Line 15 should equal the sum of lines 16 and 17 for all columns, 16. Line 15 should be less than or equal to line 5 for all columns, 17. Line 16 should be less than or equal to line 6 for all columns, 18. Line 17 should be less than or equal to line 7 for all columns, 19. Line 18 should be less than or equal to line 8 for all columns,
20. Line 18 should equal the sum of lines 19 and 20 for all columns, 21. Line 19 should be less than or equal to line 9 for all columns, 22. Line 20 should be less than or equal to line 10 for all columns, 23. Line 21 should equal the sum of lines 22-24 for all columns, 24. Line 25 should be greater than or equal to line 21 for all columns, 25. Line 25 should be equal to the sum of lines 26-28 for all columns, 26. Line 26 should be greater than or equal to line 22 for all columns, 27. Line 27 should be greater than or equal to line 23 for all columns, 28. Line 28 should be greater than or equal to line 24 for all columns, 29. Line 29 should be greater than or equal to line 25 for all columns, 30. Line 29 should equal the sum of lines 30 and 31 for all columns, 31. Line 32 should equal the sum of lines 33 and 34 for all columns; 32. Column 1 should equal column 3 for lines 3, 13, 23 and 27. 33. The following comparisons should be made between Form G and two other related forms, the CMS-1565 (Form B) and the CMS-1565A (Form A): a. Line 1, column 1, of Form G must equal the sum of lines 9, 10, + 13, column 1 of Form B for the reporting months. b. Line 1, sum of columns 2 + 4 of Form G must equal the sum of lines 9, 10, + 13, column 2 of Form B for the reporting months. c. Line 1, column 3 of Form G must equal sum of lines 9, 10, + 13, column 3 of Form B for the reporting months. d. Line 21, column 1 of Form G must equal sum of lines 11 + 14, column 1 of the CMS- 1565 for the reporting months. e. Line 21 sum of columns 2 + 4 of Form G must equal sum of lines 11 + 14, column 2 of Form B for the reporting months. f. Line 21, column 3 of Form G must equal sum of lines 11 + 14, column 3 of the Form B for the reporting months. g. Line 8, column 1 of Form G must equal line 1 column 1 of Form A for the same quarter. h. Line 8, sum of columns 2 + 4 of Form G must equal line 1 column 2 of the Form A for the same quarter. i. Line 8, column 3 of Form G must equal line 1 column 3 of Form A for the same quarter. j Line 11, column 1 of Form G must be less than or equal to the sum of lines 2, 4 + 6, column 1 of Form A for the same quarter.
k. Line 11, sum of columns 2 + 4 of Form G must be less than or equal to the sum of lines 2, 4 + 6, column 2 of the Form A for the same quarter. l Line 11, column 3 of Form G must be less than or equal to the sum of lines 2, 4 + 6 column 3 of Form A for the same quarter. m. Line 18, column 1 of Form G must equal sum of lines 3, 5 + 7, column 1 of Form A for the same quarter. n. Line 18, sum of columns 2 + 4 of Form G must equal sum of lines 3, 5 + 7, column 2 of Form A for the same quarter. o. Line 18, column 3 of Form G must equal sum of lines 3, 5 + 7, column 3 of Form A for the same quarter. p. Line 25, column 1 of Form G must equal line 8 column 1 of Form A for the same quarter. q. Line 25, sum of columns 2 + 4 of Form G must equal line 8 column 2 of Form A for the same quarter. r. Line 25, column 3 of Form G must equal line 8, column 3 of Form A for the same quarter. s. Line 32, column 1 of Form G must equal line 9, column 1 of Form A for the same quarter. t. Line 32 sum of columns 2 + 4 of Form G must equal line 9 column 2 of Form A for the same quarter. u. Line 32, column 3 of Form G must equal line 9, column 3 of Form A for the same quarter. 280 - Completing Comprehensive Limiting Charge Compliance Program (CLCCP) Quarterly Report, CMS-1565D - General (Rev. 6, 08-30-02) B3-13326 The carrier prepares and submits to CMS each quarter, a report on carrier CLCCP activity including such items as the number of Limiting Charge Exception Reports (LCERs), Limiting Charge Monitoring Reports (LCMRs), and Sanction Referral Letters (SRLs) sent during the quarter. It prepares its quarterly report based on the data captured in its cycle management reports in accordance with MCM, §7555.6ff. 280.1 - Heading (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) B3-13326.1
This report is referenced as Form N for CROWD. The carrier submits the appropriate information for the reporting period for each office assigned a separate contractor number and BSI. 280.2 - Checking Reports (Rev. 6, 08-30-02) B3-13326.2 Before submitting Form N to CMS, the carrier checks for completeness and arithmetical accuracy. It uses the following checklist: • Line 5 must be greater than or equal line 4. • Line 6 must be less than or equal line 5. • Line 7 must be less than or equal line 5. • Line 15 must be less than or equal line 14. 280.3 - LCER Data (Rev. 6, 08-30-02) B3-13326.3 The carrier reports in items 1-4 numbers of LCERs sent, not the number of providers receiving LCERs. Each of these items, therefore, will be the sum of the numbers shown on its cycle reports for the period. Line 1 - LCERs Sent to Individual Physicians - The carrier reports the total number of LCERs sent to individual physicians during the period. Line 2 - LCERs Sent to Group Practices - The carrier reports the total number of LCERs sent to group practices of physicians during the period. Line 3 - LCERs Sent to All Other Providers - The carrier reports the total number of LCERs sent to all providers other than individual physicians, or group practices of physicians. Line 4 - Total LCERs Sent for Period - The system will sum lines 1, 2, and 3 to calculate this field. Line 5 - Total Claims on LCERs Sent - The carrier reports the total number of claims included on all of the LCERs sent for the period. Line 6 - Claims Selected for Verification - The carrier reports the total number of claims selected for verification of refund/adjustment during the reporting period. Line 7 - Beneficiaries with Claims on LCERs - The carrier reports the sum of the number of individual beneficiaries counted on its cycle reports for the period. Although an individual is to be counted only once on any particular cycle report, if the individual has claims on more than one cycle report, that individual will be counted more than once on the quarterly report. 280.4 - Monetary Data (Rev. 6, 08-30-02)
B3-13326.4 The carrier reports all dollar amounts to two decimal places on lines 8-13. It reports the sum of the net figures for all of the cycles in the reporting period. It calculates and includes changes because of adjustments to claims in a cycle, or from a previous cycle, so that these figures accurately reflect the relationship between allowed dollars and excess dollars. Adjustments which leave overcharges of less than $1.00 may affect the total dollar value reported on line 13, thus it may not always equal the amount reported on line 9. Line 8 - Total Dollars Allowed - The carrier reports the total dollars allowed from the sum of the cycle reports for the period. Line 9 - Dollars in Excess of Limiting Charge - The carrier reports the total dollars in excess of the limiting charge from the sum of the cycle reports for the period. Lines 10-13 - Procedures with Related Excess Charges - The carrier reports on lines 10-13 the total number of procedures (column 1), and related total dollar value of excess charges (column 2) that fall within each of the dollar ranges of excess charges on the respective lines: Line 10 is $1.00 - 4.99, line 11 is $5.00 -499.99, and line 12 is $500.00 + . The carrier need not complete line 11, as the system will calculate it by subtracting lines 10 and 12 from line 13 (Total). 280.5 - Verification Data for Refunds and Adjustments (Rev. 6, 08-30-02) B3-13326.5 Line 14 - Verifications Posted to the Limiting Charge Exception File (LCEF) - The carrier reports the total number of acceptable verifications posted to the LCEF. Line 15 - Not Requested on LCER - The carrier reports the number of acceptable verifications included on line 14 that were not requested on an LCER. Line 16 - Unacceptable Verifications - The carrier reports the number of verifications received, either because of an LCER or unsolicited, that were unacceptable, (i.e., posted as unacceptable to the LCEF or could not be associated with an LCEF record). 280.6 - LCMR Data (Rev. 6, 08-30-02) B3-13326.6 Line 17 - LCMRs Sent to Individual Physicians - The carrier reports the total number of LCMRs sent to individual physicians during the reporting period. Line 18 - LCMRs Sent to Group Practices - The carrier reports the total number of LCMRs sent to group practices of physicians during the reporting period. Line 19 - LCMRs Sent to All Other Providers - The carrier reports the total number of LCMRs sent to all providers other than individual physicians or group practices of physicians.
Line 20 - Total LCMRs Sent for Period - The system will sum lines 17, 18, and 19 to calculate the total number of LCMRs sent. 280.7 - Sanction Referral Data (Rev. 6, 08-30-02) B3-13326.7 Line 21 - SRLs Sent to Individual Physicians - The carrier reports the number of sanction referral letters sent to individual physicians during the reporting period. Line 22 - SRLs Sent to Group Practices - The carrier reports the number of sanction referral letters sent to group practices of physicians during the reporting period. Line 23 - All Other Providers - The carrier reports the number of sanction referral letters sent to all providers other than individual physicians or group practices of physicians. Line 24 - Total SRLs Sent for Period - The system will sum lines 21, 22, and 23 to calculate the total number of sanction referral letters sent. 290 - Completing Health Professional Shortage Area (HPSA) Quarterly Report, Form CMS-1565E - General (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) The carriers/Part B MACs prepare and submit to CMS each quarter a report on information regarding incentive payments made to physicians who render covered Medicare services in HPSAs (see Pub. 100-04, Chapter 12, §§90.4 – 90.4.7) on the results of its review of sample claims for HPSA incentive payments processed during the reporting quarter. It submits this report via CROWD no later than the 75th day following the close of the reporting quarter. 290.1 - Heading (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) This report is referenced as Form S for CROWD. The carrier/Part B MAC submits the appropriate information for the reporting period for each office assigned a separate contractor number and BSI. 290.2 - Checking Reports (Rev. 176, Issued: 11-12-10, Effective: 12-13-10, Implementation: 12-13-10) Before submitting Form S to CMS, the carrier/Part B MAC checks for completeness and arithmetical accuracy. It uses the following checklist: ● Line 2 plus line 3 must equal line 1. Effective with the first quarterly report of 2005, that is due no later than 75 days after the close of the first calendar quarter of 2005, this will no longer be applicable.
● Line 5 plus line 6 must equal line 4. Line 2 plus line 3 must equal line 1. Effective with the first quarterly report of 2005, that is due no later than 75 days after the close of the first calendar quarter of 2005, this will no longer be applicable. • Line 8 must be less than or equal to line 7. • Line 9 must be greater than or equal to line 7. • Line 10 must be less than or equal to line 9. • Line 13 plus line 14 plus line 15 must be less than or equal to line 12. • Line 16 must be greater than or equal to line 12. • Line 17 must be less than or equal to line 16. • Sum of lines 19-30, column 1 must equal line 10. • Sum of lines 19-30, column 2 must equal line 17. 290.3 - Current Quarter Payments (Rev. 176, Issued: 11-12-10, Effective: 12-13-10, Implementation: 12-13-10) The carrier/Part B MAC reports in lines 1-3 the number of physicians receiving incentive payment checks during the current reporting quarter and in lines 4-6 the respective amounts of payment issued. Note: For data reporting purposes for this report, “physicians” will be defined as NPI/PIN combinations as provided to the carriers/Part B MACs by the Shared System. Physicians Receiving Checks Line 1. Total Physicians - total number of physicians receiving incentive payments. Line 2. Urban HPSAs - number of physicians receiving incentive payments classified as providing services in a HPSA urban setting. Effective with the first quarterly report of 2005, that is due no later than 75 days after the close of the first calendar quarter of 2005, this line must no longer be entered. Line 3. Rural HPSAs - number of physicians receiving incentive payments classified as providing services in a HPSA rural setting. Effective with the first quarterly report of 2005, that is due no later than 75 days after the close of the first calendar quarter of 2005, this line must no longer be entered. Amount Of Incentive Payments Line 4. Total Incentive Payments - total amount of incentive payments issued to physicians.
Line 5. Urban HPSAs - amount of incentive payments issued to physicians for services provided in a HPSA urban setting. Effective with the first quarterly report of 2005, that is due no later than 75 days after the close of the first calendar quarter of 2005, this line must no longer be entered. Line 6. Rural HPSAs - amount of incentive payments issued to physicians for services provided in a HPSA rural setting. Effective with the first quarterly report of 2005, that is due no later than 75 days after the close of the first calendar quarter of 2005, this line must no longer be entered. 290.4 - Current Quarter Reviews (Rev. 176, Issued: 11-12-10, Effective: 12-13-10, Implementation: 12-13-10) The carrier/Part B MAC reports in lines 7-11 information on physicians identified for review based on data for the current reporting quarter excluding those physicians reviewed because they were noncompliant in the previous quarter. Note: For data reporting purposes for this report, “physicians” will be defined as NPI/PIN combinations as provided to the carriers/Part B MACs by the Shared System. Line 7. Physicians Reviewed - number of physicians identified for review based on data for the current reporting quarter. The carrier/Part B MAC excludes those physicians reviewed because of noncompliance in the previous quarter. Line 8. Physicians Paid Incorrectly - number of physicians reviewed on line 7 that incorrectly received an incentive bonus on at least one claim. Line 9. Claims Reviewed - number of total claims reviewed for physicians reported on line 7. Line 10. Claims Paid Incorrectly - number of claims included on line 9 where the physician incorrectly received incentive payments. Line 11. Incentive Amount Paid Incorrectly - total incentive amount incorrectly paid on claims identified on line 10. 290.5 - Prior Quarter(s) Reviews (Rev. 176, Issued: 11-12-10, Effective: 12-13-10, Implementation: 12-13-10) The carrier/Part B MAC reports in lines 12-18 information on physicians reviewed because they were noncompliant in the previous quarter(s). Note: For data reporting purposes for this report, “physicians” will be defined as NPI/PIN combinations as provided to the carriers/Part B MACs by the Shared System. Line 12. Physicians Reviewed - number of physicians who were identified in lines 8, 13, 14, or 15 on the previous quarter report as noncompliant. Line 13. Physicians Noncompliant Two Quarters - number of physicians identified in line 12 that were noncompliant in the current and previous quarters, but no quarters prior.
Line 14. Physicians Noncompliant Three Quarters - number of physicians identified in line 12 that were included in line 13 in the previous quarter's report and still noncompliant in the current quarter. Line 15. Physicians Noncompliant Four or More Quarters - number of physicians identified in line 12 that were included in line 14 in the previous quarter's report and still noncompliant in the current quarter. Line 16. Claims Reviewed - number of claims reviewed for the physicians identified in line 12. Line 17. Claims Paid Incorrectly - number of claims in line 16 that were paid incorrectly. Line 18. Incentive Amount Paid Incorrectly - total incentive amount paid on those claims identified in line 17. 290.6 - Error Descriptions (Rev. 176, Issued: 11-12-10, Effective: 12-13-10, Implementation: 12-13-10) This report breaks down the number of claims found to be paid incorrectly by selected error categories for "Current Quarter Reviews" and "Prior Quarter(s) Reviews". Claims counts reported in lines 19-30 under the "Number of Claims Current Quarter" column should total to the number reported in line 10. Similarly, claims counts reported in lines 19-30 under the "Number of Claims Prior Quarter(s)" column should total to the number reported in line 17. In a case where the claim could fall into more than one category, the carrier/Part B MAC makes a determination as to which category to put the claim in. Each claim incorrectly receiving a HPSA incentive payment should be counted only once under the "Error Descriptions" section. Line 19. Office In, Service Outside HPSA - number of claims where the provider's office is located in a HPSA, but the provider travels to a non-HPSA to provide services. Line 20. Office Outside, Service Outside HPSA - number of claims where neither the provider's office nor the place of service is located in a HPSA. Line 21. Multiple Offices, Service Non-HPSA Office - number of claims when the physicians with multiple offices (some of which may be in a HPSA, and some of which are not) bill for services provided in their non-HPSA office. Line 22. Beneficiary in HPSA, Services Outside HPSA - number of claims where the provider used the beneficiary's address for HPSA incentive eligibility instead of the place of service. Line 23. Provider Codes Prior to Effective Date HPSA - number of claims where the services were provided before the effective date the area was designated as a HPSA. The effective date providers can begin coding claims for HPSA incentive payments is the first day of the second month following the date CMS is notified by PHS. CMS will transmit the effective date to the carrier/Part B MAC. Effective January 1, 2005, the effective date of a HPSA designation will be the date of the HRSA designation letter which will be reflected on the HRSA Web site.
Line 24. Service Area No Longer HPSA - number of claims requesting HPSA payment after the area is no longer classified as a HPSA. CMS will transmit the termination date to the carrier/Part B MAC. Line 25. Non-Physician Practitioner - number of claims coded for HPSA incentives, but the services were provided by someone other than a physician. An example is a claim submitted with the HPSA modifier, and the service was provided by a nurse practitioner. Line 26. Non-Physician Service - number of claims coded for HPSA incentives which were for services other than physician professional services. Examples of services furnished by a physician, but not subject to the HPSA incentive, are technical components of diagnostic tests, drugs, and separately payable supplies. Line 27. Carrier/Part B MAC Provided Incorrect Information - number of claims that were incorrectly coded by the provider for HPSA incentives as a result of incorrect information the carrier/Part B MAC provided. Line 28. Carrier/Part B MAC Published Incorrect Notice - number of claims where the provider code for HPSA incentives was based on a population group (noncovered) HPSA notice the carrier/Part B MAC incorrectly published. Line 29. Carrier Keying/Processing Error - number of claims paid for the HPSA incentives inappropriately due to keying or processing errors made by carrier/Part B MAC staff. Line 30. Other - number of claims that do not fit into any of the other categories. Although not routinely required, carriers/Part B MACs may be asked to expand on the reason for error on these types of claims. 300 - Exhibits (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) B3-13329 Exhibit 1 - Medicare Program Quarterly Supplement To The Carrier Performance Report CMS- 1565a (Crowd Form A) MEDICARE PROGRAM QUARTERLY SUPPLEMENT TO THE CARRIER PERFORMANCE REPORT CMS-1565A (CROWD FORM A) CARRIER REPORTING PERIOD (QUARTER AND YEAR) NUMBER AND TYPE OF CLAIM REPORTING ITEM TOTAL - 1 ASSIGNED - 2 UNASSIGNED - 3
A. CLAIMS REDUCED OR DENIED COVERED CHARGES 1. Tot. Cvrd. Charges For All Claims REAS. CHG./FEE SCHED. REDUCTIONS 2. No. of Clms w/Reas Chg/Fee Sched Red 3. Amount of Reduction (in $) MEDICAL NECESSITY REDUCTIONS 4. Number of Claims w/ Med. Nec. Red. 5. Amount of Reduction (in $) GLOBAL FEE/REBUNDLING REDUCTIONS 6. No. of Claims w/ Glo. Fee/Rebun Red. 7. Amount of Reduction (in $) DENIALS 8. Claims Denied in Full or in Part 9. Amount Disallowed (in $) REASONS FOR DENIAL NUMBER OF ITEMS DENIED (1) AMOUNT DISALLOWED (2) NUMBER OF CLMS DENIED (3) 10. Claimant Ineligible 11. Filing Limitation Exceeded 12. Duplicate Claim 13. Services Not Covered 14. Services Not Medically Necessary 15. MSP 16. Missing Information 17. Global Fee/Rebundling 18. Other 19. Total FORM-CMS 1565A
Exhibit 2 - Medicare Fraud Unit Quarterly Workload Status Report - CMS-1565B (CROWD FORM M) MEDICARE FRAUD UNIT QUARTERLY WORKLOAD STATUS REPORT CMS-1565B (CROWD FORM M) CARRIER NUMBER____________________________ REPORT PERIOD_______________________________ FRAUD WORKLOAD ITEM TOTAL 1 BENEFICIARY COMPLAINT 2 OIG HOTLINE 3 REFERRAL & OTHERS 4 1. OPENING PENDING 2. ADJUSTMENTS 3. ADJUSTED PENDING 4. WORKLOAD RECEIVED 5. TOTAL CLEARED 6. BY CONTRACTOR 7. BY REFERRAL 8. CLOSING PENDING FORM-CMS 1565B
Exhibit 3 - Medicare Program Quarterly Supplement To The Carrier Performance Report CMS-1565C (Crowd Form G) MEDICARE PROGRAM QUARTERLY SUPPLEMENT TO THE CARRIER PERFORMANCE REPORT CMS-1565C (CROWD FORM G) CARRIER REPORTING PERIOD REPORTING ITEM TOTAL 1 NON-PAR ASSIGNED 2 NON-PAR UNASSGNED 3 PARTICI- PANTS 4 1. CLAIMS APPROVED: TOTAL 2. PHYS ONLY 3. PHYS AND NONPHYS 4. NONPHYS ONLY 5. COVRD SERVICES: NUMBER 6. PHYS 7. NONPHYS 8. AMT COVRD CHRGS: TOTAL 9. PHYS 10. NONPHYS 11. CLAIMS REDUCED: TOTAL 12. PHYS ONLY 13. PHYS AND NONPHYS 14. NONPHYS ONLY 15. COVRD SRVCS RED: NUM 16. PHYS 17. NONPHYS 18. AMOUNT REDUCED: TOTAL 19. PHYS 20. NONPHYS 21. FULL DENIALS: NUMBER 22. PHYS ONLY 23. PHYS AND NONPHYS 24. NONPHYS ONLY 25. FULL/PART DENIALS: NUM 26. PHYS ONLY 27. PHYS AND NONPHYS 28. NONPHYS ONLY 29. DENIED SERVICES: NUM 30. PHYS 31. NONPHYS 32. AMT DISALLOWED: TOTAL
33. PHYS 34. NONPHYS FORM-CMS 1565C
Exhibit 4 - Comprehensive Limiting Charge Compliance Program Quarterly Report CMS- 1565d (Crowd Form N) COMPREHENSIVE LIMITING CHARGE COMPLIANCE PROGRAM QUARTERLY REPORT - CMS-1565D (CROWD FORM N) CARRIER NUMBER________________ REPORT PERIOD___________________ COLUMN 1 COLUMN 2 1. LCERs SENT TO IND PHYSICIANS 2. LCERs SENT TO GROUP PRACTICES 3. LCERs SENT TO ALL OTHER PROVIDERS 4. TOTAL LCERs SENT FOR PERIOD 5. TOTAL CLAIMS ON LCERs SENT 6. CLAIMS SELECTED FOR VERIFICATION 7. BENEFICIARIES W/CLAIMS ON LCERS 8. TOTAL DOLLARS ALLOWED 9. DOLLARS IN ECESS OF LMTNG CHARGE 10. $1.00-$4.99 11. $5.00-$499.99 12. $500+ 13. TOTAL # OF PROCEDURES TOTAL $ VALUE 14. VERIFICATIONS POSTED TO LCEF 15. NOT REQUESTED ON LCER 16. UNACCEPTABLE VERIFICATIONS 17. LCMRs SENT TO IND PHYSICIANS 18. LCMRs SENT TO GROUP PRACTICES 19. LCMRs SENT TO ALL OTHER PROVIDERS 20. TOTAL LCMRs SENT FOR PERIOD 21. SRLs SENT TO IND PHYSICIANS 22. SRLs SENT TO GROUP PRACTICES 23. SRLs SENT TO ALL OTHER PROVIDERS 24. TOTAL SRLs SENT FOR PERIOD FORM-CMS 1565D
Exhibit 5 - Health Professional Shortage Area (HPSA) Quarterly Report HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) QUARTERLY REPORT CMS- 1565E (CARRIERS ONLY - CROWD FORM S) Screen 1 CARRIER NAME______________________________ CARRIER NUMBER____________________________ CMS-1565E REPORT PERIOD____________________ CURRENT QUARTER PAYMENTS PHYSICIANS RECEIVING CHECKS: 1. TOTAL 2. URBAN HPSA'S 3. RURAL HPSA'S AMOUNT OF INCENTIVE PAYMENTS: 4. TOTAL 5. URBAN HPSA'S 6. RURAL HPSA'S
Exhibit 6 - Health Professional Shortage Area (HPSA) Quarterly Report CMS-1565E (Carriers Only - Crowd Form S) HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) QUARTERLY REPORT CMS- 1565E (CARRIERS ONLY - CROWD FORM S) Screen 2 CARRIER NAME CMS-1565E CARRIER NUMBER REPORT PERIOD CURRENT QUARTER REVIEWS 7. PHYSICIANS REVIEWED 8. PHYSICIANS PAID INCORRECTLY 9. CLAIMS REVIEWED 10. CLAIMS PAID INCORRECTLY 11. INCENTIVE AMOUNT PAID INCORRECTLY PRIOR QUARTER(S) REVIEWS 12. PHYSICIANS REVIEWED 13. PHYSICIANS NONCOMPLIANT 2 QRTS. 14. PHYSICIANS NONCOMPLIANT 3 QRTS. 15. PHYSICIANS NONCOMPLIANT 4+ QRTS. 16. CLAIMS REVIEWED 17. CLAIMS PAID INCORRECTLY 18. INCENTIVE AMOUNT PAID INCORRECTLY
Exhibit 7 - Health Professional Shortage Area (HPSA) Quarterly Report HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) QUARTERLY REPORT - CMS- 1565E (CARRIERS ONLY - CROWD FORM S) Screen 3 CARRIER NAME __________________ CMS-1565E CARRIER NUMBER ________________ REPORT PERIOD _______________ ERROR DESCRIPTIONS # OF CLAIMS CURRENT QUARTER # OF CLAIMS PRIOR QUARTER 19. OFFICE IN, SERVICE OUTSIDE HPSA 20. OFFICE OUTSIDE, SERV. OUTSIDE HPSA 21. MULTI-OFFICE, SERVICE NON-HPSA OFF. 22. BENE. IN HPSA, SERVICE OUTSIDE HPSA 23. PROV. CODE PRIOR TO EFF. DATE HPSA 24. SERVICE AREA NO LONGER HPSA 25. NON-PHYSICIAN PRACTITIONER 26. NON-PHYSICIAN SERVICE 27. CARRIER PROVIDED INCORRECT INFO. 28. CARRIER PUBLISHED INCORRECT NOTICE 29. CARRIER KEYING/PROCESSING ERROR 30. OTHER
310 - Carrier Beneficiary Overpayment Activity Report (Form CMS-2174) - (Inactive) (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) B3-13350 At the end of each calendar quarter (i.e., December, March, June, September) the carrier prepares and submits to CMS a report summarizing beneficiary overpayment activity completed during the reporting quarter. It completes a separate report for each carrier office that has been assigned a separate carrier number. 310.1 - Purpose and Scope (Rev. 6, 08-30-02) B3-13350.1 This report provides CMS with current data on beneficiary overpayments - nationally as well as for each carrier. The report enables CMS to tabulate for administrative and statistical purposes data on beneficiary overpayments: • The total dollar amount of money overpaid; • The causes of overpayments; • How overpayments are discovered; and • The amount of overpayments you recover. 310.2 - Due Date (Rev. 6, 08-30-02) B3-13350.2 The carrier transmits the CMS-2174 to CO via PC or terminal as soon as possible after the end of the reporting quarter, but no later than the 15th day of the month following the end of the reporting quarter, e.g., the October-December report is due on January 15. Non-receipt of the report by the due date will result in CMS contacting it to obtain the required information. 320 - Completing Carrier Beneficiary Overpayment Activity Report (Inactive) (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) B3-13351 320.1 - Classification of Claims for Counting (Rev. 6, 08-30-02) B3-13351.1 Data on the CMS-2174 reflects counts of claims for which the carrier has made a determination that a beneficiary-recoverable overpayment exists. The overpayment must have been made to a beneficiary or to a without-fault physician/supplier on behalf of a beneficiary. The carrier should not confuse this with an assignee overpayment (i.e., one made to an assignee who is at fault and therefore liable). (See Chapter 3, §§200-202.) It counts claims only once regardless of the number of separate instances of overpayments found on them.
330 - Completion of Items on Form CMS-2174 (Inactive) (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) B3-13360 330.1 - Heading (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) B3-13360.1 This report is referenced as Form O for CROWD. The carrier enters its ID number in the number box. In the space labeled "Reporting Period" it enters the fiscal quarter and year (e.g., 0190 for October-December 1989) for which the report is prepared. 330.2 - Section A - Beneficiary Overpayments (Rev. 6, 08-30-02) B3-13360.2 The carrier reports the number of claims and the dollar amounts for which a determination was made during the reporting quarter or a previous quarter that a beneficiary-recoverable overpayment had been made. It does not count potential overpayment claims under investigation. It includes individual overpayments discovered as part of CMS's Carrier Quality Control Program (QA) end- of-line review sample. It does not include projections of overpayments from QA samples. It includes overpayments discovered where Medicare is secondary to prime insurers (Department of Labor - BL, WC, VA, auto medical or no fault, liability, EGHP under the working aged or ESRD provisions or LGHP under the disabled provision) that also paid the beneficiary. Round amounts to the nearest whole dollar. Line 1. Pending Start of Quarter - The number of claims and dollar amount of beneficiary overpayments reported in line 13 as the closing pending on the previous quarter's report. Line 2. Adjustments to Opening Pending - Any adjustments to the previous quarter's closing pending amount due to errors, decisions resulting from reviews and hearings, reopenings, etc. Show as a plus or a minus, as appropriate. Line 3. Adjusted Opening Pending - The result of line 1 + line 2, as appropriate. Line 4. Discovered During Reporting Quarter - The number of claims and the dollar amount for which a determination was made during the reporting quarter that a beneficiary-recoverable overpayment had been made. This does not include potential overpayments under investigation. It includes claims where the payee returned or never negotiated the check(s). Claim counts are treated differently from money amounts in lines 5-9 below. A claim is counted in these lines only when it has been fully disposed. This line does not include partial dispositions in the claim counts for lines 5-9. It does not include any money amounts partially disposed in lines 5-9 as appropriate. Line 5. Dispositions - The number of claims for which: Recovery of a beneficiary-recoverable overpayment by offset or refund was completed during the quarter (see NOTE 3); or
A determination was made during the quarter that the overpayment is uncollectible or is to be abandoned in accordance with Chapter 3, §§190 ff. This includes any amount recouped by offset or refund, or determined to be uncollectible or abandoned in accordance with Chapter 3, §§190 ff. during the quarter, regardless of whether it was a full or partial determination. NOTES: 1. If part of an overpayment is recouped and the remainder is determined to be uncollectible or abandoned, the disposition of the overpayment is considered to be completed. 2. If the disposition of the overpayment is completed and it falls into more than one line of lines 7, 8, 10-12, it is counted once under the "number of claims" in the line category accounting for the greatest dollar amount. The carrier reports the money amount in each appropriate line, however. (It does not report any money amounts reported in previous quarters.) 3. If part of the overpayment has been recouped and part is still outstanding at the end of the quarter, the carrier includes the amount recouped. It does not include the claim count. It includes the portion of the overpayment which is still outstanding in the claim count and amount for line 10. Line 6. Collected - The carrier enters the number of overpayments recouped by offset or refund during the reporting quarter. Under the money column, it reports any amount recovered by offset or refund. Line 7. Recouped by Offset - The carrier enters the number of beneficiary-recoverable overpayment claims for which it completed disposition during the reporting quarter and for which most or all of the dollar amounts were recouped by offsetting payment on subsequent requests for payment. (This includes cases where a letter has been written to the payee requesting a refund, but before the refund is received a request for payment is received which completes repayment of the overpayment.) Under the money amount column, it reports any amount recovered by this method, whether a full or partial recovery. Line 8. Recouped by Refund - The carrier enters the number of beneficiary-recoverable overpayment claims for which it completed disposition during the reporting quarter and the final disposition was made by a refund. (It includes cases where the payees returned the checks.) Under the money amount column, it reports any amount recovered by refund, whether a full or partial recovery. Line 9. Uncollectibles - The carrier reports the number of beneficiary-recoverable overpayment claims for which it completed disposition during the reporting quarter by determining for most or all of the dollar amount, to be uncollectible and have either referred to the RO, waived, or abandoned them. Under the money column, it reports the amount involved. Line 10. Referred to RO - The carrier enters the number of beneficiary-recoverable overpayment claims for which it completed disposition during the reporting quarter and where, for most or all of the dollar amount, it terminated recovery efforts and referred the claim to the RO. (See Chapter 3, §§190 ff.) Under the money amount column, it reports the amount referred to RO.
Line 11. Waived by Contractor - The carrier enters the number of beneficiary-recoverable overpayment claims for which it completed disposition during the reporting quarter and where it waived most or all of the dollar amounts. (See Chapter 3, §§190 ff). Under the recovery amount column, it reports any amount waived in this way during the quarter. NOTE: A waiver is a case in which the beneficiary is liable and the criteria in Chapter 4, §100B for waiver recovery is met; i.e., it appears from the circumstances of the overpayment that the beneficiary was without fault and that the recovery would be against equity and good conscience or would defeat the purpose of the Medicare Program (i.e., cause the individual financial hardship). Line 12. Abandoned in Accordance with Manual Instructions - The carrier enters the number of beneficiary-recoverable overpayment claims for which it completed disposition during the reporting quarter and which it abandoned for most or all of the dollar amount in accordance with Chapter 4, §70. Under the money amount column, it reports any amount abandoned. A claim is abandoned when recovery has been terminated because: • The total overpayment is less than $50, • The carrier has not taken action to reopen the payment decision within 4 years (48months) after the date of the initial payment determination, • Deceased beneficiary has no estate and there are no surviving relatives, or Beneficiary is on public assistance Line 13. Pending End of Quarter - The carrier enters the number of beneficiary-recoverable overpayments claims with any amount outstanding at the end of the reporting quarter. If part of a claim is recouped and part is outstanding, it reports only the amount outstanding. It does not include any amounts which have been recouped, either in full or in part. 330.3 - Section B - Cause of Overpayments (Rev. 315, Issued: 05-17-19, Effective: 06-18- 19, Implementation: 06-18-19) The term Medicare beneficiary identifier (Mbi) is a general term describing a beneficiary's Medicare identification number. For purposes of this manual, Medicare beneficiary identifier references both the Health Insurance Claim Number (HICN) and the Medicare Beneficiary Identifier (MBI) during the new Medicare card transition period and after for certain business areas that will continue to use the HICN as part of their processes. This solicits the reasons for overpayments in which a determination was made during the quarter that an overpayment had been made to, or on behalf of, the beneficiary. The data include both the number of claims on which beneficiary-recoverable overpayments were discovered and the amount of overpayment (not over-allowance) involved.
Where more than one cause of overpayment exists, the carrier reports the claim and dollar amount of the overpayment on only one of the lines 14 through 23 according to the principal reason for overpayment. The principal reason is that which involves the greatest dollar amount. The number of claims and amounts of beneficiary overpayments for reasons 14 through 23 combined should equal the number of claims and amount reported in Section A on line 4. Line 14. Beneficiary Not Entitled - The carrier enters under the appropriate columns the number and dollar amount of overpayments which resulted because payments were made to, or on behalf of, a beneficiary for services rendered during a period of non-entitlement or for claims processed under the wrong Medicare beneficiary identifier. (See Medicare Carrier Quality Assurance Handbook §290.1). Line 15. Services Not Covered - The carrier enters the number and dollar amount of overpayments which resulted because payments were made for non-covered services other than medically unnecessary services. (See Medicare Carrier Quality Assurance Handbook §290.2). Line 16. Charge Exceeded Reasonable Charge - The carrier enters under the appropriate columns the number and dollar amount of overpayments which resulted when improper charges, higher than the reasonable charge amount, were allowed. (See Medicare Carrier Quality Assurance Handbook §290.3). Line 17. Payment Made to Wrong Payee - The carrier enters under the appropriate columns the number and dollar amount of overpayments which resulted when a person other than the proper payee received the payment (e.g., the beneficiary is paid on an assigned claim). It reports duplicate payments made to the wrong payee in line 18 instead of here. Line 18. Duplicate Payment - The carrier enters under the appropriate columns the number and dollar amount of overpayments which occurred when payment was made to, or on behalf of, the beneficiary more than once for the same service. Line 19. Medically Unnecessary Services - The carrier enters under the appropriate columns the number and dollar amount of overpayments discovered which arose because of payments for services later determined to be medically unnecessary. Line 20. Services Not Rendered - The carrier enters under the appropriate columns the number and dollar amount of overpayments discovered which arose because of payments for services not actually rendered. It includes claims which involve forgery or fraudulent billing for noncovered services and other identified program abuses. Line 21. Medicare Secondary Payor - The carrier enters under the appropriate columns the number and dollar amounts of overpayments which arose because Medicare is secondary to prime insurers (e.g., Department of Labor, BL, WC, VA, auto, medical or no fault, liability, EGHP under the working aged or ESRD provision or LGHP under the disabled provision). Line 22. Documentation/Coding/Data Entry - The carrier enters under the appropriate columns the number and dollar amount of overpayments which resulted from:
• Insufficient documentation to support the payment action. (This could involve a claims processor's failure to resolve questions concerning entitlement, coverage, utilization, or reasonable charge) • Incorrect or incomplete coding; and • Errors in the transferring of data from an external document into a machine readable form, including errors in keypunching and other methods for data entry. (See Medicare Carrier Quality Assurance Handbook §§210.5-210.6). NOTE: If a documentation/coding data entry error results in an overpayment which may be categorized into any of lines 14 - 21, the carrier uses one of lines 14 - 21 instead of using line 22. Line 23. Other - The carrier enters under the appropriate columns the number and dollar amount of overpayments discovered which are not specifically provided for in lines 14-22 above. 330.4 - Section C - How Overpayments Were Discovered (Rev. 6, 08-30-02) B3-13360.4 This shows data on beneficiary-recoverable overpayments according to how they were discovered. Where more than one method of discovery exists, the carrier reports the claim and dollar amount of overpayment on only one of lines 24 - 28 according to the principal method of discovery. The principal method is that which involves the greatest dollar amount. Line 24. Reported by Beneficiary or Provider - The carrier enters under the appropriate columns the number of overpayments and that part of the dollar amount reported on line 4 which were discovered when a beneficiary or provider reported a beneficiary-recoverable overpayment. (This includes the situation where the beneficiary was paid instead of the provider.) Line 25. CMS's Carrier Quality Control Program - The carrier enters under the appropriate columns the number of overpayments and that part of the dollar amount reported on line 4 which were discovered through CMS's Carrier Quality Control Program - including both the carrier sample and the RO sub-sample. Line 26. Carrier Internal Audit or Review - The carrier enters under the appropriate columns the number of overpayments and that part of the dollar amount reported on line 4 which were discovered through its internal auditing procedures or review of subsequent claims. It excludes cases where the overpayment was discovered through CMS's Carrier Quality Control Program. (See line 25.) Line 27. Government Agency - The carrier enters under the appropriate columns the number of overpayments and that part of the dollar amount reported on line 4 which were discovered by DHHS, GAO, OIG, or other government agency audit. Line 28. Other Methods of Discovery - The carrier enters under the appropriate columns the number and dollar amounts involved for overpayments discovered by methods.
The number and amount of beneficiary overpayments reported on lines 24 through 28, when combined, should equal the number and amount reported in Section A on line 4. 330.5 - Checking Reports Prior to Submittal to CMS (Rev. 6, 08-30-02) B3-13360.5 Before sending reports to CMS, the carrier checks for completeness and arithmetic accuracy. The following checklist assists in the arithmetic check for both the number of claims and the amount of money involved. • A valid 5-digit carrier number is required. • The default value for areas not keyed is zero. • Appropriate fiscal quarter (1-4) and year is required. o For each column, line 1, plus or minus line 2, must equal line 3. Line 3cannot be negative. o For each column line 6 + 9 must equal line 5. o For each column line 7 + 8 must equal line 6. o For each column line 10 + 11 + 12 must equal line 9. o For each column line 3 + 4 - 5 must equal line 13. o For each column line 14 + 15 + 16 + 17 + 18 + 19 + 20 + 21 + 22 + 23 must equal line 4. o For each column line 24 + 25 + 26 + 27 + 28 must equal line 4. o For each column line 1 of the current report must equal line 13 of the previous report.
340 - Exhibit - Medicare Program Carrier Beneficiary Overpayment Activity Report - (Form CMS-2174) (Rev. 6, 08-30-02) B3-13379 MEDICARE PROGRAM CARRIER BENEFICIARY OVERPAYMENT ACTIVITY REPORT CARRIER NUMBER ________________ REPORTING PERIOD ______________ NUMBER OF CLAIMS AMOUNT OF MONEY A.BENEFICIARY OVERPAYMENTS 1. PENDING START OF QUARTER 2. ADJUSTMENTS TO OPENING PENDING 3. ADJUSTED OPENING PENDING 4. DISCOVERED DURING REPORTING QUARTER 5. DISPOSITIONS 6. COLLECTED 7. RECOUPED BY OFFSET 8. RECOUPED BY REFUND 9. UNCOLLECTIBLES 10. REFERRED TO REGIONAL OFFICE 11. WAIVED BY CONTRACTOR 12. ABANDONED IN ACCORD WITH MAN. INSTR. 13. PENDING END OF QUARTER B. CAUSE OF OVERPAYMENTS 14. BENEFICIARY NOT ENTITLED 15. SERVICES NOT COVERED 16. CHARGE EXCEEDED REASONABLE CHARGE 17. PAYMENT MADE TO WRONG PAYEE 18. DUPLICATE PAYMENT 19. MEDICALLY UNNECESSARY SERVICES 20. SERVICES NOT RENDERED
NUMBER OF CLAIMS AMOUNT OF MONEY 21. MEDICARE SECONDARY PAYER 22. DOCUMENTATION/CODING/DATA ENTRY 23. OTHER C. HOW OVERPAYMENTS WERE DISCOVERED 24. REPORTED BY BENEFICIARY OR SUPPLIER 25. CMS's CARRIER QUALITY CONTROL PROGRAM 26. CARRIER INTERNAL AUDIT OR REVIEW 27. GOVERNMENT AGENCY 28. OTHER METHODS OF DISCOVERY
Monthly Statistical Report on Carrier Appeal Activity 350 - Carrier Appeals Report (Form CMS-2590) (Rev. 6, 08-30-02) B3-13400 At the end of each month the carrier prepares and transmits to CMS a report summarizing its Part B review and hearing activity during the month. The carrier completes a separate report for each office assigned a separate carrier number. Form CMS-2590 is subject to the Paperwork Reduction Act and requires approval from the Office of Management and Budget (OMB). OMB approval has been requested. 350.1 - Purpose and Scope (Rev. 6, 08-30-02) B3-13400.1 The CMS-2590 (see §300 - Exhibits 1 through 4) provides CMS with the basic data needed on review and hearing (both carrier and ALJ) activity. This report enables CMS to tabulate data for administrative purposes on the following information: • The number of reviews and hearings requested, completed, and pending; • The number of reviews and hearings resulting in affirmations or reversals of previous determinations; • The number of reviews and hearings involving waiver of liability determinations and dollar amount of charges allowed; • Data on timeliness; and • The number of Part B reopenings. 350.2 - Due Date (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) B3-13400.2 The carrier transmits form CMS-2590 to CO via PC or terminal. It uses instructions in the CROWD User Guide available via the CMS Enterprise Portal. The report is due as soon as possible after the end of the reporting month but no later than the 15th of the month following the end of the reporting month. 360 - Completion of Items on Form CMS-2590 (Rev. 6, 08-30-02) B3-13410
360.1 - Heading (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) B3-13410.1 This report is referenced as Form H for CROWD. The carrier submits the appropriate information for the reporting period for each office assigned a separate contractor number and BSI. 360.2 - Section A - Carrier Appeal Requests (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) B3-13410.2 Section A: Carrier Appeal Requests - This part concerns data from the Part B appeals process. The number of appeals requested (received), completed, and pending reflects the status of the workload as of the last day of the reporting month. The carrier bases data on actual counts of each activity and not on sampling or other estimating techniques. APPEALS FALL INTO THE FOLLOWING CATEGORIES: Column (1) Total Reviews - The first formal level of appeal following denial of a Part B claim. It is a second look by a different employee at the claim and supporting evidence. (See The Medicare Claims Processing Manual, Chapter 30, Beneficiary Correspondence and Appeals). The carrier does not count duplicate review requests or review requests received before it has made an initial determination on a claim. It counts one review per request received. With the exception of line 7, it does not count the number of claims or beneficiaries involved in the requests. It reports in Column (1) data relating to all types of reviews (both those requested in writing and those conducted by telephone). Column (2) Telephone Reviews - The carrier reports in this column, data on those reviews included in column 1 that were conducted by telephone. It reports data in this column on lines 6, 7, 9, 10, 11, and 12 only. Column (3) Carrier Hearings - This column represents independent determinations on claims for which the party has appealed the carrier review decision. Such independent determinations are rendered by Hearing Officers (HO) that the carrier assigns. The amount in controversy must be at least $100. (See The Medicare Claims Processing Manual, Chapter 30, Beneficiary Correspondence and Appeals) The carrier counts one hearing per request received (i.e., form CMS-1965 or equivalent written request). It includes hearings requested that do not meet the minimum $100 requirements and are subsequently dismissed. With the exception of line 7, it does not count the number of claims or beneficiaries involved in the requests. (It reports claim counts in line 7.) It does not count hearing requests that qualify for an ALJ hearing (i.e., Part B hearings are those hearings that a hearing officer adjudicates, as opposed to an ALJ). See definition for Section D. It does not count requests for HO hearings received after it has rendered an OTR decision in lines 1-32 of the report. It counts these cases only in lines 33, 34, 35, 36, and 38 as appropriate.
Line 1. Opening Pending - It reports, under the appropriate columns, the numbers of reviews on line 18 and hearings reported on line 28 as the closing pending on the previous month's report. Line 2. Adjustments to Pending - If it is necessary to revise the pending figure for the close of the previous month because of inventories or reporting errors, the carrier reports the adjustment. It reports requests received near the end of the reporting month and placed under control sometime after the reporting month as received in the reporting month, not as requests received in the subsequent month. If some cases were not counted in the proper month's receipts, it counts them as adjustments to the opening pending in the subsequent month. If line 3 of the current month differs from the closing pending of the previous month, there must be an entry in line 2 for the current month. The carrier precedes the entry by a "+" or "-," as appropriate. Line 3. Adjusted Pending - It reports the result of line 1 + line 2 (taking into account the "-" sign, if any). Line 4. Requests Received - It reports, under the appropriate columns, the number of review and hearing requests received during the reporting month. (See definitions for columns 1 and 3 for a discussion of what constitutes a request for a review and hearing.) It includes requests transferred to it by other contractors if it incurs the administrative costs for processing the appeals, and reports the costs on the Interim Expenditure Report (Form CMS-1524). If one physician submits one request involving several assigned claims (and several beneficiaries), the carrier counts this as one request. If one beneficiary submits a request involving several unassigned bills (from several different physicians), it counts this as one request. If an appellant submits more than one request (for different claims) at different times, the carrier counts each request. NOTE: See definition of column (3) for instructions on hearings requested subsequent to OTR decisions. Line 4A. Medical Necessity Documentation Denials - The carrier reports the number of requests included in line 4 that involved initial claim denials for lack of medical documentation. Line 5. Transferred - The carrier reports, under column 1, the number of review requests it transferred to other carriers because it did not process the original claim(s). It reports, under column 3, the number of hearing requests transferred to other carriers because the claimant is not within the original carrier's geographical area, or the claim was transferred to ROs because the issues are outside the HO's responsibility. (See The Medicare Claims Processing Manual, Chapter 30, Beneficiary Correspondence and Appeals) For columns 1 and 3, if it reported a review or hearing as transferred, it does not report any information regarding it on lines 6-39. The transfer is the final action. Line 6. Requests Cleared - The carrier reports, under the appropriate columns, the total number of all reviews, telephone reviews, and hearings completed during the month. It reports all completed reviews and hearings, regardless of the final outcome, i.e., affirmation, reversal, withdrawal, or dismissal. It considers a review cleared when the final determination (EOMB or other notice - including dismissal) is printed or typed, or upon notification of withdrawal by the
appellant. In the case of a reversal, it considers the case cleared when it initiates the adjustment action. A hearing is cleared when the decision is signed, or one of the following conditions is present: • The claimant indicates satisfaction with the OTR decision; • The claimant indicates after the OTR decision the desire to proceed with an ALJ hearing (if the amount in controversy is $500 or more); • The HO dismisses the hearing request; or • The appellant withdraws the hearing request. The carrier does not consider a hearing completed upon release of an OTR decision unless the appellant specifically requested an OTR hearing. It does not count the OTR hearing as completed until it has completed all follow-up actions as required in The Medicare Claims Processing Manual, Chapter 30, Beneficiary Correspondence and Appeals. If, as a result of follow-up actions, the appellant requests an in-person or telephone hearing after release of the OTR decision, the OTR hearing and decision are not counted on the report with the exception noted below. If the appellant does not appear for the subsequent hearing, the hearing is dismissed. The dismissal is the final action. However, the decision to record in lines 9-11 is the OTR decision. NOTE: If the carrier closes a review or hearing after the end of a reporting month, but before the report is due on the fifteenth of the subsequent month, it does not count it until the subsequent month's report. Line 7. No. of Claims Involved - The carrier reports the total number of claims (as defined in §§3000-3000.2) involved in the appeals reported as cleared during the month on line 6. For example, if it processes decisions for two hearings in the month, one of which involved three claims, and the other involved seven claims, it reports 10 claims under column 3. Line 8. Amount in Controversy - For the hearings reported as affirmed (line 9) or reversed (line 11), during the month, the carrier shows the total dollar amount in controversy on the initial hearing request. (See The Medicare Claims Processing Manual, Chapter 30, Beneficiary Correspondence and Appeals on how to determine the amount in controversy.) It shows results rounded to the nearest dollar. Line 9. Affirmations - Under the appropriate columns, the carrier shows the number of all reviews, telephone reviews, and hearings completed during the month in which the previous determination was completely upheld, e.g., no change was made. All parts of all claims in a case must be upheld in order to be counted as an affirmation. An OTR hearing decision does not count as a previous decision if the appellant subsequently requests an in-person or telephone hearing. If the in-person/telephone hearing is dismissed because the appellant did not appear, or the request was withdrawn, the carrier uses the OTR decision to determine if the case is counted here. See line 11 for partial affirmations. (They are not included here.)
If the carrier upholds its original determination, but pays under limitation of liability, it counts the review or hearing determination as an affirmation. It reports the appropriate information in Section D. Line 10. Dism./Withdr - The carrier reports, under the appropriate columns, the number of all reviews, telephone reviews, and hearings that were withdrawn by the appellant or dismissed (before determination) by the carrier or the HO. It reports here and in lines 4 and 6 an appeal that is requested and withdrawn or dismissed within the same month. If the appellant requests an in- person or telephone hearing after receiving an OTR decision and the carrier dismisses the hearing because the appellant failed to appear, the OTR decision is the final decision, not the dismissal. Similarly, for a withdrawal, the OTR decision is used. A dismissal at the review level is done when written correspondence or a telephone conversation has been identified as a review request, but the claimant does not have the right to an appeal. Misrouted correspondence is not a dismissal. If the carrier has incorrectly counted such correspondence as a review on a previous report, it uses line 2 (adjustments to pending) to correct the count. It does not count a duplicate request for review on the report. Likewise, it does not count on the report a request for review received before an initial claim determination has been rendered. (It considers the request an inquiry.) Line 11. Reversals (Full or Part) - Under the appropriate columns, the carrier shows the number of all reviews, telephone reviews, and hearings completed during the month in which at least part of the prior determination was reversed (e.g., a change was made and some or all of the new determination was in favor of the appellant). For example, if a review or hearing involves several claims, and the initial determinations for some of the claims are affirmed and some are reversed, the review or hearing decision is a reversal. An OTR hearing decision does not count as a previous decision if the appellant subsequently requests an in-person or telephone hearing. If the in-person/telephone hearing is dismissed because the appellant did not appear, or the request was withdrawn, the carrier uses the OTR decision to determine if the case is counted here. Line 12. Amount Awarded - For cases included in line 11 where the issue on the appeal was not a reasonable charge determination, the carrier shows the amount of allowed charges for services where the determination was reversed. It shows charges after reasonable charge reductions, but prior to application of deductible and coinsurance amounts. If the issue was a reasonable charge reduction, it shows the additional amount allowed. It rounds results to the nearest dollar. Computing Time to Process Carrier Reviews for Lines 13-17 For lines 13-17, the carrier uses the matrix below to determine the number of days from receipt to completion of all reviews (both written and telephone). The date of receipt in all written review requests is the day the processing carrier received it in its corporate mailroom. The date of receipt in all telephone review requests is the day the processing carrier received the request on the dedicated lines or in the dedicated area. Situation Date Completed The appellant withdraws the request The date the carrier is notified of the withdrawal Carrier dismisses the request or affirms the original determination The date of the notice
Carrier processes the request to reversal The date the carrier initiates the adjustment request Line 13. Review Processing Time - Average - The average number of days from receipt of the review request to the date of completion for all review requests (both written and telephone). To compute the average number of days from request to completion, the carrier divides the total days elapsed for all requests cleared in the month by the number of requests cleared. It rounds results to the nearest day. It calculates the days elapsed for an individual request by subtracting the Julian date of receipt of the request from the Julian date of completion. If the request is cleared in the year following the year of receipt, the carrier adds 365 or 366 to the result, as appropriate. (Otherwise, it will get a negative number.) If a case is cleared the same day it is received, it considers the case to require one day. NOTE: The carrier includes all cases cleared regardless of whether they were affirmed, reversed, dismissed, or withdrawn. Line 14. Reviews Completed in 1-30 Days - The number of reviews that required 1-30 days to complete. If a case is cleared the same day it is received, the carrier considers it to require 1 day. Line 15. Reviews Completed in 31-45 Days - The number of reviews that required 31-45 days to complete. Line 16. Reviews Completed in 46-60 Days - The number of reviews that required 46-60 days to complete. Line 17. Reviews Completed Over 60 Days - The number of reviews that required more than 60 days to complete. Line 18. Closing Pending-Reviews - The total number of reviews that have not been completed by the end of the reporting month. Line 19. Reviews Pending 1-30 Days - The number of reviews included in line 18 that have been pending 1-30 days, inclusive, at the end of the reporting month. Line 20. Reviews Pending 31-45 Days - The number of reviews included in line 18 that have been pending 31-45 days, inclusive, at the end of the reporting month. Line 21. Reviews Pending 46-60 Days - The number of reviews included in line 18 that have been pending 46-60 days, inclusive, at the end of the reporting month. Line 22. Reviews Pending Over 60 Days - The number of reviews included in line 18 that have been pending more than 60 days at the end of the reporting month. Computing Time to Process Carrier Hearings for Lines 23-27 For lines 23-27, the carrier uses the matrix below to determine the number of days from receipt to completion of hearings. The date of receipt in all cases is the day the carrier who is processing the
case received it in its corporate mailroom. In out-of-area cases the receipt date is the date that the second carrier received the request. Situation Date Completed An OTR decision is made and the appellant accepts the decision or decides to go directly to an ALJ hearing. The date of the OTR decision. An OTR decision is made, and the appellant chooses in a timely fashion, to proceed with the in-person or telephone hearing. The date of the second decision. If the appellant does not appear, and the carrier dismisses the hearing, it uses the date of the dismissal notice. An in-person or telephone hearing is held without an OTR decision. The date of the decision. The appellant withdraws the hearing request. The date the carrier was notified of the withdrawal. The HO dismisses the hearing request. The date of the dismissal notice. Line 23. Hearing Processing Time - Average - The carrier reports the average number of days from the receipt of the hearing request to the date of completion. See methodology under line 13. Line 24. Hearings Completed in 1-60 Days - The number of hearings that required 1-60 days to complete. If a case is cleared the same day it is received, the carrier considers it to require 1 day. Line 25. Hearings Completed in 61-90 Days - The number of hearings that required 61-90 days to complete. Line 26. Hearings Completed in 91-120 Days - The number of hearings that required 91-120 days to complete. Line 27. Number Completed Over 120 Days - The number of cases that required 121 days or more to complete. Line 28. Closing Pending-Hearings - The total number of hearings that have not been completed by the end of the reporting month. Line 29. Hearings Pending 1-60 Days - The number of hearings included in line 28 that were pending 1-60 days, inclusive, at the end of the reporting month. Line 30. Hearings Pending 61-90 Days - The number of hearings included in line 28 that were pending 61-90 days, inclusive, at the end of the reporting month. Line 31. Hearings Pending 91-120 Days - The number of hearings included in line 28 that were pending 91-120 days, inclusive, at the end of the reporting month. Line 32. Hearings Pending Over 120 Days - The number of hearings included in line 28 that were pending more than 120 days at the end of the reporting month. HEARING RESULTS Hearings fall into the following categories:
Column (1) On-the-Record with No Subsequent Hearings - This column represents hearings where: • The appellant originally requested an OTR hearing. • The appellant indicated that the appellant was satisfied with the OTR decision, or • That the appellant wished to proceed with an ALJ hearing (if the amount in controversy is $500 or more). In addition, if the appellant requests an in-person or telephone hearing subsequent to an OTR decision, but the hearing is dismissed or withdrawn, it is included here and not in columns (2) or (3). Column (2) All Telephone - This column represents hearings where the appellant requested and had a telephone hearing subsequent to an OTR hearing decision, or a telephone hearing was held without a prior OTR decision. The carrier counts all telephone hearings including those where the appellant did not follow-up timely to the OTR notice but later requested a telephone hearing. Column (3) All In-Person - This column represents hearings where the appellant requested and had an in-person hearing subsequent to an OTR hearing decision, or an in-person hearing was held without a prior OTR decision. The carrier counts all in-person hearings including those where the appellant did not follow-up timely to the OTR notice but later requested an in-person hearing. Column (4) Number in 120 Days - For the total cases included in line 35, columns 2 and 3, the carrier shows for lines 37-39 the numbers that were completed within 120 days of receipt. It uses the methodology shown for lines 23-27 to determine the completion date. Where an OTR decision is made and the appellant chooses to not follow-up timely and later requests either an in-person or telephone hearing, the carrier measures the completion time for this second reported hearing from the date of receipt of the original request to the date of the second decision. If the appellant does not appear, it dismisses the hearing, and uses the date of notice of dismissal as its date completed. Line 33. Reversals - Under the appropriate columns, the carrier shows the number of OTR, telephone, and in-person hearings completed in the month in which at least part of the review determination was reversed; i.e. a change was made and some, or all, of the new determination was in favor of the appellant. (See line 11 for a definition of a reversal.) Line 34. Affirmation - Under the appropriate columns, the carrier shows the number of OTR, telephone, and in-person hearings completed in the month in which the review determination was completely upheld; i.e., no change was made. (See line 9 for a definition of affirmation.) Line 35. Total Decisions - The carrier reports the total number of hearing decisions completed during the month that resulted in a reversal or affirmation (exclude dismissals and withdrawals). This includes those hearings shown in lines 9 and 11. Line 36. Number in 120 Days - For cases included in line 35, the carrier shows the number that were completed within 120 days of receipt. It uses the methodology shown in column (4) to determine the completion date.
Line 37. No Previous OTR Held - For cases included in line 35, columns (2) and (3), the carrier reports the number where it held the telephone or in-person hearing without first making an OTR decision (i.e., the OTR hearing was bypassed.) In column (4), it reports the number of cases included in either column (2) or (3) that were completed within 120 days. Line 38. Previous OTR Counted - For cases included in line 35, columns (2) and (3), the carrier reports the number where it included the OTR count on a previous report. In column (4), it reports the number of cases included in either column (2) or (3) that were completed within 120 days. Cases reported in line 38 are those where an OTR decision was made, and the appellant either accepted the OTR decision, did not respond timely in accordance with The Medicare Claims Processing Manual, Chapter 30, Beneficiary Correspondence and Appeals, or decided to go directly from the OTR decision to an ALJ hearing. Then, subsequent to this OTR decision "acceptance," the appellant decided that they wanted a telephone or in-person hearing. The carrier does not include these cases in line 6. Line 39. Previous OTR Not Counted - For cases included in line 35, columns (2) and (3), the carrier reports the number where it did not include the OTR count on a previous report. These are cases where it made the OTR decision first and the appellant indicated in a timely fashion that they wanted a telephone or in-person hearing. In column (4), it reports the number of cases included in either column (2) or (3) that were completed within 120 days. 360.3 - Section B - ALJ Hearings (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) B3-13410.3 Section B is intended for all requests for ALJ hearings including those expected to be dismissed for failure to meet the $500 amount in controversy requirement or for any other reason (such as a lack of a fair hearing). The carrier counts ALJ Hearings in Columns 1 and 2 using the following two methodologies: Column (1) Total - The total of all ALJ hearing requests as originally filed. Column (2) Dispositions - For lines 49 and 51-53 only, the carrier reports the number of dispositions rendered by the ALJ(s) in cases reported as cleared for the month in Line 49. There will usually be more ALJ dispositions than cases counted in line 49. A case is not counted in line 49 until the ALJ has cleared all of the claims included in the request for hearing. EXAMPLE: The carrier forwards one request to an ALJ involving 20 claims. The ALJ dismisses 10 claims at once. A month later, the ALJ decides to affirm the original decision on 5 others as one group. The other 5 receive separate determinations. This is counted as 7 dispositions. Line 40. Opening Pending - The number of ALJ hearings reported on line 57 as closing pending on the previous month's report.
Line 41. Adjustments to Pending - If line 42 of the current month differs from data in line 57 of the previous month, there must be an entry in line 41 for the current month. The carrier precedes the entry by a "+" or "-", as appropriate. See definition for line 2. Line 42. Adjusted Opening Pending - The result of line 40 + line 41 (taking into account the "-" sign, if any). Line 43. Requests Received - The number of ALJ hearings requested during the month. (See The Medicare Claims Processing Manual, Chapter 30, Beneficiary Correspondence and Appeals.) Line 44. Requests Forwarded to ALJ - The number of ALJ hearing requests forwarded to ALJs during the month. The carrier considers the case forwarded when all necessary material has been mailed to the ALJ. Line 45. No. of Claims Involved - The number of claims involved in the ALJ hearing requests forwarded to ALJs as reported on line 44. (See MCM-3, §§3000-3000.2 for definition of claim.) Line 46. No. Forwarded in 1-7 Days - The number of ALJ hearing requests forwarded to ALJs within 7 calendar days from receipt of the request to mailing of the necessary information. The carrier shows data for all cases mailed during the month. The number must be less than, or equal to, the number shown in line 44. Line 47. No. Forwarded in 1-14 Days - The number of ALJ hearing requests forwarded to ALJs within 14 days from receipt of the request to mailing of the necessary information. The carrier shows data for all cases mailed during the month. The number must be less than, or equal to, the number shown in line 44. Line 48. Average Time to Forward - The average number of calendar days from receipt of the ALJ request to the mailing date of the necessary information. The carrier the same methodology for counting as discussed in §360.2 for line 13. Line 49. ALJ Hearings Completed - The number of ALJ hearing requests completed during the month. The carrier considers a case completed when it receives the completed decision from the ALJ for all parts of the case. Line 50. Amount in Controversy - For ALJ hearings reported as affirmed (line 51) or reversed (line 53), during the month, the carrier shows the total dollar amount remaining in controversy according to the initial ALJ hearing request. This should be the amount remaining after previous appeal decisions. (See The Medicare Claims Processing Manual, Chapter 30, Beneficiary Correspondence and Appeals on how to determine the amount in controversy.) It rounds results to the nearest dollar. Line 51. Affirmations - The carrier reports number of completed ALJ hearings in which the previous determination was completely upheld i.e., no change was made. All parts of all claims in a case must be upheld in order for the case to be counted as an affirmation. See line 53 for partial affirmations. (The carrier does not include partial affirmations on this line.)
If the prior determination is upheld, but payment is made under limitation of liability, the carrier counts the ALJ hearing determination as an affirmation. It reports the appropriate information in lines 55 and 56. Line 52. Dismissals/Withdrawals - The e number of completed ALJ hearings that were withdrawn by the appellant or dismissed (before determination) by the ALJ. The carrier reports an appeal that was requested and withdrawn or dismissed within the same month here and in lines 43, 44, and 49. Line 53. Reversals (Full or Part) - The total number of completed ALJ hearings in which at least part of the prior determination was reversed i.e., a change was made and some or all of the new determination was in favor of the appellant. For example, if an ALJ hearing involves several claims, and the initial determinations for some of the claims are affirmed and some are reversed, the carrier considers the decision a reversal. Line 54. Amount Awarded - For cases included in line 53, the carrier shows the amount of allowed charges for services where the determination was reversed. It shows charges after reasonable charge reductions, but prior to application of deductible and coinsurance amounts. (If the appeal involved a reasonable charge reduction, it shows the additional amount allowed.) It rounds results to the nearest dollar. Line 55. Waived - Ben. and Prov - The number of claims involved in requests for ALJ hearings where limitation of liability was granted to both the beneficiary and provider in an assigned claim (see The Medicare Claims Processing Manual, Chapter X, Limitation on Liability), or where the provider's liability was limited in an unassigned claim(see 3 The Medicare Claims Processing Manual, Chapter X, Limitation on Liability). Line 56. Amount Awarded - For cases included in line 55, the carrier shows the amount of allowed charges for services (including the noncovered services) where the liability of the beneficiary and provider were limited. It shows charges after reasonable charge reductions, but prior to application of deductible and coinsurance amounts, rounding results to the nearest dollar. Line 57. Closing Pending - The total number of ALJ hearing requests that were not completed by the end of the reporting month. The carrier considers a case transferred to an ALJ as pending until it has received the complete decision from the ALJ for all parts of the case. Line 58. Effectuation of ALJ Decisions - The number of ALJ hearing decisions for which it initiated effectuation during the month. The carrier considers effectuation of a decision to be initiated when it completes the following: • Submission of claim to CWF if payment can be made without further development; or • Initiation of development e.g., when it must ascertain whether or not the provider has refunded payment to the beneficiary. Line 59. Number 1-7 Days - The number of cases where the carrier effectuated the decision within 7 days, inclusive, of receipt of the decision in its corporate mailroom.
Line 60. Number 8-15 Days - The number of cases where the carrier effectuated the decision within 8-15 days, inclusive, of receipt of the decision in its corporate mailroom. Line 61. Number 16-30 Days - The number of cases where the carrier effectuated the decision within 16-30 days, inclusive, of receipt of the decision in its corporate mailroom. Line 62. Number Over 30 Days - The number of cases where the carrier effectuated the decision in more than 30 days, inclusive, of receipt of the decision in its corporate mailroom. 360.4 - Section C - Reopenings (Claim Counts) (Rev. 6, 08-30-02) B3-13410.4 The carrier reports the number of claims (as defined in §§3000-3000.2) involved in reopenings completed during the month. (See The Medicare Claims Processing Manual, Chapter 30, Beneficiary Correspondence and Appeals) for discussion of what constitutes a reopening.) Claims review, hearings, and ALJ hearings undertaken as part of the appeal process are not considered reopenings. Reopenings fall into the following categories: Column (1) Total - The number of reopenings completed. Column (2) Pre-Review - The number of reopenings of initial claim determinations. If a claim has been through a review or any type of hearing, the carrier does not count it here. Column (3) Post-Review - The number of reopenings of review determinations. If a claim has been through any type of hearing, the carrier does not count it here. Column (4) Post-Hearing - The number of reopenings of hearing determinations regardless of the type of hearing e.g., carrier HO or ALJ. Once a claim has been through a carrier hearing, it is counted here if it is reopened. Line 63. Total - The number of claims for which the carrier completed the reopening of a claim determination, review determination, or hearing determination, whether or not the determination was revised. Line 64. Unfavorable to Claimant - Of the claims shown in line 63, this is a count of those that resulted in an unfavorable revision of a previously favorable decision. Line 65. No Change - Of the claims shown in line 63, these are those that the carrier reopened but did not revise the initial determination. Line 66. Favorable to Claimant - Of the claims shown in line 63, these are those that resulted in a favorable revision of a previously unfavorable decision. Line 67. Amount Awarded - For cases included in line 66, the carrier shows the amount of allowed charges for services that involved a revision of a previously unfavorable decision. It
shows charges after reasonable charge reductions but prior to application of the deductible and coinsurance amounts. (If the reopening involved a reasonable charge reduction, it shows the additional amount allowed.) It rounds results to the nearest dollar. 360.5 - Section D - Limitation of Liability (Claim Counts) (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) B3-13410.5 ASSIGNED CASES To include an assigned claim in lines 68-71, the carrier must have originally denied it or reduced it as "not reasonable and necessary" under §1862(a)(1) of the Act. (see The Medicare Claims Processing Manual, Chapter X, Limitation on Liability) Lines 69-71 are mutually exclusive i.e., a claim meeting the above condition may be counted on only one of the three lines. Therefore, the carrier ensures that the sum of the number of claims recorded on each of these lines equals the total number of assigned claims considered for limitation of liability during the period reported on line 68. The counts in lines 69-71 reflect counts of claims at the initial claim (column 1), review (column 2), and hearing levels (column 3) (as defined in MCM-3, §§3000-3000.2), not review or hearing requests. The carrier reports cases corresponding to the claims counted here in Section A also, as appropriate. If a claim is considered for limitation of liability at the initial claim level, the carrier does not count it at the or hearing level unless it changes the limitation of liability decision. It categorizes claims for columns shown in Section D according to the adjudication level at which limitation of liability is considered or granted. If it makes several different limitation of liability decisions on the same claim, it uses the highest numbered line on the report that applies to that claim. It counts the claim only once. For instance, if it waives liability for both the beneficiary and provider liability on any part of the claim, it counts the claim only on line 71. Line 68. Total Number Considered - The carrier reports, under the appropriate columns, the number of assigned claims meeting the conditions above for which limitation of liability was considered during the month. Line 69. Considered - Not Waived - The carrier reports under the appropriate columns the number of assigned claims meeting the conditions above on which limitation of liability was considered but was not granted to the beneficiary. Line 70. Waived - Bene. Only - The carrier shows, under the appropriate columns, the number of assigned claims meeting the conditions above on which it granted limitation of liability to only the beneficiary. Line 71. Waived - Bene. and Prov. - The carrier reports, under the appropriate columns, the numbers of assigned claims where it granted limitation of liability during the reporting month to both the beneficiary and provider. Line 72. Amount Awarded - For cases included in line 71, the carrier shows the amount of allowed charges for services (including noncovered services) where limitation of liability is
granted to the beneficiary and provider. It shows charges after reasonable charge reductions, but prior to application of deductible and coinsurance amounts, rounding results to the nearest dollar. UNASSIGNED CASES This section applies to claims where waiver of a provider's liability to make refund to the beneficiary on unassigned claims for those services found to be not reasonable or necessary is considered under “Limitation on Liability”. See The Medicare Claims Processing Manual, Chapter X, Limitation on Liability. Line 73. Total Number Considered - The carrier reports, under the appropriate columns, the number of unassigned claims that meet the conditions of §7330 for which limitation of liability was considered during the month. Line 74. Phys. Refund Waived - The carrier reports, under the appropriate columns, the number of unassigned claims that meet the requirements of §7330 on which it waived the liability of the provider to refund to the beneficiary the amount disallowed as not reasonable and necessary. Line 75. Phys. Refund Upheld - The carrier reports, under the appropriate columns, the number of unassigned claims that meet the requirements of The Medicare Claims Processing Manual, Chapter X, Limitation on Liability chapter, on which it required the physician to refund the amount disallowed. 370 - Checking Reports (Rev. 6, 08-30-02) B3-13415 Before sending the report to CMS, the carrier checks for completeness and arithmetical accuracy. It uses the following checklist for each column: • Line 1 column (1) must be equal to line 18 of previous month. • Line 1 column (3) must be equal to line 28 of previous month. • Line 1 + line 2 = line 3 for columns (1) and (3). • Line 3 column (1) + line 4 column (1) - line 5 column (1) - line 6 column (1) = line 18. • Line 3 column (3) + line 4 column (3) - line 5 column (3) - line 6 column (3) = line 28. • Line 4A must be less than or equal to line 4 for columns (1) and (3). • Line 6 = line 9 + line 10 + line 11. • Line 9 column (3) + line 11 column (3) must be less than or equal to line 35 (sum of all columns). • Line 6 column (1) = line 14 + line 15 + line 16 + line 17. • Line 6 column (3) = line 24 + line 25 + line 26 + line 27. • Column (2) must be less than or equal to column (1) for lines 6, 7, 9, 10, 11, and 12. • Line 7 must be greater than or equal to line 6. • Line 18 = line 19 + line 20 + line 21 + line 22. • Line 28 = line 29 + line 30 + line 31 + line 32. • Line 35 = line 33 + line 34. • Line 35 = line 37 + line 38 + line 39 for columns 2 and 3 only.
• Line 36 must be less than or equal to line 35 for columns 1, 2, and 3. • Line 37 (column 4) must be less than or equal to line 37 (column 2) + line 37 (column 3). • Line 38 (column 4) must be less than or equal to line 38 (column 2) + line 38 (column 3). • Line 39 (column 4) must be less than or equal to line 39 (column 2) + line 39 (column 3). • Line 40 must be equal to line 57 of the previous month for column 1 only. • Line 42 = line 40 + line 41 for column 1. • Line 42 + line 43 - line 49 = line 57 for column 1 only. • Line 45 must be greater than or equal to line 44 for column 1 only. • Line 46 must be less than or equal to line 44 for column 1 only. • Line 47 must be less than or equal to line 44 for column 1 only. • Line 49 = line 51 + line 52 + line 53. • Line 50 must be greater than or equal to 500 times the sum of lines 51 and 53 for column 1 only (each case must involve at least $500). • Column 2 must be greater than or equal to column 1 for lines 49 and 51 - 53. • Line 54 must be greater than or equal to line 53 for column 1 only (must award at least $1 per case). • Line 56 must be greater than or equal to line 55 for column 1 only (at least $1 per case). • Line 58 = line 59 + line 60 + line 61 + line 62. • Line 63 = line 64 + line 65 + line 66. • Line 67 must be greater than or equal to line 66 (at least $1 per case). • Line 68 = line 69 + line 70 + line 71. • Line 72 must be greater than or equal to line 71 (at least $1 per case). • Line 73 must be greater than or equal to line 74. • Line 73 must be greater than or equal to line 75. • Column 1 = column 2 + column 3 + column 4 for lines 63 - 67. Public reporting burden for this collection of information is estimated to average 2 hours per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining data needed, and completing and reviewing the collection of information. Comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden may be sent to the following: Centers for Medicare & Medicaid Services Office of Financial Management P.O. Box 26684 Baltimore, MD 21207 and to the Office of Management and Budget Paperwork Reduction Project (0938-0452) Washington, DC 20503.
380 - Exhibits (Rev. 6, 08-30-02) B3-13416 Exhibit 1 - Medicare Program - Carrier Appeal Report - Form CMS-2590 MEDICARE PROGRAM - CARRIER APPEAL REPORT - FORM CMS-2590 CARRIER ID ___________________ REPORT PERIOD _____________________ A. CARRIER APPEAL REQUESTS TOTAL REVIEWS (1) TELEPHONE REVIEWS (2) HEARINGS (3) 1. OPENING PENDING 2. ADJSTMTS TO PNDNG 3. ADJUSTED PENDING 4. REQUESTS RECEIVED 4A. MED. DOC. DENIALS 5. REQUESTS TRANSFERRED 6. REQUESTS CLEARED 7. NO. OF CLAIMS 8. AMT IN CONTROVERSY 9. AFFIRMATIONS 10. DISMISSED/WITHDRAWN 11. REVERSALS 12. AMOUNT AWARDED FORM CMS-2590 SCREEN 1
Exhibit 2 - Medicare Program - Carrier Appeals Report - Form CMS-2590 MEDICARE PROGRAM - CARRIER APPEALS REPORT - FORM CMS-2590 CARRIER ID __________________ REPORT PERIOD _____________________ REVIEW REQUESTS REVIEWS (1) HEARING REQUESTS HEARINGS (2) PROCESSING TIMES PROCESSING TIMES 13. REVIEWS- AVERAGE 23. HEARINGS- AVERAGE 14. NBR COMP 1-30 DYS 24. NBR COMP 1-60 DYS 15. NBR COMP 31-45 DYS 25. NBR COMP 61-90 DYS 16. NBR COMP 46-60 DYS 26. NBR COMP 91-120 DYS 17. NBR COMP 60 DYS+ 27. NBR COMP 120 DYS+ PENDING TIMES PENDING TIMES 18. CLOSING PENDING 28. CLOSING PENDING 19. NBR COMP 1-30 DYS 29. NBR COMP 1-60 DYS 20. NBR COMP 31-45 DYS 30. NBR COMP 61-90 DYS 21. NBR COMP 46-60 DYS 31. NBR COMP 91-120 DYS 22. NBR COMP 60 DYS+ 32. NBR COMP 120 DYS+ HEARING RESULTS OTR WITH NO SUBSEQUENT HEARING (1) TELEPHONE (2) IN- PERSON (3) NBR IN 120 DYS (4) 33. REVERSALS 34. AFFIRMATIONS 35. TOTAL DECISIONS 36. NBR IN 120 DYS 37. NO PREV OTR HELD 38. PREV OTR COUNTED 39. PREV OTR NOT COUNTED FORM CMS-2590 SCREEN 2
Exhibit 3 - Medicare Program - Carrier Appeals Report - Form CMS 2590 MEDICARE PROGRAM - CARRIER APPEALS REPORT - FORM CMS 2590 CARRIER ID ___________________ REPORT PERIOD _____________________ B. PART B ALJ HEARINGS TOTAL (1) DISPOSITIONS (2) B. PART B ALJ HEARINGS TOTAL (1) 40 OPENING PENDING 55. WAIVED - BEN & PROV 41 ADJUSTMENTS TO PENDING 56. AMOUNT AWARDED 42. ADJUSTED OPENING PENDING 57. CLOSING PENDING 43. REQUESTS RECEIVED 58. EFFECT. OF ALJ DEC 44. REQ. FORWARDED TO ALJ 59. NO. 1-7 DAYS 45. NO. OF CLAIMS INVOLVED 60. NO. 8-15 DAYS 46. NO. IN 1-7 CALNDR DAYS 61. NO. 16-30 DAYS 47. NO. IN 1-14 CLNDR DAYS 62. NO. OVER 30 DAYS 48. AVG TIME TO FORWARD 49. COMPLETED 50. AMOUNT IN CONTROVERSY 51. AFFIRMATIONS 52. DISMISSALS/WITHDRAW ALS 53. REVERSALS (FULL/PART) 54. AMOUNT AWARDED FORM CMS-2590 SCREEN 3
Exhibit 4 - Medicare Program - Carrier Appeals Report - Form CMS-2590 MEDICARE PROGRAM - CARRIER APPEALS REPORT - FORM CMS-2590 CARRIER ID ___________________ REPORT PERIOD ____________________ C. REOPENINGS (CLAIM COUNTS TOTAL (1) PRE-REVIEW (2) POST- REVIEW (3) POST- HEARING (4) 63. TOTAL 64. UNFAVORABLE TO CLAIMANT 65. NO CHANGE 66. FAVORABLE TO CLAIMANT 67. AMOUNT AWARDED D. LIMITATION OF LIABILITY (CLAIM COUNTS) INITIAL CLAIM (1) REVIEW (2) HEARING (3) ASSIGNED CASES 68. TOTAL NUMBER CONSIDERED 69. CONSIDERED - NOT WAIVED 70. WAIVED-BEN. ONLY 71. WAIVED-BEN.& PROV 72. AMT AWARDED UNASSIGNED CASES 73. TOTAL NUMBER CONSIDERED 74. PHYS REFUND WAIVED 75. PHYS REFUND UPHELD FORM CMS-2590 SCREEN 4
390 - Participating Physician/Supplier Report (Rev. 191, Issued: 07-13-11, Effective: 07-01-11, Implementation: 07-05-11) Unless otherwise requested, the carrier/A/B MAC prepares and transmits to CMS each year a report updating the number and category of participating physicians and suppliers. It completes a separate report for each office assigned a separate carrier number. 390.1 - Purpose and Scope (Rev. 191, Issued: 07-13-11, Effective: 07-01-11, Implementation: 07-05-11) This report enables CMS to gather data for administrative purposes on the number of physicians, limited license physicians, non-physician practitioners and suppliers, by specialty code, electing to participate in CMS' Participating Physician/Supplier Program. 390.2 - Due Date (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) The carrier/A/B MAC transmits data about the Participating Physician/Supplier Program to CO via PC or terminal. It uses instructions in the CROWD User Guide available via the CMS Enterprise Portal. The report is due 45 days after the end of the enrollment period. It includes updated data as of the end of the most recent enrollment period. The carrier/A/B MAC does not submit hard copies of the report. 400 - Completion of Items on Participating Physician/Supplier Report (Rev. 6, 08-30-02) B3-13422 400.1 - Heading (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) B3-13422.1 This report is referenced as Form F for CROWD. The carrier submits the appropriate information for the reporting period for each office assigned a separate contractor number and BSI. 400.2 - Definitions of Columns One Through Eight (Rev. 175, Issued: 10-28-10, Effective: 04-01-11, Implementation: 04-04-11) Column 1 - Participating Physicians/LLPs/NPPs/Suppliers - Prior - A count of the number of physicians, limited license physicians (LLPs), non-physician practitioners (NPPs), and suppliers participating prior to the beginning of the latest enrollment period. Note: The carrier or A/B MAC adjusts this data if there are changes from the information submitted in column 2 on the previous enrollment period. Examples of possible reasons for changes to the data include:
• Addition of new physicians to the Medicare file; • Reclassification of physicians, LLPs, NPPs, and suppliers between specialty designations; • Deletion of deceased or retired physicians from the Medicare file; or • Technical corrections to previously submitted data. Column 2 - Participating Physicians/LLPs/NPPs/Suppliers - Current - The number of physicians, limited license physicians, NPPs, and suppliers who are continuing as participants from the prior participation period into the new participation period and the number who have newly signed participation agreements in the latest enrollment period. Column 3 - Participating Physicians/LLPs/NPPs/Suppliers - Continuing - Only the number of physicians, limited license physicians, NPPs, and suppliers continuing as participants from the prior participation period into the new participation period, not including those who have newly signed participation agreements in the latest enrollment period or those who have dropped out. Column 4 - Non-Participating Physicians/LLPs/NPPs/Suppliers - Prior - A count of physicians, limited license physicians, NPPs, and suppliers not participating at the beginning of the latest enrollment period. Note: The carrier or A/B MAC adjusts this data if the information is different from that submitted in column 5 on the previous enrollment period. (See column 1 for further information.) Column 5 - Non-Participating Physicians/LLPs/NPPs/Suppliers - Current - A count of physicians, limited license physicians, NPPs, and suppliers not participating after the latest enrollment period, including those who were not participating at the beginning of the latest enrollment period and chose not to enroll and those who disenrolled during the latest period. Column 6 - Participating Drop-Out - Current – Physicians/LLPs/NPPs, and suppliers who, prior to this enrollment period, were participating in the program and have now decided to drop out. Column 7 - Non-Participating Sign-Up - Current – Physicians/LLPs/NPPs, and suppliers who were non-participating prior to the latest enrollment period and who enrolled in the program during the latest enrollment period. Column 8 – Participating Disenrolls - Only the number of participants who disenrolled from the Medicare program during an authorized disenrollment period held during the past 12 months. This is blank unless CMS declares an authorized disenrollment period. 400.3 - Specialty Codes (Rev. 191, Issued: 07-13-11, Effective: 07-01-11, Implementation: 07-05-11) The contractor counts individual participants by specialty. It does not count an individual more than once, even if the individual practices in more than one setting. NOTE: Refer to the pre-April 2010 version for DMERC activity (Calendar Years 1993-2007)
400.4 - Physician/Limited License Physician Specialty Codes (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) The following list of codes and narrative describe the kind of medicine physicians practice. Code Physician/Limited License Physician (LLP) Specialty Codes 01 General Practice 02 General Surgery 03 Allergy/Immunology 04 Otolaryngology 05 Anesthesiology 06 Cardiology 07 Dermatology 08 Family Practice 09 Interventional Pain Management 10 Gastroenterology 11 Internal Medicine 12 Osteopathic Manipulative Medicine 13 Neurology 14 Neurosurgery 16 Obstetrics/Gynecology 17 Hospice and Palliative Care 18 Ophthalmology 19 Oral Surgery (Dentists only) (LLP) 20 Orthopedic Surgery 21 Cardiac Electrophysiology 22 Pathology 23 Sports Medicine 24 Plastic and Reconstructive Surgery 25 Physical Medicine and Rehabilitation 26 Psychiatry 27 Geriatric Psychiatry 28 Colorectal Surgery (formerly Proctology) 29 Pulmonary Disease 30 Diagnostic Radiology 33 Thoracic Surgery 34 Urology 35 Chiropractic (LLP) 36 Nuclear Medicine 37 Pediatric Medicine 38 Geriatric Medicine 39 Nephrology 40 Hand Surgery 41 Optometry (LLP) 44 Infectious Disease 46 Endocrinology
Code Physician/Limited License Physician (LLP) Specialty Codes 48 Podiatry (LLP) 66 Rheumatology 70 Single or Multispecialty Clinic or Group Practice 72 Pain Management 76 Peripheral Vascular Disease 77 Vascular Surgery 78 Cardiac Surgery 79 Addiction Medicine 81 Critical Care (Intensivist) 82 Hematology 83 Hematology/Oncology 84 Preventive Medicine 85 Maxillofacial Surgery (LLP) 86 Neuropsychiatry 90 Medical Oncology 91 Surgical Oncology 92 Radiation Oncology 93 Emergency Medicine 94 Interventional Radiology 98 Gynecological Oncology 99 Unknown Physician Specialty C0 Sleep Medicine C3 Interventional Cardiology C5 Dentist C6 Hospitalist C7 Advanced Heart Failure and Transplant Cardiology C8 Medical Toxicology C9 Hematopoietic Cell Transplantation and Cellular Therapy D3 Medical Genetics and Genomics D4 Undersea and Hyperbaric Medicine D7 Micrographic Dermatologic Surgery D8 Adult Congenital Heart Disease E1 Marriage and Family Therapist E2 Mental Health Counselors E3 Dental Anesthesiology E4 Dental Public Health E5 Endodontics E6 Oral and Maxillofacial Pathology E7 Oral and Maxillofacial Radiology E9 Oral Medicine F1 Orofacial Pain F2 Orthodontics and Dentofacial Orthopedics F3 Pediatric Dentistry F4 Periodontics F5 Prosthodontics F6 Epileptologists
NOTE: Specialty Code Use for Service in an Independent Laboratory. For services performed in an independent laboratory, show the specialty code of the physician ordering the x-rays and requesting payment. If the independent laboratory requests payment, use supplier code "69". 400.5 - Non-Physician Practitioner/Supplier Specialty Codes (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) The following list of codes and narrative describe the kind of medicine non- physician practitioners or other healthcare providers/suppliers practice. Code Non-Physician Practitioner/Supplier Specialty Codes 15 Speech Language Pathologist in Private Practice 31 Intensive Cardiac Rehabilitation (ICR) 32 Anesthesiologist Assistant 42 Certified Nurse Midwife (effective July 1, 1988) 43 Certified Registered Nurse Anesthetist (CRNA) 45 Mammography Screening Center 47 Independent Diagnostic Testing Facility (IDTF) 49 Ambulatory Surgical Center 50 Nurse Practitioner 59 Ambulance Service Supplier, e.g., private ambulance companies, funeral homes 60 Public Health or Welfare Agencies (Federal, State, and local) 61 Voluntary Health or Charitable Agencies (e.g., National Cancer Society, National Heart Association, Catholic Charities) 62 Psychologist (Billing Independently) 63 Portable X-Ray Supplier (Billing Independently) 64 Audiologist (Billing Independently) 65 Physical Therapist in Private Practice 67 Occupational Therapist in Private Practice 68 Clinical Psychologist 69 Clinical Laboratory (Billing Independently) 71 Registered Dietitian/Nutrition Professional 73 Mass Immunization Roster Biller (Mass Immunizers have to roster bill assigned claims and can only bill for immunizations) 74 Radiation Therapy Centers 75 Slide Preparation Facilities 80 Licensed Clinical Social Worker 88 Unknown Provider 89 Certified Clinical Nurse Specialist 95 Unknown Supplier 97 Physician Assistant A5 Pharmacy
C1 Centralized Flu C2 Indirect Payment Procedure C4 Restricted Use D1 Medicare Diabetes Prevention Program D2 Restricted Use D5 Opioid Treatment Program D6 Home Infusion Therapy Services Note: Specialty Code Use for Service in an Independent Laboratory. For services performed in an independent laboratory, show the specialty code of the physician ordering the x-rays and requesting payment. If the independent laboratory requests payment, use supplier code “69”. 410 - Checking Reports (Rev. 191, Issued: 07-13-11, Effective: 07-01-11, Implementation: 07-05-11) Before submitting Form F, the carrier/A/B MAC checks for completeness and arithmetical accuracy using the following checklist: • Column 3 must be = to or < column 1 • Column 3 must be = to or < column 2 • Column 6 = column 1 - column 3 • Column 7 = column 2 - column 3 • Total Physicians = sum of Group PHY for all columns. • Total LLPs = sum of Group LLP for all columns. • Total NPPs = sum of Group NPP for all columns. • Total Suppliers = sum of Group SUP for all columns.
420 - Exhibit (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) Exhibit - Participating Physician/Supplier Report - Screen 1 PARTICIPATING PHYSICIAN/SUPPLIER REPORT SPECIALTY CODES 01 General Practice 02 General Surgery 03 Allergy/Immunology 04 Otolaryngology 05 Anesthesiology 06 Cardiology 07 Dermatology 08 Family Practice 09 Interventional Pain Management 10 Gastroenterology 11 Internal Medicine Participants Non-Participants Par Drop-Out Current (6) Non-Par Sign-Up Current (7) Par Disenrolls (8) SPECIALTY CODE/GROUP Prior (1) Current (2) Contin. (3) Prior (4) Current (5) 01-PHY 02-PHY 03-PHY 04-PHY 05-PHY 06-PHY 07-PHY 08-PHY 09-PHY 10-PHY 11-PHY
Exhibit 1 - Participating Physician/Supplier Report - Screen 2 PARTICIPATING PHYSICIAN/SUPPLIER REPORT SPECIALTY CODES 12 Osteopathic Manipulative Medicine 13 Neurology 14 Neurosurgery 15 Speech Language Pathologist in Private Practice 16 Obstetrics/Gynecology 17 Hospice and Palliative Care 18 Ophthalmology 19 Oral Surgery (Dentists only) 20 Orthopedic Surgery 21 Cardiac Electrophysiology 22 Pathology 23 Sports Medicine 24 Plastic and Reconstructive Surgery SPECIALTY CODE/GROUP Participants Non-Participants Par Drop-Out Current (6) Non-Par Sign-Up Current (7) Par Disenrolls (8) Prior (1) Current (2) Contin. (3) Prior (4) Current (5) 12-PHY 13-PHY 14-PHY 15-NPP 16-PHY 17-PHY 18-PHY 19-LLP 20-PHY 21-PHY 22-PHY 23-PHY 24-PHY
Exhibit 1 - Participating Physician/Supplier Report - Screen 3 PARTICIPATING PHYSICIAN/SUPPLIER REPORT SPECIALTY CODES 25 Physical Medicine and Rehabilitation 26 Psychiatry 27 Geriatric Psychiatry 28 Colorectal Surgery (formerly Proctology) 29 Pulmonary Disease 30 Diagnostic Radiology 31 Intensive Cardiac Rehabilitation (ICR) 32 Anesthesiologist Assistant 33 Thoracic Surgery 34 Urology 35 Chiropractic 36 Nuclear Medicine 37 Pediatric Medicine SPECIALTY CODE/GROUP Participants Non-Participants Par Drop-Out Current (6) Non-Par Sign-Up Current (7) Par Disenrolls (8) Prior (1) Current (2) Contin. (3) Prior (4) Current (5) 25-PHY 26-PHY 27-PHY 28-PHY 29-PHY 30-PHY 31-SUP 32-NPP 33-PHY 34-PHY 35-LLP 36-PHY 37-PHY
Exhibit 1 - Participating Physician/Supplier Report - Screen 4 PARTICIPATING PHYSICIAN/SUPPLIER REPORT SPECIALTY CODES 38 Geriatric Medicine 39 Nephrology 40 Hand Surgery 41 Optometry 42 Certified Nurse Midwife 43 Certified Registered Nurse Anesthetist (CRNA) 44 Infectious Disease 45 Mammography Screening Center 46 Endocrinology 47 Independent Diagnostic Testing Facility (IDTF) 48 Podiatry 49 Ambulatory Surgical Center 50 Nurse Practitioner SPECIALTY CODE/GROUP Participants Non-Participants Par Drop-Out Current (6) Non-Par Sign-Up Current (7) Par Disenrolls (8) Prior (1) Current (2) Contin. (3) Prior (4) Current (5) 38-PHY 39-PHY 40-PHY 41-LLP 42-NPP 43-NPP 44-PHY 45-SUP 46-PHY 47-SUP 48-LLP 49-SUP 50-NPP
Exhibit 1 - Participating Physician/Supplier Report - Screen 5 PARTICIPATING PHYSICIAN/SUPPLIER REPORT SPECIALTY CODES 59 Ambulance Service Supplier 60 Public Health/Welfare Agency 61 Volunteer Health/Charitable Agency 62 Psychologist (Billing Independently) 63 Portable X-Ray Supplier (Billing Independently) 64 Audiologist (Billing Independently) 65 Physical Therapist in Private Practice 66 Rheumatology 67 Occupational Therapist in Private Practice 68 Clinical Psychologist 69 Clinical Laboratory (Billing Independently.) 70 Single or Multispecialty Clinic or Group Practice 71 Registered Dietitian/Nutrition Professional SPECIALTY CODE/GROUP Participants Non-Participants Par Drop-Out Current (6) Non-Par Sign-Up Current (7) Par Disenrolls (8) Prior (1) Current (2) Contin. (3) Prior (4) Current (5) 59-SUP 60-SUP 61-SUP 62-NPP 63-SUP 64-NPP 65-NPP 66-PHY 67-NPP 68-NPP 69-SUP 70-PHY 71-NPP
Exhibit 1 - Participating Physician/Supplier Report - Screen 6 PARTICIPATING PHYSICIAN/SUPPLIER REPORT SPECIALTY CODES 72 Pain Management 73 Mass Immunization Roster Biller 74 Radiation Therapy Centers 75 Slide Preparation Facilities 76 Peripheral Vascular Disease 77 Vascular Surgery 78 Cardiac Surgery 79 Addiction Medicine 80 Licensed Clinical Social Worker 81 Critical Care (Intensivist) 82 Hematology 83 Hematology/Oncology 84 Preventative Medicine SPECIALTY CODE/GROUP Participants Non-Participants Par Drop-Out Current (6) Non-Par Sign-Up Current (7) Par Disenrolls (8) Prior (1) Current (2) Contin. (3) Prior (4) Current (5) 72-PHY 73-SUP 74-SUP 75-SUP 76-PHY 77-PHY 78-PHY 79-PHY 80-NPP 81-PHY 82-PHY 83-PHY 84-PHY
Exhibit 1 - Participating Physician/Supplier Report - Screen 7 PARTICIPATING PHYSICIAN/SUPPLIER REPORT SPECIALTY CODES 85 Maxillofacial Surgery 86 Neuropsychiatry 88 Unknown Provider 89 Certified Clinical Nurse Specialist 90 Medical Oncology 91 Surgical Oncology 92 Radiation Oncology 93 Emergency Medicine 94 Interventional Radiology 95 Unknown Supplier 97 Physician Assistant 98 Gynecological Oncology 99 Unknown Physician Specialty SPECIALTY CODE/GROUP Participants Non-Participants Par Drop-Out Current (6) Non-Par Sign-Up Current (7) Par Disenrolls (8) Prior (1) Current (2) Contin. (3) Prior (4) Current (5) 85-LLP 86-PHY 88-NPP 89-NPP 90-PHY 91-PHY 92-PHY 93-PHY 94-PHY 95-SUP 97-NPP 98-PHY 99-PHY
Exhibit 1 - Participating Physician/Supplier Report - Screen 8 PARTICIPATING PHYSICIAN/SUPPLIER REPORT SPECIALTY CODES A5 Pharmacy C0 Sleep Medicine C1 Centralized Flu C2 Indirect Payment Procedure C3 Interventional Cardiology C4 Restricted Use C5 General Dentist C6 Hospitalist C7 Advanced Heart Failure and Transplant Cardiology C8 Medical Toxicology C9 Hematopoietic Cell Transplantation and Cellular Therapy D1 Medicare Diabetes Prevention Program D2 Restricted Use D3 Medical Genetics and Genomics D4 Undersea and Hyperbaric Medicine D5 Opioid Treatment Program D6 Home Infusion Therapy Services D7 Micrographic Dermatologic Surgery D8 Adult Congenital Heart Disease E1 Marriage and Family Therapist E2 Mental Health Counselors E3 Dental Anesthesiology E4 Dental Public Health E5 Endodontics E6 Oral and Maxillofacial Pathology E7 Oral and Maxillofacial Radiology E9 Oral Medicine F1 Orofacial Pain F2 Orthodontics and Dentofacial Orthopedics F3 Pediatric Dentistry F4 Periodontics F5 Prosthodontics F6 Epileptologists SPECIALTY CODE/GROUP Participants Non-Participants Par Drop-Out Current (6) Non-Par Sign-Up Current (7) Par Disenrolls (8) Prior (1) Current (2) Contin. (3) Prior (4) Current (5) A5-SUP C0-PHY C1-NPP
C2-NPP C3-PHY C4-RES C5-PHY C6-PHY C7-PHY C8-PHY C9-PHY D1-SUP D2-RES D3-PHY D4-PHY D5-SUP D6-SUP D7-PHY D8-PHY E1-PHY E2-PHY E3-PHY E4-PHY E5-PHY E6-PHY E7-PHY E9-PHY F1-PHY F2-PHY F3-PHY F4-PHY F5-PHY F6-PHY
Exhibit 1 - Participating Physician/Supplier Report - Screen 9 PARTICIPATING PHYSICIAN/SUPPLIER REPORT SPECIALTY CODES Total Physicians - The contractor reports in the appropriate column the total of all specialty codes applicable to physicians. Total LLPs - The contractor reports in the appropriate column the total of all specialty codes applicable to limited license physicians. Total NPPs - The contractor reports in the appropriate column the total of all specialty codes applicable to non-physician practitioners. Total Physicians/LLPs/NPPs - The contractor reports in the appropriate column the sum of all physicians, LLPs and NPPs. Total Suppliers - The contractor reports in the appropriate column the total of all specialty codes applicable to suppliers. SPECIALTY CODE/GROUP Participants Non-Participants Par Drop-Out Current (6) Non-Par Sign-Up Current (7) Par Disenrolls (8) Prior (1) Current (2) Contin. (3) Prior (4) Current (5) TOTALs PHYs* LLPs* NPPs* PHYs/LLPS/NPPs* SUPs* * These lines do not represent specific specialty codes. They are the totals of the specialty sub- groups. 430 - Completing Quarterly Report On Provider Enrollment (Inactive) (Rev. 175, Issued: 10-28-10, Effective: 04-01-11, Implementation: 04-04-11) Each quarter, the carrier prepares and submits to CMS a report on the number of provider enrollment applications received, processed, and pending during the quarter. It submits this report via the Contractor Reporting of Operational and Workload Data (CROWD) system no later than the fifteenth day following the close of the reporting quarter.
430.1 - Heading (Rev. 6, 08-30-02) B3-13430.1 This report is referenced as Form 4 in the CROWD system. The carrier completes the ADD/UPDATE/DELETE DATA criteria screen with the appropriate information to bring the reporting format to its screen. 430.2 - Checking Reports (Rev. 6, 08-30-02) B3-13430.2 Before submitting Form 4 to CMS, the carrier checks for completeness and arithmetical accuracy, using the following checklist: • For all lines, column 1 must equal the sum of columns 2-24. • For all columns, line 1 must equal line 11 from the previous quarter. • For all columns, line 3 must equal line 1 plus line 2. • For all columns, line 6 must equal line 4 plus line 5. • For all columns, line 10 must equal the sum of lines 7-9. • For all columns, line 11 must equal line 3 plus line 6 minus line 10. • For all columns, the sum of lines 12-17 must equal line 8. • For all columns, the sum of lines 18-22 must equal line 9. • For all columns, the sum of lines 23-26 must equal line 10. • For all columns, line 27 must equal line 34 from the previous quarter. • For all columns, line 29 must equal line 27 plus line 28. • For all columns, line 33 must equal line 31 plus line 32. • For all columns, line 34 must equal line 29 plus line 30 minus line 33. 430.3 - Type of Provider (Rev. 6, 08-30-02) B3-13430.3 The carrier reports provider enrollment application data in the following columns for all lines on Form 4. Column (1) - Total - The sum of columns 2-24 for each line. Column (2) - Physician - Provider applications for specialty codes 1-8, 10-14, 16, 18-20, 22, 24- 26, 28-30, 33-41, 44, 46, 48, 66, 76-79, 81-86, 90-94, 98, and 99. Column (3) - Group - Provider applications for specialty code 70. Column (4) - Certified Nurse Midwife - Provider applications for specialty code 42. Column (5) - Certified Registered Nurse Anesthetist - Provider applications for specialty code 43.
Column (6) - Nurse Practitioner - Provider applications for specialty code 50. Column (7) - Ambulance Service Supplier - Provider applications for specialty code 59. Column (8) - Independent Audiologist - Provider applications for specialty code 64. Column (9) - Independent Physical Therapist - Provider applications for specialty code 65. Column (10) - Independent Occupational Therapist - Provider applications for specialty code 67. Column (11) - Clinical Psychologist - Provider applications for specialty code 68. Column (12) - Licensed Clinical Social Worker - Provider applications for specialty code 80. Column (13) - Certified Nurse Specialist - Provider applications for specialty code 89. Column (14) - Independent Physiological Laboratory - Provider applications for specialty code 95. Column (15) - Physician Assistant - Provider applications for specialty code 97. Column (16) - Mammography Screening Center - Provider applications for specialty code 45. Column (17 - Ambulatory Surgical Center - Provider applications for specialty code 49. Column (18) - Public Health/Welfare Agency - Provider applications for specialty code 60. Column (19) - Voluntary Health/Charitable Agency - Provider applications for specialty code 61. Column (20) - Independent Psychologist - Provider applications for specialty code 62. Column (21) - Portable X-Ray - Provider applications for specialty code 63. Column (22) - Independent Clinical Laboratory - Provider applications for specialty code 69. Column (23) - Unknown Supplier/Provider - Provider applications for specialty code 88. Column (24) - Flu Immunization Biller - Providers applications from individuals identified as flu immunization billers. 430.4 - Completing Lines One Through Eleven - Workload Operations (Rev. 6, 08-30-02) B3-13430.4 Line 1 - Pending End of Last Quarter - The CROWD system will automatically enter the value from line 11 on the previous quarter's report.
Line 2 - Adjustments to Pending - If it is necessary to revise the pending figure for the close of the previous quarter because of inventories taken or reporting errors discovered, the carrier enters the adjustment here. Adjustments can be positive or negative values. If entering a negative value, it precedes the number with a minus (-) sign. Line 3 - Adjusted Opening Pending - The CROWD system will automatically sum the values on lines 1and 2. Line 4 - New Applications Received - The number of applications received for the first time during the reporting quarter. Line 5 - Returned Applications Resubmitted - The number of applications received during the reporting quarter that had previously been received and returned to the applicant for correction/completion. Line 6 - Total Applications Received - The CROWD system will automatically sum the values on lines 4 and 5. Line 7 - Applications Approved - The number of applications approved (i.e., Medicare number issued) during the reporting quarter. Line 8 - Applications Denied - The number of applications denied during the reporting quarter. Line 9 - Applications Returned - The number of applications returned to the applicant for corrections/completion during the reporting quarter. Line 10 - Total Applications Processed - The CROWD system will automatically sum the values on lines 7, 8, and 9. Line 11 - Pending End of Quarter - The CROWD system will automatically compute the number of applications pending at the end of the reporting quarter by adding the value on line 3 to the value on line 6 and then subtracting the value on line 10. 430.5 - Completing Lines Twelve Through Seventeen - Reason for Denial (Rev. 6, 08-30-02) B3-13430.5 Line 12 - Sanctioned From Medicare - The number of applications denied because the applicant is currently excluded/sanctioned from Medicare. Line 13 - Debarred/Excluded by Other Federal Agency - The number of applications denied because the applicant had been debarred, suspended, or excluded by any other Federal agency. Line 14 - Not Professionally Licensed - The number of applications denied because the applicant was not professionally licensed. Line 15 - Business Address Invalid - The number of applications denied because the applicant had an invalid business address.
Line 16 - Business Location Not Licensed - The number of applications denied because the applicant’s business location was not properly licensed. Line 17 - CMS Requirements Not Met - The number of applications denied because the applicant did not meet all CMS requirements. 430.6 - Completing Lines Eighteen Through Twenty-Two - Reason for Return (Rev. 6, 08-30-02) B3-13430.6 Line 18 - Incomplete - The number of applications returned to the applicant because the application was incomplete. Line 19 - Unverifiable Information - The number of applications returned to the applicant because the application included unverifiable information. Line 20 - Not Signed - The number of applications returned to the applicant because the applicant did not sign the certification statement. Line 21 - Invalid Billing Agreement - The number of applications returned to the applicant because the billing agreement did not meet CMS requirements. Line 22 - Other - The number of applications returned to the applicant for any reason other than the ones indicated on lines 18 through 21. 430.7 - Completing Lines Twenty-Three Through Twenty-Six - Application Processing Times (Rev. 6, 08-30-02) B3-13430.7 Line 23 - Number Under 21 Days - The number of applications processed in less than 21 days from the date of receipt. Line 24 - Number in 21-30 Days - The carrier enters the number of applications processed in 21 through 30 days from the date of receipt. Line 25 - Number in 31-40 Days - The number of applications processed in 31 through 40 days from the date of receipt. Line 26 - Number Over 40 Days - The number of applications processed in more than 40 days from the date of receipt. 430.8 - Completing Lines Twenty-Seven Through Thirty-Four - Denials Appealed (Rev. 6, 08-30-02) B3-13430.8
Line 27 - Pending End of Last Quarter - The CROWD system will automatically enter the value from line 34 on the previous quarter's report. Line 28 - Adjustments - If it is necessary to revise the pending figure for the close of the previous quarter because of inventories taken or reporting errors discovered, the carrier enters the adjustment here. Adjustments can be positive or negative values. If entering a negative value, it precedes the number with a minus (-) sign. Line 29 - Adjusted Opening Pending - The CROWD system will automatically sum the values on lines 27 and 28. Line 30 - Appeals Received - The number of appeals of previously denied applications received during the reporting quarter. Line 31 - Denials Sustained - The number of appeals processed for which the carrier sustained the initial denial. Line 32 - Denials Overturned - The number of appeals processed for which the carrier overturned the initial denial. Line 33 - Total Appeals Processed - The CROWD system will automatically sum the values on lines 31 and 32. Line 34 - Pending End of Quarter - -The CROWD system will automatically compute the number of appeals pending at the end of the reporting quarter by adding the value on line 29 to the value on line 30 and then subtracting the value on line 33.
430.9 - Exhibits (Rev. 6, 08-30-02) B3-13430.9 Exhibit 1 - Screens 1 and 2 of Carrier Provider Enrollment Quarterly Workload ReportCARRIER NAME: CONTRACTOR NUMBER: REPORT PERIOD: CROW D FORM 4 Total Physician Group Cert Nurse M-W Cert RNA 1 2 3 4 5 W orkload Operations 1. Pending End of Last Quarter 2. Adjustments 3. Adjusted Opening Pending 4. New Applications Received 5. Returned Apps Resubmitted 6. Total Applications Received 7. Applications Approved 8. Applications Denied 9. Applications Returned 10. Total Applications Processed 11. Pending End of Quarter SCREEN 1 CARRIER NAME: CONTRACTOR NUMBER: REPORT PERIOD: CROW D FORM 4 Nurse Prac Ambulance Audiologist Ind Phys Ther Ind Occ Ther 6 7 8 9 10 W orkload Operations 1. Pending End of Last Quarter 2. Adjustments 3. Adjusted Opening Pending 4. New Applications Received 5. Returned Apps Resubmitted 6. Total Applications Received 7. Applications Approved 8. Applications Denied 9. Applications Returned 10. Total Applications Processed 11. Pending End of Quarter SCREEN 2
Exhibit 2 - Screens 3 and 4 of Carrier Provider Enrollment Quarterly Workload Report CARRIER NAME: CONTRACTOR NUMBER: REPORT PERIOD: CROW D FORM 4 Ind Clin Psych Lic Clin SW Cert Nurse Sp Ind Phys Lab Phys Asst 11 12 13 14 15 W orkload Operations 1. Pending End of Last Quarter 2. Adjustments 3. Adjusted Opening Pending 4. New Applications Received 5. Returned Apps Resubmitted 6. Total Applications Received 7. Applications Approved 8. Applications Denied 9. Applications Returned 10. Total Applications Processed 11. Pending End of Quarter SCREEN 3 CARRIER NAME: CONTRACTOR NUMBER: REPORT PERIOD: CROW D FORM 4 MSC ASC PH/W Agency VH/C Agency Ind Psych 16 17 18 19 20 W orkload Operations 1. Pending End of Last Quarter 2. Adjustments 3. Adjusted Opening Pending 4. New Applications Received 5. Returned Apps Resubmitted 6. Total Applications Received 7. Applications Approved 8. Applications Denied 9. Applications Returned 10. Total Applications Processed 11. Pending End of Quarter SCREEN 4
Exhibit 3 - Screens 5 and 6 of Carrier Provider Enrollment Quarterly Workload Report CARRIER NAME: CONTRACTOR NUMBER: REPORT PERIOD: CROW D FORM 4 Port X-Ray Ind Clin Lab Unk Supp/Prov Flu Imm Biller 21 22 23 24 W orkload Operations 1. Pending End of Last Quarter 2. Adjustments 3. Adjusted Opening Pending 4. New Applications Received 5. Returned Apps Resubmitted 6. Total Applications Received 7. Applications Approved 8. Applications Denied 9. Applications Returned 10. Total Applications Processed 11. Pending End of Quarter SCREEN 5 CARRIER NAME: CONTRACTOR NUMBER: REPORT PERIOD: CROW D FORM 4 Total Physician Group Cert Nurse M-W Cert RNA 1 2 3 4 5 Reasons for Denial 12. Sanctioned from Medicare 13. Debarred/Excluded by Other Fed 14. Not Professionally Licensed 15. Business Address Invalid 16. Business Location Not Licensed 17. HCFA Requirements Not Met Reason for Return 18. Incomplete 19. Unverifiable Information 20. Not Signed 21. Invalid Billing Agreement 22. Other SCREEN 6
Exhibit 4 - Screens 7 and 8 of Carrier Provider Enrollment Quarterly Workload Report CARRIER NAME: CONTRACTOR NUMBER: REPORT PERIOD: CROW D FORM 4 Nurse Prac Ambulance Audiologist Ind Phys Ther Ind Occ Ther 6 7 8 9 10 Reasons for Denial 12. Sanctioned from Medicare 13. Debarred/Excluded by Other Fed 14. Not Professionally Licensed 15. Business Address Invalid 16. Business Location Not Licensed 17. HCFA Requirements Not Met Reason for Return 18. Incomplete 19. Unverifiable Information 20. Not Signed 21. Invalid Billing Agreement 22. Other SCREEN 7 CARRIER NAME: CONTRACTOR NUMBER: REPORT PERIOD: CROW D FORM 4 Ind Clin Psych Lic Clin SW Cert Nurse Sp Ind Phys Lab Phys Asst 11 12 13 14 15 Reasons for Denial 12. Sanctioned from Medicare 13. Debarred/Excluded by Other Fed 14. Not Professionally Licensed 15. Business Address Invalid 16. Business Location Not Licensed 17. HCFA Requirements Not Met Reason for Return 18. Incomplete 19. Unverifiable Information 20. Not Signed 21. Invalid Billing Agreement 22. Other SCREEN 8
Exhibit 5 - Screens 9 and 10 of Carrier Provider Enrollment Quarterly Workload Report CARRIER NAME: CONTRACTOR NUMBER: REPORT PERIOD: CROW D FORM 4 MSC ASC PH/W Agency VH/C Agency Ind Psych 16 17 18 19 20 Reasons for Denial 12. Sanctioned from Medicare 13. Debarred/Excluded by Other Fed 14. Not Professionally Licensed 15. Business Address Invalid 16. Business Location Not Licensed 17. HCFA Requirements Not Met Reason for Return 18. Incomplete 19. Unverifiable Information 20. Not Signed 21. Invalid Billing Agreement 22. Other SCREEN 9 CARRIER NAME: CONTRACTOR NUMBER: REPORT PERIOD: CROW D FORM 4 Port X-Ray Ind Clin Lab Unk Supp/Prov Flu Imm Biller 21 22 23 24 Reasons for Denial 12. Sanctioned from Medicare 13. Debarred/Excluded by Other Fed 14. Not Professionally Licensed 15. Business Address Invalid 16. Business Location Not Licensed 17. HCFA Requirements Not Met Reason for Return 18. Incomplete 19. Unverifiable Information 20. Not Signed 21. Invalid Billing Agreement 22. Other SCREEN 10
Exhibit 6 - Screens 11 and 12 of Carrier Provider Enrollment Quarterly Workload Report CARRIER NAME: CONTRACTOR NUMBER: REPORT PERIOD: CROW D FORM 4 Total Physician Group Cert Nurse M-W Cert RNA 1 2 3 4 5 Application Processing Times 23. # under 21 Days 24. # in 21-30 Days 25. # in 31-40 Days 26. # over 40 Days Denials Appealed 27. Pending End of Last Quarter 28. Adjustments 29. Adjusted Opening Pending 30. Appeals Received 31. Denials Sustained 32. Denials Overturned 33. Total Appeals Processed 34. Pending End of Quarter SCREEN 11 CARRIER NAME: CONTRACTOR NUMBER: REPORT PERIOD: CROW D FORM 4 Nurse Prac Ambulance Audiologist Ind Phys Ther Ind Occ Ther 6 7 8 9 10 Application Processing Times 23. # under 21 Days 24. # in 21-30 Days 25. # in 31-40 Days 26. # over 40 Days Denials Appealed 27. Pending End of Last Quarter 28. Adjustments 29. Adjusted Opening Pending 30. Appeals Received 31. Denials Sustained 32. Denials Overturned 33. Total Appeals Processed 34. Pending End of Quarter SCREEN 12
Exhibit 7 - Screen 13 and 14 of Carrier Provider Enrollment Quarterly Workload Report CARRIER NAME: CONTRACTOR NUMBER: REPORT PERIOD: CROW D FORM 4 Ind Clin Psych Lic Clin SW Cert Nurse Sp Ind Phys Lab Phys Asst 11 12 13 14 15 Application Processing Times 23. # under 21 Days 24. # in 21-30 Days 25. # in 31-40 Days 26. # over 40 Days Denials Appealed 27. Pending End of Last Quarter 28. Adjustments 29. Adjusted Opening Pending 30. Appeals Received 31. Denials Sustained 32. Denials Overturned 33. Total Appeals Processed 34. Pending End of Quarter SCREEN 13 CARRIER NAME: CONTRACTOR NUMBER: REPORT PERIOD: CROW D FORM 4 MSC ASC PH/W Agency VH/C Agency Ind Psych 16 17 18 19 20 Application Processing Times 23. # under 21 Days 24. # in 21-30 Days 25. # in 31-40 Days 26. # over 40 Days Denials Appealed 27. Pending End of Last Quarter 28. Adjustments 29. Adjusted Opening Pending 30. Appeals Received 31. Denials Sustained 32. Denials Overturned 33. Total Appeals Processed 34. Pending End of Quarter SCREEN 14
Exhibit 8 - Screen 15 of Carrier Provider Enrollment Quarterly Workload Report CARRIER NAME: CONTRACTOR NUMBER: REPORT PERIOD: CROW D FORM 4 Port X-Ray Ind Clin Lab Unk Supp/Prov Flu Imm Biller 21 22 23 24 Application Processing Times 23. # under 21 Days 24. # in 21-30 Days 25. # in 31-40 Days 26. # over 40 Days Denials Appealed 27. Pending End of Last Quarter 28. Adjustments 29. Adjusted Opening Pending 30. Appeals Received 31. Denials Sustained 32. Denials Overturned 33. Total Appeals Processed 34. Pending End of Quarter SCREEN 15
Monthly Statistical Report on Medicare Secondary Payer Savings 440 - Monthly Carrier Report on Medicare Secondary Payer Savings (Form CMS-1564) (Rev. 6, 08-30-02) B3-13450 440.1 - General (Rev. 188, Issued: 04-22-11, Effective: 07-01-11, Implementation: 07-05-11) NOTE: For MSP reporting effective July 2011 for carriers/Part B MACs and October 2011 for DME MACs, refer to the manual instructions located within Publication 100-05, Chapter 5, Section 60 (MSP Reports). Each month the carrier electronically transmits to CO a Monthly Report on Medicare Secondary Payer Savings (CMS-1564) via the IBM PC. It continues to use existing dialup instructions and the RLINK software sent to it. (See §440.9). Hard copy reports are not required. It transmits a separate report for each office assigned a separate carrier number. When its service area covers more than one State, however, it transmits a separate report for each State even though it has been assigned only one number. It is not required to complete an individual State report for those States in which it has had no MSP activity during the month (reports that would show zeros in every cell, including pending). 440.2 - Purpose and Scope (Rev. 6, 08-30-02) B3-13450.2 The Monthly Carrier Report on Medicare Secondary Payer Savings supplies CMS with current data on MSP savings and MSP pending workloads. 440.3 - Due Date (Rev. 6, 08-30-02) B3-13450.3 Form CMS-1564 is due in CMS as soon as possible after the end of the reporting month, but no later than the 15th of the following month. Nonreceipt of the report by the due date will result in a telephone contact with the carrier to obtain the report data. 440.4 - Form Heading (Rev. 6, 08-30-02) B3-13450.4 The carrier enters its name, assigned number and the State in which the provider is located. In the space labeled "Reporting Period" it enters the numeric designation for month and year for which the report is prepared, e.g., show 01/02 for January 2002.
440.5 - Savings Calculations (Rev. 6, 08-30-02) B3-13450.5 Reporting Dollar Values - The carrier rounds values to the nearest whole dollar. This includes all amounts shown on lines 2, 4, 6, 8 and 10. Checking Reports - Before mailing the reports, the carrier checks their completeness and accuracy as follows: • Lines 1 + 3 + 5 = line 7 for all columns. • Lines 2 + 4 + 6 = line 8 for all columns. • Line 10 should be equal to or greater than line 9 for all columns, unless line 9 is equal to "0" in any column; in that case, line 10 should also be equal to "0" for the same column. • For each line of the report, column "I" (TOTAL) must equal the sum of the items in columns "ii" + "iii" + "iv" + "v" + "vi." 440.6 - Recording Savings (Rev. 315, Issued: 05-17-19, Effective: 06-18- 19, Implementation: 06-18-19) The term Medicare beneficiary identifier (Mbi) is a general term describing a beneficiary's Medicare identification number. For purposes of this manual, Medicare beneficiary identifier references both the Health Insurance Claim Number (HICN) and the Medicare Beneficiary Identifier (MBI) during the new Medicare card transition period and after for certain business areas that will continue to use the HICN as part of their processes. The carrier controls all claims from which it extracts MSP savings and is able to verify all amounts recorded on the CMS-1564. MSP Savings File - The carrier retains claims specific key identifying information on each claim counted as savings on the CMS-1564. At a minimum, it records the beneficiary's name, Medicare beneficiary identifier, claim control number, type/dates of service, billed charges and savings amounts reported. Savings Data from Non-Medicare Sources - If the carrier records savings from data which it has obtained from its "private side" records or any other "outside" source, it must be able to extract the same claims specific information noted above; i.e., it must verify that Medicare covered services are involved and be able to calculate "what Medicare would have paid." In addition, it compares these data with the data contained in its MSP savings file to ensure that savings have not previously been recorded for the same claim. If savings have not previously been taken, it counts them as savings on the CMS-1564 and enters them into its MSP savings file. .
440.7 - Source of Savings (Rev. 6, 08-30-02) B3-13450.7 The carrier reports data by total and by source as shown below: Column (i) Total - All MSP savings regardless of source. Column (ii) Worker's Compensation, Black Lung, and VA - Data related to all MSP savings resulting from medical benefits provided by the WC Plans of the 50 States, the District of Columbia, Guam and Puerto Rico. Also included is Federal WC provided under the Federal Employee's Compensation Act, the U. S. Longshoremen's and Harbor Workers' Compensation Act and its extensions, the Federal Coal Mine Health and Safety Act of 1969 as amended (the Federal BL Program), and any fee-for-service medical care paid for by the VA. The carrier keeps separate records for each distinct category (WC, BL or VA) as this may become a reporting requirement in the future. Column (iii) Working Aged - The carrier includes data related to all MSP savings resulting from benefits payable under an EGHP for beneficiaries aged 65 and older who are covered by reason of their own employment or the employment of a spouse of any age. Medicare Claims Processing, Chapter 28, Coordinating With Medicaid and Medigap Insurers further defines the individuals subject to this limitation on payment. Column (iv) ESRD - The carrier includes data related to all MSP savings resulting from benefits payable under an EGHP for individuals who are entitled to Medicare benefits solely on the basis of ESRD during a period of up to 12 months. The period during which Medicare pays benefits is defined in Medicare Claims Processing, Chapter 28, Coordinating With Medicaid and Medigap Insurers. Column (v) Auto Medical, No Fault and Liability Insurance - The carrier includes data related to all MSP savings resulting from both: Automobile Medical or No Fault Insurance - Insurance coverage (including a self-insured plan) that pays for all, or part, of the medical expenses for injuries sustained in the use of, or occupancy of, an automobile, regardless of who may have been responsible for the accident. (This insurance is sometimes called "personal injury protection," "medical payments coverage" or "medical expense coverage.") Liability Insurance - Insurance (including a self-insured plan) that provides payment based on legal liability for injury, illness, or damage to property. It includes, but is not limited to, automobile liability insurance, uninsured motorist insurance, homeowners' liability insurance, malpractice insurance, product liability insurance, and general casualty insurance. It does not include situations where a beneficiary receives medical payment under his or her own homeowner's insurance.
Column (vi) Disabled - The carrier includes data related to all MSP savings resulting from situations where Medicare is the secondary payer for disabled beneficiaries under age 65 (except ESRD beneficiaries) who elect to be covered by a large group health plan (LGHP) as a current employee or family member of such employee. A LGHP is any health plan that covers employees of at least one employer who normally employs 100 or more employees. The disabled provisions apply to items and services furnished on or after January l, 1987 and before January l, 1992. 440.8 - Type of Savings (Rev. 6, 08-30-02) B3-13450.8 The carrier reports data by type of savings as shown below. Unpaid (Cost Avoided) MSP Claims Unpaid (cost avoided) claims are those that the carrier returned without payment because it has strong evidence that another insurer is the primary payer and there is no indication that payment has been requested from that payer. Any information the carrier obtains from a non-Medicare source and uses as the basis for claiming cost avoidance savings must meet the criteria in §440.6B. Information considered adequate for claiming cost avoidance savings includes statements on the claim noting "automobile accident," "collision", or the name of an automobile insurer. The carrier does not count claims it develops as "possible" MSP situations based on routine edits as cost avoidance savings unless it has previous information that another payer has primary responsibility. For example, "trauma code" edits are not, by themselves, considered strong evidence that Medicare is the secondary payer. Line 1 - Number - The total number of cost avoided claims from which it is recording savings on the report. Line 2 - Dollar Value - The total dollar value of the potential Medicare payments calculated for the claims on Line 1 that will be saved if the primary payer makes a payment which relieves Medicare of all payment liability. The carrier shows as the cost avoided amount what Medicare would have paid. It does not count total charges as cost avoided savings. It reduces the cost avoided amount based upon reasonable charge and coinsurance calculations: • Reasonable Charge Reductions - The reasonable charge amount may be calculated through the actual reasonable charge methodology or through a "reasonable charge reduction factor" which is the percentage derived from the most current CMS-1565A by dividing Line 3 (Total Amount of Reduction) by Line 1 (Total Covered Charges for All Claims). (See 240.2.) • Coinsurance - The carrier reduces line items subject to the Part B coinsurance by that amount or apply a "coinsurance reduction factor" of 19 percent to all charges.
The carrier may assume that the deductible has been met. Tracking/Adjusting Cost Avoidance Savings Cost avoidance savings may not duplicate savings reported as full or partial recoveries and may not be shown where Medicare ultimately makes primary payment. To prevent duplicate counting, the carrier suspends all claims which it returns unpaid. It sets up a control on the claim when it is returned for development. It maintains this control for 75 days, unless it receives further information before that time allowing it to process the claim. If no further information on the claim is received after 75 days, it denies the claim. It is not required to continue tracking the claim, but retains the key identifying information on the claim, as described in §440.6A. The CMS prefers the carrier to show cost avoidance savings only after 75 days have elapsed. The carrier does, however, have the option of counting the savings when the claim is initially suspended or at any time during the suspension period. If it chooses the latter alternative, it must adjust its cost avoidance savings if the claim is resubmitted during the suspension period with information showing it is not a legitimate cost avoidance. NOTE: Nonassigned claims may not be returned to beneficiaries (see §3311), but must be controlled as described above when being developed for MSP involvement and counted as cost avoidance savings. The following situations require special consideration if cost avoidance savings are counted before the 75 day suspense period has ended: • A claim returned (and counted as cost avoided) is paid in part by another payer and the submitter resubmits it for secondary payment. • A claim returned (and counted as cost avoided) is denied by the other payer and the submitter resubmits it for primary payment. • A claim returned (and counted as cost avoided) is paid in full by the other payer and the provider or some other source informs the carrier of this. The carrier shows "full recovery" savings and not cost avoidance. In these situations the carrier adjusts its cost avoidance savings figures by deducting or "backing out" the applicable amounts. It makes the adjustments in the reporting month in which a final determination is rendered. The following chart outlines the correct reporting of savings in each situation:
ADJUSTMENTS TO REPORTED MSP COST AVOIDANCE SAVINGS CLAIMS PROCESSING ACTIONS MSP SAVINGS REPORTED Cost Avoidance Partial Recoveries Full Recoveries I. Partial Recovery Adjustment MSP situation indicated. Medicare's payment calculated to be $50 if Medicare was primary payer. Claim is returned to submitter. $ 50 Claim is resubmitted showing $30 paid by the other insurer. a Medicare secondary payment of $20 is made. $(50) * $ 30 II. "Other" Payer Denial Adjustment MSP situation indicated - Medicare's "primary" payment calculated to be $75. Claim is returned to submitter. $ 75 Other payer denies claim. Medicare found to be primary and Medicare payment of $75 is made. $ (75)* III. Full Recovery Adjustment MSP situation indicated - Medicare's "primary" payment calculated to be $80. Claim is returned to submitter .$ 80 Provider or other source informs carrier that full payment was made by the other payer. $ (80)* $ 80 *Amounts "backed out" of cost avoidance savings figures.
Full Recoveries Line 3 - Number - The number of full recoveries made during the month. Line 4 - Dollar Value - The dollar value of full recoveries made during the month. Full recoveries represent savings from claims where the primary payer made a payment which relieved Medicare of all payment liability. They can be either prepayment or post-payment. The carrier counts full recoveries in the month in which it renders a final determination on the claim. In post payment situations this is when it has recovered the full amount paid by Medicare. In prepayment situations it is when it receives documentation showing that an MSP resource made a payment equal to or greater than what Medicare would have paid. a. Prepayment Full Recovery - a prepayment full recovery occurs when an MSP resource makes full payment on a charge before Medicare makes any payment. EXAMPLE: A physician identifies an EGHP as the primary payer, submits the bill to that insurer, and the EGHP pays the charges in full. The beneficiary informs the carrier of this and submits a copy of the EGHP EOB. The carrier determines what it would have paid if the EGHP had not made payment and records that total as full recovery savings. 1. Post payment Full Recovery - a post payment full recovery occurs when an MSP resource makes full payment on a charge after Medicare has paid. EXAMPLE: Medicare paid a physician's bill for charges incurred as a result of an automobile accident. Subsequently an auto liability insurer reimburses the Medicare beneficiary for the full amount and the beneficiary refunds that amount to the carrier. The carrier counts the amount of initial payment as a post payment full recovery. It records as savings, that portion of a full recovery paid to an attorney or other agent as Medicare's share of the recovery cost. When it refers a case to the RO for recovery action, however, it does not record any savings at that point. Savings from a compromise or "subrogation" case may be recorded only after a final determination. The carrier does not count these cases for CPEP credit prior to final settlement. EXAMPLE: A beneficiary incurs a $1,000 physician's bill and a $5,000 hospital bill as a result of injuries sustained in an automobile accident. Assuming that all deductibles are satisfied, Part B pays $800 toward the physician's charges, and Part A covers the hospital bill in full. After litigation, a liability insurer agrees to pay $6,000 for the beneficiary's medical expenses from which the attorney will take a fee. (If the attorney's fee were 33 percent, the actual dollar recovery would be $4,000.) The carrier records $800 in Full Recovery savings (Part Bs full payment). The intermediary is able to count its payment as a Full Recovery savings even though the actual amount recovered, due to the attorney's fee did not equal what the intermediary paid. Partial Recoveries Line 5 - Number - The number of partial recoveries made during the month. Line 6 - Dollar Value - The dollar value of partial recoveries made during the month.
Partial recoveries are those savings realized when a primary payer makes a payment which covers only a part of the Medicare allowable charge, leaving Medicare with a balance to pay. The carrier uses the following formula in computing the savings from a partial recovery: • The dollar amount of Medicare benefits available for the services or supplies (calculated as if Medicare were the primary payer) less the Medicare benefits paid for the services or supplies equals the partial recovery savings. (Primary Payment - Actual Payment = Partial Recovery Savings) It counts partial recoveries in the month when it takes final action on the claim (either making a payment supplemental to that of the primary payer or making a partial recovery from a payment by the primary payer) on the claim. Instructions for processing partial recovery claims are in Medicare Claims Processing, Chapter 28, Coordination with Medicaid and Medigap Insurers. The carrier records as savings, that portion of a partial recovery paid to an attorney or other agent as Medicare's share of the recovery cost. When it refers a case to the RO for recovery action it does not record any savings at that point. Savings from a compromise or "subrogation" case may be recorded only after a final determination. These cases may not be counted for CPEP credit prior to reaching final settlement. Totals In this part of the report (lines 7 and 8), the carrier reports data on the totals of unpaid claims plus full and partial recoveries. Line 7 - Claims - The total number of MSP claims handled during the month. Line 8 - Dollar Value - The total dollar value associated with MSP claims during the month. Pending Claims/Cases Line 9 - Number - The number of pending claims/cases as of the close of the month. This includes claims/cases for which "Full Recovery" is expected but all money due has not been received. Line 10 - Estimated Value - The gross charges for all claims/cases reported as pending on line 9. Where "Full Recovery or Partial Recovery" has been determined, but all monies have not been received, the carrier reports the gross charges until it receives the full amount due or it is reasonable to expect no further payments. A case is defined as one or more claims filed on behalf of an individual and related to one specific occurrence which necessitated medical care. When recording data for column 1 concerning WC and Auto Liability, and No Fault Insurance, the carrier counts only cases. For Working Aged (column iii), ESRD (column iv), and Disabled (column vi), it counts each individual claim. A case/claim is considered pending only after it has been developed to the point where it is determined to be an MSP claim and no final resolution has been made. A partial or interim
payment is not sufficient to remove a case/claim from the pending rolls. Final resolution occurs when there is no longer a practical expectation of further reimbursement by another resource. Remarks - The carrier enters any comments relevant to the interpretation and analysis of this report. Signature - The report should be signed by the individual responsible for its compilation. Date - Date the report is completed and signed. 440.9 - Electronic Submission (Rev. 6, 08-30-02) B3-13450.9 A. Keying CMS-1564 - The carrier: • Uses existing RLINK dialup instructions. • Keys letter "K" to bring up blank CMS-1564. • Enters valid 5 digit carrier number. It uses the tab key to move from column to column. • Enters reporting period using numeric designation for month and year, e.g., 0102 for January 2002. • Enters two-position alpha State code. • Completes each column of data. Fields with zero do not have to be keyed. System will presume all blank fields to be zero. • Does not key dollar signs or commas. Keys only whole dollar amounts. • After completing the form, the carrier keys F1. System edits and prints any error messages on the line above "contractor number." The carrier tabs to incorrect field and rekeys correct entry. When form passes all edits, line will read "record has been written." Carrier keys F4 to return to menu. • To abort at any time without writing a record, the carrier keys F3 and refers to CICS instructions. • To verify that a report has been written, the carrier returns to the main menu (F4) and keys "K" to bring up a blank form. It keys in contractor number, reporting period and State code. It keys F7. Completed report should appear on the screen. B. Edits for CMS-1564: • A valid 5-digit carrier number is required. • The default value for areas not keyed is zero. • Appropriate reporting period (MMYY) is required. • Two-position alpha State code required. • Lines 1 + 3 + 5 must equal line 7 for all columns. • Lines 2 + 4 + 6 must equal line 8 for all columns. • Line 10 must be equal to or greater than line 9 for all columns, unless line 9 is zero. In that case line 10 must also be zero. • For each line of the report column I must equal the sum of columns ii + iii + iv + v + vi.
440.10 - Exhibit (Rev. 6, 08-30-02) B3-13450.10
460 - Monthly Statistical Report on A/B and DME Medicare Administrative Contractor (MAC) Part A and Part B Appeals Activity Form (CMS-2592) (Rev. 253, 08-06-15, Effective: 01-01-16, Implementation: 01-04-15) 460.1 – General (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) At the end of each month, the contractor prepares and transmits to CMS a report summarizing monthly activity on redeterminations processed by A/B and DME MACs, as well as those actions associated with reconsiderations, and Administrative Law Judge (ALJ) hearings and Part A and Part B Medicare Appeals Council effectuations that are processed by A/B and DME MACs. Contractors shall complete separate reports for each office where a separate A/B or DME MAC Jurisdictional identification number has been assigned. NOTE: The report is NOT designed to be completed by the Qualified Independent Contractor (QIC) or the Administrative Qualified Independent Contractor (AdQIC). All data shall be entered by the contractor except for those lines that are indicated as “Not Applicable” (e.g., Medicare Approved Amount). The data in the “Not Applicable” lines are not required. Contractors shall continue to use the CMS-2591 and CMS-2590 reports to capture data on appeal workloads received prior to the implementation date of the CMS-2592 report. The CMS-2591 and 2590 reports will be used to record appeals related data received prior to the implementation of the CMS-2592 report until all pending appeals workloads have been completed. If a case was received prior to the implementation of the CMS-2592, and as such is captured on the CMS-2591 or CMS- 2590, tracking for the case remains on the CMS-2591 or CMS-2590 until all levels of appeal for the case have been completed. Note: The CMS-2591 and 2590 reports will continue to be used to capture reopenings data that is not clerical in nature, and as such, is not captured on the CMS-2592 report. Form CMS-2592 is subject to the Paperwork Reduction Act and requires approval by the Office of Management and Budget (OMB). OMB approval has been requested. Purpose and Scope--The CMS-2592 enables CMS to tabulate data for administrative purposes on the following information. • The number of redeterminations, reconsiderations, and ALJ hearings requested, completed, and pending; • The number of redeterminations resulting in affirmations or reversals of previous determinations; • Timeliness Data (including processing, forwarding and effectuation data at various levels of appeal); and, • Clerical Error Reopenings Data Unless specifically indicated, data on the CMS-2592 Report is captured in cases. Where noted, information is also requested in claims. Information on decisions is also requested, as applicable.
Due Date -Transmit the CMS-2592 to CO via PC or terminal. Use instructions in the CROWD User Guide available via the CMS Enterprise Portal. The report is due as soon as possible after the end of the reporting month but no later than the 15th of the month following the end of the reporting month. COMPLETION OF ITEMS ON FORM CMS-2592 Heading – This report is referenced as Form 7 for CROWD. It submits the appropriate information for the reporting period for each office assigned a separate contractor number and BSI. General Information – Completing the Report Refer to the information below when determining how to count and categorize data for reporting purposes. Controlling Receipt of Cases - In order to ensure that cases are processed timely, cases shall be date stamped or controlled in some way upon receipt. The date of receipt in all cases is the day the processing contractor received the request in its corporate mailroom. The days elapsed for an individual request are calculated using the number of days starting from the Julian date of case receipt through the Julian date of completion. Include the time required for the response to be mailed to the appellant. For example, a case that is received and processed on January 7 is considered to require1 day to clear. A case received on January 7 and cleared on January 8 is considered to require 2 days to clear. Consider the day of receipt to be Day 1. Cases that are not received in the mailroom (for example, requests from the QIC for case files received by fax or telephone) shall be controlled in some way to ensure that timeliness requirements are met. Counting Cases -- If an appellant submits one request involving several different claims (and several different beneficiaries), count it as one case. If the contractor receives one envelope with multiple request forms and supporting documentation, count 1 case per request received. For example, if the envelope contains 10 separate request forms with supporting documentation, count as 10 cases. Counting Part A, B of A and Part B Claims - If an appellant submits one request involving 5 different claims, count as 5 claims. If an appellant submits one request involving 1 claim, count as 1 claim. If the appellant submits two cases in the same envelope, of which one case has 3 claims and the other 4 claims, count as 2 cases with 7 claims. If an appellant submits a case containing 7 claims, of which 5 are requests for an appeal and the remaining 2 are determined to be reopenings, count the 5 appeal claims among the appeals workload. The remaining 2 claims shall not be counted among the appeals workload, but shall be counted as reopenings (see Line 1 of the Reopenings Section). Counting Part A, B of A and Part B Cases Involving Appeals and Reopenings – If you receive a case involving multiple claims and some claims are subject to appeal but others must be handled
as a reopening, count the case as an appeal. Note: Reopenings data is captured by claims only. Because of this, no case count is recorded for reopenings. Additional Evidence Submitted After Request is Received -- If you receive a case for which additional documentation is submitted for some but not all of the claims, count the case among those recorded on Line 7 (Cleared - Evidence Submitted After Request). When to Consider a Case Reversed -- Consider a case reversed when the initial determination is changed upon appeal, (e.g., the claim was denied at the initial determination level but is reversed when the case is appealed). When to Consider a Case Completed – Consider a case to be completed when you complete the action that sets in motion correct payment of the claim and you mail the decision letter to the appellant. All redeterminations shall be processed and mailed by the 60th day (unless additional evidence is submitted by the party after the request is received, in which case the contractor has up to 14 additional days for each submission to process and mail the decision letter to the parties. See Line 6.1 for additional guidance. When to Consider a Case Effectuated – Consider effectuation of a decision to be completed when payment is issued to the appellant based on a fully favorable or partially favorable decision. If you enter the adjustment in the month of July, but payment is not issued to the appellant until August, the case is considered to be effectuated in August. Note: Considering a case to be completed is different from determining when a case is effectuated. Note the distinctions in the previous paragraphs. It is possible for some overlap of completion and effectuation timeframes to occur. 460.2 - Section I – Redeterminations (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) The term Medicare beneficiary identifier (Mbi) is a general term describing a beneficiary's Medicare identification number. For purposes of this manual, Medicare beneficiary identifier references both the Health Insurance Claim Number (HICN) and the Medicare Beneficiary Identifier (MBI) during the new Medicare card transition period and after for certain business areas that will continue to use the HICN as part of their processes. This section concerns data from Part A and Part B of A appeals processed by A/B MACs (A) as well as Part B appeals processed by A/B MACs (B) and DME MACs. Redeterminations. The number of redeterminations requested (received), completed, and pending reflects the status of the workload as of the last day of the reporting month. Base data on actual counts of each activity and not on sampling or other estimating techniques. A redetermination is the first level of appeal following an initial determination of a Part A claim or Part B claim. It is a re-evaluation of the facts and findings of a claim to determine whether the initial decision was correct. (See the Medicare Claims Processing Manual, Publication 100-04, Chapter 29, Section 310.)
Do not count duplicate redetermination requests or redetermination requests received before you have made an initial determination on a claim. Do not count inquiries. Count one redetermination per request received. With the exception of those lines for which claims counts are specifically requested in the report, count only cases. Do not count a duplicate request for appeal as a processed appeal. Duplicate requests can be reflected in Line 2 (Adjustment to Pending) of the CMS-2592 Report for the subsequent month. Redeterminations fall into the following categories: Column (1) Part A Cases- Use Column 1 to report information on Part A services processed by the A/B MAC (A). Column (2) Part B of A Cases- Use Column 2 to report information on Part B services processed by the A/B MAC (A). Column (3) Part B Cases- Use Column 3 to report information on Part B services processed by the A/B MAC (B) or DME MAC. Line 1. Opening Pending - Show under columns 1-3, the number of redetermination cases reported on Line 21 as the closing pending redetermination cases on the previous month's report. Line 2. Adjustments to Pending - CMS understands that it is often necessary to revise the categorization of data from the original categorization given when a case was initially received at the contractor. Likewise, it is often necessary to move data from one line to another in order to maintain accuracy. Prior to the submission of the monthly 2592 report to CMS, contractors are permitted to make changes to data during the reporting month to ensure that appeal workloads are accurately reflected. Once the monthly 2592 report has been submitted to CMS, any changes to the closing pending figure of the report must be reflected in the Adjustments to Pending line of the subsequent month’s report. If it is necessary to revise the pending figure for the close of the previous month’s report because of inventories or reporting errors, enter the adjustment. If some cases were not counted in the proper month's receipts, count them as adjustments to the opening pending count in the subsequent month. Examples include any instances where something originally categorized as an appeal was determined not to be an appeal, or vice-versa. Duplicate requests for redetermination are also reflected here. If the contractor receives a request for appeal near the end of the reporting month but the case arrives too late to be reflected as a receipt in the CMS-2592 report for that month, count the case in the Adjustment to Pending line of the subsequent month’s report. The purpose of the Adjustments to Pending line is to allow the contractor to modify Opening Pending counts, thereby correcting errors resulting from inventory or reporting problems that were identified after the submission of the CMS-2592 previous month’s report to CMS. Do not make adjustments to the Pending line or other lines of the 2592 report once the report has been submitted to CMS. If there is an entry for Line 2, it should be preceded by a "+" or "-", as appropriate. Line 3. Adjusted Pending - Enter the result of Line 1 + Line 2 (taking into account the "-" sign, if any).
Line 4. Requests Received - Show, under the appropriate columns, the number of requests for redeterminations received during the reporting month. Include requests transferred to you by other A/B or DME MACs or remanded by the Qualified Independent Contractor (QIC). NOTE: See the “Note” under Line 6 (Requests Cleared) regarding the handling of Medicare Secondary Payer (MSP) cases. Line 4.a. Adjusted Requests Received - As a result of actions taken by the A/B and DME MACs to process appeals during the reporting month, show on this line the number of receipts that have actually been validated by the MAC to be a redetermination. This line should include both RAC and non-RAC redeterminations. NOTE: See the “Note” under Line 6 (Requests Cleared) regarding the handling of Medicare Secondary Payer (MSP) cases. Line 4.1. Number of Claims Received – Show the total number of redetermination claims involved in Line 4.a. Line 4.2. Recovery Audit Contractor (RAC) Requests Received - Of the redetermination requests reported in Line 4.a, show the number that are Recovery Audit related. Line 4.2 is a subset of Line 4.a and should contain only RAC redeterminations. Line 4.2.1. Number of RAC Claims Received – Show the number of redetermination claims involved in Line 4.2. Line 5. Misrouted Requests Forwarded to Another Contractor - Show under columns 1 through 3 the number of redetermination requests the contractor forwarded to other contractors, because they were misrouted to you and you did not process the original claim(s). For columns 1- 3, if you have reported a redetermination as forwarded, do not report any information regarding it on Lines 6-29. The forwarding of the misrouted request is the final action. NOTE: This line is not intended for QIC reconsideration requests that were misrouted. Line 6. Requests Cleared - Show, under the appropriate columns, the total number of redeterminations completed during the month. Report all completed redeterminations, regardless if the final outcome was an affirmation, reversal, withdrawal, or dismissal. Do not count cases that were transferred to another contractor because they were misrouted. NOTE: A/B MACs (A) should count received and completed MSP redetermination cases in Columns 1 of Lines 4 and 6, as appropriate, regardless of whether claims involved are Part A, Part B or a combination. Do not count or report claims involved in MSP cases. MSP cases should be counted in Lines 4, 6, 7, 8, 9, 10 and 11. Do not count MSP claims on Lines 4.1, 6.1, 7.1, 8.1, 9.1, 10.1 and 11.1. A/B MACs (B) that handle MSP cases should count them in Column 3. Line 6.1. Number of Claims Cleared – Show the total number of claims involved in Line 6.
NOTE: For Lines 6.1 through 11.1 (letters a through i), enter the number and type of claim processed. If no claims from a certain claim type are processed, report zero (0). Refer to instructions for the CMS-1565 and 1566, as well as appropriate sections of the Claims Processing Manual for guidance on determining the categories and types of claims processed by A/B MACs and DME MACs. Line 6.1a – Report the number of SNF claims included in Line 6.1. Line 6.1b – Report the number of Home Health claims included in Line 6.1. Line 6.1c – Report the number of Inpatient Hospital claims included in Line 6.1. Line 6.1d – Report the number of Outpatient claims included in Line 6.1. Line 6.1e – Report the number of Lab claims included in Line 6.1. Line 6.1f – Report the number of Ambulance claims included in Line 6.1. Line 6.1g – Report the number of DME claims included in Line 6.1. Line 6.1h – Report the number of Physician claims reported in Line 6.1. Line 6.1i – Report the number of Other claims or claims where the provider type cannot be determined based on the information on the claim included in Line 6.1. Consider a redetermination cleared when: • For affirmations, when all claims of the case are included in the decision and the decision letter is mailed to the parties • For full and partial reversals: (1) all claims within the case are included in the decision and the decision letter is mailed to the parties, and (2) the contractor completes the action that sets in motion correct payment of the claim. • For withdrawals and dismissals, the dismissal notice is mailed to the parties. Note that sending a letter to the mailroom does not constitute mailing the letter. Letters must be mailed to the appellant on or before the 60th day in order for the requirement to be met. NOTE: Considering a case to be completed is different from determining when a case is effectuated. Please note the distinctions in the previous paragraphs. Line 6.2. Recovery Audit Contractor (RAC) Redeterminations Cleared - Of the cases reported in Line 6, how many are RAC related? Line 6.2.1. Number of RAC Claims Involved – Show the number of claims involved in Line 6.2. Line 7. Cleared -- Evidence Submitted After Request - Of the cases reported in Line 6, show under the appropriate columns, the total number of redetermination cases for which additional documentation was submitted by the party on his or her own or when the documentation was requested by the contractor after the request was received. Line 7.1. Number of Claims Involved – Show the total number of claims involved in Line 6.1 for which evidence was submitted after the request was received.
Lines 7.1a through 7.1i are Not Applicable. Line 7.1a – Report the number of SNF claims included in Line 7.1. Line 7.1b – Report the number of Home Health claims included in Line 7.1. Line 7.1c – Report the number of Inpatient Hospital claims included in Line 7.1. Line 7.1d – Report the number of Outpatient claims included in Line 7.1. Line 7.1e – Report the number of Lab claims included in Line 7.1. Line 7.1f – Report the number of Ambulance claims included in Line 7.1. Line 7.1g – Report the number of DME claims included in Line 7.1. Line 7.1h – Report the number of Physician claims reported in Line 7.1. Line 7.1i - Report the number of Other claims or claims where the provider type cannot be determined based on the information on the claim included in Line 7.1. Line 7.2. RAC Redeterminations Cleared With Additional Documentation - Of the cases reported in Line 7, how many are RAC related? Line 7.2.1. Number of RAC Claims Involved – Show the number of claims involved in Line 7.2. Note about Lines 8-11: Count the cases in the following manner: • If a case has multiple claims and all are affirmed, count the case as an affirmation. • If a case has multiple claims, some of which are affirmed and others are partially reversed, count the case as a partial reversal. Consider a case reversed when the initial determination is changed upon appeal, irrespective of a change in payment. • If a case has multiple claims, some of which are partially reversed and others are fully reversed, count the case as a partial reversal. Consider a case reversed when the initial determination is changed upon appeal, irrespective of a change in payment. • If a case has multiple claims, all of which are fully reversed, count the case as a full reversal. • If a case has multiple claims, some of which are fully reversed and the others are dismissed or withdrawn, count the case as a full reversal. • If a case has multiple claims, one of which is affirmed, one of which is a partial reversal and one of which is dismissed, count the case as a partial reversal. • If a case has multiple claims which are fully reversed, affirmations and withdrawals/dismissals, count the case as a partial reversal. • If a case has two claims, one of which is affirmed and the other is dismissed, count the case as an affirmation. Full Partial Affirmation Dismissal/ Withdrawal = Report As
X Full X Partial X Affirmation X Dismissal/ Withdrawal X X Partial X X Partial X X Full X X X Partial X X X X Partial X X Partial X X Partial X X Affirmation X X X Partial Line 8. Affirmations - Under the appropriate columns, show the number of completed redeterminations from Line 6 in which the previous determinations were completely upheld; i.e., no change was made. All claims in a case must be upheld in order for the case to be counted as an affirmation. In instances where claims some are affirmed, but all others are dismissed or withdrawn, count the case as an affirmation. (Do not include partial reversals in this line. See Line 9 for partial reversals). Include those instances where the decision was affirmed, but a change in liability was noted. Line 8a. Waiver of Liability Amount Paid (Not Applicable) - Show the amount paid under waiver of liability, on the basis that the party did not know that the service wasn’t payable under Medicare. Line 8.1. Number of Claims Affirmed – Show the number of claims involved in Line 6.1 for which the decision was affirmed. NOTE -- The following example is counted as an affirmation: A claim is denied at the initial determination level and a redetermination is requested. At the redetermination level, the denial is upheld but the denial is for a reason other than was determined to be applicable at the initial determination level. Count the claim as an affirmation. Line 8.1a – Report the number of SNF claims included in Line 8.1. Line 8.1b – Report the number of Home Health claims included in Line 8.1. Line 8.1c – Report the number of Inpatient Hospital claims included in Line 8.1. Line 8.1d – Report the number of Outpatient claims included in Line 8.1. Line 8.1e – Report the number of Lab claims included in Line 8.1. Line 8.1f – Report the number of Ambulance claims included in Line 8.1. Line 8.1g – Report the number of DME claims included in Line 8.1. Line 8.1h – Report the number of Physician claims reported in Line 8.1. Line 8.1i – Report the number of Other claims or claims where the provider type cannot be determined based on the information on the claim included in Line 8.1. Line 8.2. RAC Redeterminations Affirmed- Of the affirmation cases reported in Line 8, how many are RAC related?
Line 8.2.1. Number of RAC Claims Involved – Show the number of claims involved in Line 8.2. Line 9. Partial Reversals - Under the appropriate columns, show the number of completed redeterminations, from Line 6 in which part of the prior determination decision of the appealed lines was reversed. That is, a change was made and some part of the new determination was in favor of the appellant. NOTE: Consider a case reversed when the initial determination is changed upon appeal, irrespective of a change in payment. Line 9.1. Number of Claims Partially Reversed – Show the number of claims involved in Line 6.1 for which the decision is partially reversed. Note: It is possible to have zero claims in Line 9.1, even when cases are recorded in Line 9. Line 9.1a – Report the number of SNF claims included in Line 9.1. Line 9.1b – Report the number of Home Health claims included in Line 9.1. Line 9.1c – Report the number of Inpatient Hospital claims included in Line 9.1. Line 9.1d – Report the number of Outpatient claims included in Line 9.1. Line 9.1e – Report the number of Lab claims included in Line 9.1. Line 9.1f – Report the number of Ambulance claims included in Line 9.1. Line 9.1g – Report the number of DME claims included in Line 9.1. Line 9.1h – Report the number of Physician claims reported in Line 9.1. Line 9.1i – Report the number of Other claims or claims where the provider type cannot be determined based on the information on the claim included in Line 9.1. Line 9.2. RAC Redeterminations Partially Reversed– Of the partially reversed cases reported in Line 9, how many are RAC related? Line 9.2.1 Number of RAC Claims Involved – Show the number of claims involved in Line 9.2. Line 10. Full Reversals - Under the appropriate columns, show the total number of completed redeterminations from Line 6 in which the previous determination decision of the appealed lines was completely reversed. NOTE: Consider a case reversed when the initial determination is changed upon appeal, irrespective of a change in payment. Line 10.1. Number of Claims Fully Reversed – Show the number of claims involved in Line 6.1 for which the decision is fully reversed. Line 10.1a – Report the number of SNF claims included in Line 10.1. Line 10.1b – Report the number of Home Health claims included in Line 10.1. Line 10.1c – Report the number of Inpatient Hospital claims included in Line 10.1. Line 10.1d – Report the number of Outpatient claims included in Line 10.1. Line 10.1e – Report the number of Lab claims included in Line 10.1. Line 10.1f – Report the number of Ambulance claims included in Line 10.1. Line 10.1g – Report the number of DME claims included in Line 10.1. Line 10.1h – Report the number of Physician claims reported in Line 10.1. Line 10.1i – Report the number of Other claims or claims where the provider type cannot be determined based on the information on the claim included in Line 10.1. Line 10.2 RAC Redeterminations Fully Reversed – Of the fully reversed cases reported in Line 10, how many are RAC related?
Line 10.2.1 Number of RAC Claims Involved – Show the number of claims involved in Line 10.2. Line 11. Dismissals/Withdrawals - Report, under the appropriate column, the number of cases from Line 6 that were withdrawn by the appellant or dismissed (before determination) by you. In order for a case to be recorded in Line 11, all claims in the case must be dismissed or withdrawn. NOTE: Do not count cases that were dismissed because they were determined to be incomplete in Line 11. Cases that were dismissed because they were determined to be incomplete should only be counted in Line 12. Line 11.1. Number of Claims Dismissed or Withdrawn – Show the number of claims involved in Line 6.1 which were dismissed or withdrawn. Line 11.1a – Report the number of SNF claims included in Line 11.1. Line 11.1b – Report the number of Home Health claims included in Line 11.1. Line 11.1c – Report the number of Inpatient Hospital claims included in Line 11.1. Line 11.1d – Report the number of Outpatient claims included in Line 11.1. Line 11.1e – Report the number of Lab claims included in Line 11.1. Line 11.1f – Report the number of Ambulance claims included in Line 11.1. Line 11.1g – Report the number of DME claims included in Line 11.1. Line 11.1h – Report the number of Physician claims reported in Line 11.1. Line 11.1i – Report the number of Other claims or claims where the provider type cannot be determined based on the information on the claim included in Line 11.1. Notes: Misrouted correspondence and duplicate requests are not dismissals. Line 11.2. RAC Redeterminations Dismissed or Withdrawn - Of the dismissed or withdrawn cases reported in Line 11, how many are RAC related? Line 11.2.1. Number of RAC Claims Involved – Show the number of claims involved in Line 11.2. Line 12. Number of Incomplete Redetermination Requests Dismissed - Enter the number of cases that were dismissed because the request was incomplete. Report incomplete cases in Line 12 only if ALL the claims from the case are incomplete. For information on what constitutes an incomplete request, refer to the Medicare Claims Processing Manual, Publication 100-04; Chapter 29; Section 310.1 NOTE: If one redetermination request contains multiple claims and or line items and is split, report the case according to the overall disposition of the individual claims and/or line items. (In many instances, split cases will be reported as partially reversed). Example: A supplier submits a redetermination request that contains one request with 50 claims involving different beneficiaries. The request contains a name and signature of the appellant/supplier, and the supporting documentation identifies individual claims of the beneficiaries, pertinent Medicare beneficiary identifier and the dates of service. However, for some of the claims, the supplier does not identify the specific services (among the several line items on the claim) that are disputed. The contractor should not dismiss the
entire redetermination request. Rather, in this situation, the contractor issues dismissals (incomplete requests) with respect to the individual claims for which the requisite information is incomplete, and issues favorable and/or unfavorable decisions for the remaining claims, as appropriate. For the purposes of reporting, the case is reported according to the overall disposition of the individual claims and/or line items. If the case contains some affirmations, reversals and dismissals, count the case as partially reversed in Line 9. Example: A supplier submits a redetermination request that contains one request with 50 claims involving different beneficiaries. The request is missing the signature of the appellant/supplier, but identifies the individual claims of the beneficiaries, pertinent names and Medicare beneficiary identifiers, dates of service and the items or services disputed. Since the signature is missing, the entire request would be dismissed as incomplete, and counted in Line 12 of the CMS-2592. Do not count cases that were dismissed for reasons other than being incomplete on Line 12. Only count those instances for which the entire request is dismissed on Line 12. Line 13. Medicare Approved Amount (Not Applicable) - For cases included in Lines 9 and 10, show the Medicare Approved Amount for services where the initial determination was reversed at the redetermination level, either fully (Line 10) or partially (Line 9). Show charges prior to application of the deductible and coinsurance. Round results to the nearest dollar. Processing and Pending Times - This deals with processing and pending times for Part A and Part B appeals. Computing Time to Process Redeterminations for (Lines 6 through 25) For Lines 6-25, use the matrix below to determine the number of days from receipt to completion of redeterminations. The date of receipt in all cases is the day the processing contractor received the request in its corporate mailroom. In order to ensure that cases are processed timely, cases should also be date stamped or controlled in some way in the mailroom. Situation Date Completed o The appellant withdraws the request. The date the dismissal letter is mailed to the party. o The contractor dismisses the request The date the dismissal letter is mailed to the party. o The contractor reverses the initial determination. For both full and partial reversals, when the contractor completes the action that sets in motion correct
o The contractor affirms the initial determination payment of the claim and the contractor mails the decision letter to the party. The date the decision letter is mailed to the party. REDETERMINATIONS PROCESSING TIME: REDETERMINATIONS WITH DOCUMENTATION SUBMITTED TIMELY (Lines 14-16) Line 14. Redetermination Processing Time – Average – Report, under the appropriate columns, the average number of days from receipt of the redetermination in the corporate mailroom to the date of completion. Do not include redeterminations where documentation is submitted after the request (i.e., a redetermination cannot be counted in both Line 14 and Line 17). To compute the average number of days from request to completion, divide the total days elapsed for all requests (where the documentation was submitted timely) cleared in the month by the number of requests cleared. Round results to the nearest day. The days elapsed for an individual request are calculated using the number of days from the Julian date of case receipt through the Julian date of completion. Include the time required for the response to be mailed to the appellant. If the request is cleared in the year following the year of receipt, add 365 or 366 to the result, as appropriate. (Otherwise, you will get a negative number). If a case is cleared the same day it is received, consider it to require one day. For example, a case that is received and processed on January 7 is considered to require one day to clear. A case received on January 7 and cleared on January 8 is considered to require 2 days to clear. Include all cases cleared, regardless of whether they were affirmed, reversed, dismissed, or withdrawn. Line 15. Redeterminations Completed in 1-60 Days - Show the number of redeterminations that required 1-60 calendar days to complete (based on the date of receipt of the request in the corporate mailroom). Do not include redeterminations reported in Lines 18-20. Line 15a. RAC Redeterminations Completed in 1-60 Days – Of the total number of appeals reported in Line 15, show the number that are RAC related. Line 16. Redeterminations Completed in over 60 Days - Show the number of redeterminations that required more than 60 calendar days to complete (based on the date of receipt of the request in the corporate mailroom). Do not include redeterminations reported in Lines 18-20. Line 16a. RAC Redeterminations Completed in Over 60 Days – Of the number of appeals reported in Line 16, show the number that are RAC related. PROCESSING TIME: Redeterminations with DOCUMENTATION SUBMITTED AFTER REQUEST WAS RECEIVED (Lines 17-20)
NOTE: This section captures information in instances where the party submits additional documentation at the redetermination level (including those instances when the contractor requests the additional documentation) after the initial request for redetermination is received. The contractor must receive the documentation before the 60 day timeframe is up in order for data to be entered into Lines 17-20. Line 17. Redeterminations Processing Time - Average (Documentation Submitted Later) – For redeterminations where documentation/evidence is submitted after the request is received, report under the appropriate columns, the average number of days from receipt of the redetermination to the date of completion. Using redeterminations where documentation was submitted later as the basis, follow instructions in Line 14 to calculate the average processing time. Line 18. Redeterminations Completed in 1-60 Days (Documentation Submitted Later) - Show the number of redeterminations from Line 6 where documentation/evidence is submitted after the request is received, and 1-60 calendar days were required to complete the case. Line 18a. RAC Redeterminations Completed in 1-60 Days (Documentation Submitted Later) – Of the number of appeals reported in Line 18, show the number that are RAC related. Line 19. Redeterminations Completed in 61-74 Days (Documentation Submitted Later) - Show the number of redeterminations from Line 6 where documentation/evidence is submitted after the request is received, and 61-74 calendar days were required to complete the case. Line 19a. RAC Redeterminations Completed in 61-74 Days (Documentation Submitted Later) – Of the number of appeals reported in Line 19, show the number that are RAC related. Line 20. Redeterminations Completed in over 74 Days (Documentation Submitted Later) - Show the number of redeterminations from Line 6 where documentation/evidence is submitted after the request is received, and more than 74 calendar days were required to complete the case. Line 20a. RAC Redeterminations Completed in over 74 Days (Documentation Submitted Later) – Of the number of appeals reported in Line 20, show the number that are RAC related. Pending Time Frames Line 21. Closing Pending Redeterminations - Show, under the appropriate columns, the total number of redeterminations that have not been completed by the end of the reporting month. Note: Do not include pending effectuations in this line. Line 22. Redeterminations Pending 1-30 Days – Show the number of redeterminations included in Line 21 that have been pending for 1-30 days, inclusive, at the end of the reporting month. Line 23. Redeterminations Pending 31-60 Days - Show the number of redeterminations included in Line 21 that have been pending 31-60 days, inclusive, at the end of the reporting month.
Line 24. Redeterminations Pending 61-74 Days - Show the number of redeterminations included in Line 21 which have been pending 61-74 days, inclusive at the end of the reporting month. Line 25. Redeterminations Pending Over 74 Days - Show the number of redeterminations included in Line 21 which have been pending more than 74 days at the end of the reporting month. EFFECTUATION OF REDETERMINATION DECISIONS Line 26. Total Effectuations - Show the number of redetermination cases for which you effectuated a decision during the month. Consider effectuation of a decision to be completed when you issue payment to the appellant based on a fully favorable or partially favorable decision. Include effectuation of affirmations where changes in liability are at issue. Do not include cases for which no effectuation is required. Notes: Considering a case to be completed is different from determining when a case is effectuated. Please refer to the distinctions in the introductory sections of the2592 report (“When to Consider a Case Completed” and “When to Consider a Case Effectuated”). Line 26a. Number of Claims Involved – Show the number of claims involved in Line 26. Line 27. Number Effectuated 1-30 Days - Show the number of claims from Line 26a where you effectuated the decision within 30 calendar days of the date of the decision. Line 28. Number Effectuated 31-60 Days - Show the number of claims from Line 26a where you effectuated the decision within 31- 60 calendar days of the date of the decision. Line 29. Number Effectuated Over 60 Days - Show the number of claims from Line 26a where you effectuated the decision in more than 60 calendar days of the date of the decision. 460.3 - Section II - Qualified Independent Contractor (QIC) Reconsiderations (Rev. 253, 08-06-15, Effective: 01-01-16, Implementation: 01-04-15) - Use Section II to report requests for reconsideration. Reconsiderations, the second level of appeal, are processed by the QIC. This section of the report captures information related to several distinct pieces associated with the reconsideration process. While requests for reconsideration should be sent directly by the appellant to the QIC, it is probable that some requests will be sent to A/B MACs and DME MACs, requiring the need for forwarding the request, and the associated case file, to the QIC. In those instances where the requests for reconsideration are sent directly to the QIC as required, the QICs will have to request case file information from the contractor before the reconsideration can be conducted. In addition, the contractor will effectuate QIC decisions, as appropriate. QIC RECONSIDERATIONS FALL INTO THE FOLLOWING CATEGORIES: Column (1) Part A Cases- Use Column 1 to record information on reconsiderations of redeterminations for Part A services processed by the A/B MAC (A).
Column (2) Part B of A Cases Use Column 2 to record information on reconsiderations of redeterminations for Part B services processed by the A/B MAC (A). Column (3) Part B Cases- Use Column 3 to record information on reconsiderations of redeterminations for Part B services processed by the A/B MAC (B) or DME MAC. Line 30. Opening Pending - Show the number of closing pending reconsiderations reported on Line 47 on the previous month's report. Line 31. Adjustments to Pending - If it is necessary to revise the pending figure for the close of the previous month because of inventories or reporting errors, enter the adjustment. Report requests received near the end of the reporting month and placed under control in the subsequent month as received in the reporting month, not as requests received in the subsequent month. If some cases were not counted in the proper month's receipts, count them as adjustments to the opening pending in the subsequent month. Line 32. Adjusted Opening Pending - Show the result of Line 30 + Line 31 (taking into account the “-“ sign, if any). Line 33. Requests for QIC Reconsideration Received by the Contractor - Show the number of QIC reconsiderations received by the contractor during the month. Although the requests for reconsideration should be sent directly to the QIC, some requests may be sent directly to the contractor in error, and as such, are considered to be “misrouted”. Enter the number reconsideration requests sent by the appellant or their representative directly to the contractor. The contractor must forward these requests, along with the associated case file, to the QIC. Line 33a. Misrouted Requests Forwarded to QIC –Show the number of misrouted reconsideration requests that were forwarded to the QIC, along with the associated case file, during the month. Do not include duplicate requests for reconsideration in this line. Line 33b. Misrouted Requests Forwarded Timely – Of the number reflected in Line 33a, show the number forwarded to the QIC in 1-30 calendar days. Line 33c. Misrouted Requests Forwarded Untimely – Of the number reflected in Line 33a, show the number forwarded to the QIC in more than 30 calendar days. Line 34. Requests from QIC for Case Files: Upon receipt of the request for reconsideration, the QIC must contact the contractor to request the case file. Show the number of requests for case files received by the contractor from the QIC during the month. Requests can be received in the corporate mailroom, by telephone or by fax. Consider the date of receipt as the date you receive the QIC request for the case file. Line 35. Number of Case Files Forwarded to QIC - Show the number of reconsideration case files forwarded to QICs during the month. Consider the case forwarded when all necessary material has been mailed to the QIC.
Line 36. Number Forwarded in 1-5 Days – Show the number of Reconsideration case files forwarded to the QIC in 1-5 calendar days from the date of receipt of the QIC request to mailing of the necessary information to the QIC. Show data for all cases mailed during the month. Line 36a. Number Forwarded In 6 Days - Show the number of Reconsideration case files forwarded to the QICs in 6 calendar days from the date of receipt of the QIC request to mailing of the necessary information to the QIC. Show data for all cases mailed during the month. Line 37. Number Forwarded In 7-8 Days - Show the number of Reconsideration case files forwarded to the QICs in 7-8 calendar days from the date of receipt of the QIC request to mailing of the necessary information to the QIC. Show data for all cases mailed during the month. Line 37a. Number Forwarded In Over 8 Days - Show the number of Reconsideration case files forwarded to QICs in over 8 calendar days from the date of receipt of the QIC request to mailing of the necessary information to the QIC. Show data for all cases mailed during the month. Line 38. Average Time to Forward - The average number of calendar days from date of the QIC request to the date you mail the necessary information. Refer to instructions contained in Line 14 to determine average time to forward. Line 39. Pending Case File Requests – Show the number of case files yet to be forwarded to the QIC. This could include requests received from, but not yet sent to the QIC, as well as those reconsideration requests sent to the contractor instead of the QIC. Disposition of QIC Decisions Line 40. Number of QIC Decisions Received From QIC- Show the number of Reconsideration requests completed by the QIC and returned to the contractor during the month. Line 41. Number of QIC Decisions That Need Effectuation - Show the number of Reconsideration decisions from Line 40 which must be effectuated. 41a. Number of Claims Involved: Show the number of claims involved in Line 41. EFFECTUATION OF QIC DECISIONS Line 42. Total Effectuations - Show the number of Reconsideration decisions for which you effectuated a decision during the month. Consider effectuation of a decision to be completed when you issue payment to the appellant based on a fully favorable or partially favorable decision. Include effectuation of affirmations where changes in liability are at issue. Do not include cases for which no effectuation is required. NOTE: Considering a case to be completed is different from determining when a case is effectuated. Please refer to the distinctions in the introductory sections of the2592 report (“When to Consider a Case Completed,” and “When to Consider a Case Effectuated”). NOTE: If the QIC’s decision is favorable to the appellant and gives a specific amount to be paid, effectuation must occur within 30 calendar days of the date of the QIC’s decision. If the decision is favorable but the amount to be paid must be computed, effectuation must occur within 30 days
after the amount is computed. The amount must be computed as soon as possible, but no later than 30 calendar days of the date of receipt of the QIC’s decision. Line 42a. Number of Claims Involved – Show the number of claims involved in Line 42. NOTE: Information captured in Lines 43, 44 and 45 reflects time to compute the amount to be paid as well as the effectuation timeframes. Information provided in Lines 43-45 also assumes that contractors must calculate the amounts to be paid. Even though all appropriate timeframes are not reflected here, contractors are still required to follow applicable manual requirements and timeframes with regard to receipt, calculation and effectuation of decisions. CMS anticipates that effectuation of most decisions for which the amount is provided should fall into Line 43. Line 43. Number Effectuated in 1-30 Days - Show the number of claims from Line 42a where you effectuated the decision within 30 calendar days. Effectuation days include the day of receipt of the reconsideration effectuation notice in your corporate mailroom or electronic transmission, such as fax or secure e-mail through the day the payment is issued. 43a. Contractor Computed Amount – Of the number reflected on Line 43, show the number where the contractor was required to compute the amount to be paid. An entry of zero indicates that the contractor was not required to compute the amount for any claim. Line 44. Number Effectuated in 31-60 Days - Show the number of claims from Line 42a where you effectuated the decision within 31-60 calendar days. Effectuation days include the day of receipt of the reconsideration effectuation notice in your corporate mailroom or electronic transmission, such as fax or secure e-mail through the day the payment is issued. 44a. Contractor Computed Amount – Of the number reflected on Line 44, show the number where the contractor was required to compute the amount to be paid. An entry of zero indicates that the contractor was not required to compute the amount for any claim. Line 45. Number Effectuated in Over 60 Days - Show the number of claims from Line 42a where you effectuated the decision in more than 60 calendar days. Effectuation days include the day of receipt of the reconsideration effectuation notice in your corporate mailroom or electronic transmission, such as fax or secure e-mail through the day the payment is issued. 45a. Contractor Computed Amount – Of the number reflected on Line 45, show the number where the contractor was required to compute the amount to be paid. An entry of zero indicates that the contractor was not required to compute the amount for any claim. Line 46. Medicare Approved Amount (Not Applicable) - For decisions included in Line 42 show the Medicare approved amount for services at the QIC level where the determination was reversed, either fully or partially. Show the charges prior to application of the deductible and coinsurance. Round results to the nearest dollar. It is preferable to report the Medicare Approved Amount at the time that cases are reported on line 42. However, CMS will consider it acceptable for contractors to report the Medicare Approved Amount when adjustment claims tied to cases that are reporting or will report to line 42 finalize.
Line 46a. Waiver of Liability Amount Paid (Not Applicable) – Of the amount recorded on Line 46, show the amount applicable to a waiver of liability payment on the basis that the party did not know that the service wasn’t payable under Medicare. Line 47. Closing Pending Reconsiderations - Show the total number of reconsideration requests that were not effectuated by the end of the reporting month. Consider a case pending from the date of receipt of the request at the contractor, or the date of the request for the case file from the QIC, until you have received the completed decision from the QIC for all parts of the case. This number shall also reflect those case files not yet forwarded to the QIC by the contractor as well as those decisions that have been received by the contractor from the QIC that still require effectuation on the part of the contractor. For example, if you receive a case from the QIC, and have initiated the adjustment into the system, but have not issued the payment, the case is reported in Line 47 as pending. Do not include instances where a misrouted file has been sent to the proper QIC in another jurisdiction. Misrouted files that belong to a QIC in another jurisdiction should be considered closed once they have been forwarded to the appropriate QIC. Files that are forwarded to the QIC servicing the same jurisdiction as the contractor should remain open until the effectuation is complete. 460.4 – Section III- Administrative Law Judge Results (Rev. 253, 08-06-15, Effective: 01-01-16, Implementation: 01-04-15) Line 48. Opening Pending - Show the number of ALJ decisions reported on Line 57 as the closing pending on the previous month's report. Line 49. Number of Appeal Requests for ALJ Hearing Misrouted to Contractor – Report the number of appeal requests for an ALJ hearing that were misrouted to the contractor when they should have been filed with the Office of Medicare Hearings and Appeals instead. These are ALJ requests that were filed with the contractor by mistake. Line 50. Number of ALJ Decisions Received From Administrative QIC (AdQIC) - Show the number of ALJ hearing decisions returned by the AdQIC to the contractor during the month. Consider the receipt date to be the date the case is received from the AdQIC. Include instances where decisions were received in the previous month, but were not entered into the system until the current month. Line 51. Number of ALJ Decisions Received that Need Effectuation - Show the number of ALJ decisions from Line 50 which must be effectuated. Line 51a. Number of Claims Involved – Show the number of claims involved in Line 51. Line 52. Total Effectuations -Show the number of ALJ decisions effectuated during the month. Consider effectuation of a decision to occur when you issue payment based on a fully favorable or partially favorable decision. Include effectuation of affirmations where changes in liability are at issue. Do not include cases for which no effectuation is required. Line 52a. Number of Claims Involved – Show the number of claims involved in Line 52.
NOTE: Information captured in Lines 53, 54 and 55 assumes that contractors must calculate the amounts to be paid before effectuation can occur. Contractors are required to follow other applicable timeframes used when specific amounts to be paid have been provided with the information received from the AdQIC. CMS anticipates that effectuation of most decisions for which the amount is provided should fall into Line 53. Line 53. Number Effectuated in 1 - 30 Days - Show the number of claims from Line 52a where you effectuated the decision within 30 calendar days. Effectuation days include day of receipt of the effectuation notice from the AdQIC in your corporate mailroom or electronic transmission, such as fax or secure e-mail, through the day the payment is issued. Line 54. Number Effectuated in 31 - 60 Days - Show the number of claims from Line 52a where you effectuated the decision within 31-60 calendar days. Effectuation days include day of receipt of the effectuation notice from the AdQIC in your corporate mailroom or electronic transmission, such as fax or secure e-mail, through the day the payment is issued. Line 55. Number Effectuated in Over 60 Days - Show the number of claims from Line 52a where you effectuated the decision in more than 60 calendar days. Effectuation days include day of receipt of the effectuation notice from the AdQIC in your corporate mailroom or electronic transmission, such as fax or secure e-mail, through the day the payment is issued. Line 56. Medicare Approved Amount (Not Applicable) - For decisions included in Line 52, show the Medicare approved amount for services where the reconsideration determination was reversed at the ALJ level, either fully or partially. Show charges prior to application of the deductible and coinsurance. Round results to the nearest dollar. It is preferable to report the Medicare approved amount at the time that cases are reported on line 52. However, CMS will consider it acceptable for contractors to report the Amount Paid when adjustment claims tied to cases that are reporting or will report to line 52 finalize. Line 56a. Waiver of Liability Amount Paid (Not Applicable) – Of the amount recorded on Line 56, show the amount applicable to a waiver of liability payment on the basis that the party did not know that the service wasn’t payable under Medicare. Line 57. Closing Pending ALJ Decisions - Show the total number of ALJ decisions that were received from the AdQIC, but were not completed by the contractor at the end of the reporting month, and as such, are still pending effectuation. All claims associated with the decision must be received from the AdQIC in order for the decision to be considered complete. 460.5 - Section IV – Medicare Appeals Council Effectuations (Rev. 130, Issued: 08-31-07, Effective: 01-01-08, Implementation: 01-07-08) Line 58. Medicare Appeals Council Effectuations – Show the total number of cases received from the Medicare Appeals Council which require effectuation by the contractor. While it is acknowledged that contractors will not have responsibility for forwarding these cases to the Medicare Appeals Council, information is requested since the contractor will have ultimate
responsibility to make payment. For reporting purposes, the contractor shall consider the date of receipt as the date the Medicare Appeals Council case is received from the AdQIC. 460.6 - Clerical Error Reopenings (Rev. 144; Issued: 11-28-08; Effective Date: 04-01-09; Implementation Date: 04-06-09) When a determination is made on a claim for services, the beneficiary (and the provider, physician or other supplier of medical services) should be able to rely on the fact that the coverage decision and payment amount are correct. Occasionally, information disclosing an error (on the part of the appellant or the contractor) in the determination comes to light after the payment has been incorrectly processed. Regulations do not permit unrestricted reopening of determinations and decisions, but rather, set specific circumstances under which a determination or decision may be reopened. Refer to 42 Code of Final Regulations (CFR) 405.980-986, Interim Final Rule, dated March 8, 2005.The Clerical Error Reopening section of the 2592 report focuses primarily on those clerical error and minor omission reopenings that occur at the pre and post redetermination level. Data on requests at the QIC level and above are only captured in Lines13 and 14 of the Clerical Error Reopening section of the report. Requests for a clerical error reopening may be received in writing or by telephone. Contractors shall continue to use the appropriate columns and lines of the CMS-2591 and CMS-2590 reports to capture data on reopenings that are not clerical in nature. Do not capture clerical error reopenings data on the 2590/2591. NOTE: Clerical Error Reopenings data requested in this section should be reported in claims, not cases. Line 1. Total Number of Clerical Error Reopenings Received – Show the total number of clerical error reopening requests received during the month. This number includes any requests originally categorized as a reopening at the pre or post-redetermination level, as well as those requests that were originally categorized as an appeal, but were later determined to be a clerical error reopening. Line 2. Total Number of Clerical Error Reopenings Processed -- Show the total number of clerical error reopenings processed by the contractor during the month. Line 3. Total Number Processed – Own Motion – Of the number reflected on Line 2, show the number the contractor reopened the claim on their own motion. Line 4. Total Number Processed – Claimant Initiated – Of the number reflected on Line 2, show the number of reopenings initiated by the claimant. Line 5. Total Number of Clerical Error Reopenings Resulting From Contractor Error -- Of the reopenings reflected in Line 2, show the total number of claims that were the result of contractor error, whether discovered by the contractor or the claimant. Line 6. Total Number of Clerical Error Reopenings Resulting From Provider Error -- Of the reopenings reflected in Line 2, show the total number of claims that were the result of provider error, whether discovered by the contractor or the claimant.
NOTE: Particularly with regard to Lines 3 through 6, it is possible for the same claim to be reflected on more than one line. Line 7: Reserved for Future Use Line 8: Reserved for Future Use Line 9. Medicare Approved Amount (Not Applicable) – For cases included on Line 2, show the amount paid for services where the determination was reversed either fully or partially. This is the amount sent after the reopening has been completed – the check amount. Round results to the nearest dollar. NOTE: Time frames noted in Lines 10, 11 and 11a are for clerical error reopenings initiated by the party only. The time frames do not apply to contractor initiated reopenings or mass adjustments. In addition, no time frames have been established for other types of reopenings. Line 10. Clerical Error Reopenings Processed in 1-30 Days – Show the number of clerical error reopenings from Line 2 processed in 1-30 calendar days. The processing time frame starts from the date of receipt of the request in the contractor’s mailroom. Line 11. Clerical Error Reopenings Processed in 31-60 Days - Show the number of clerical error reopenings from Line 2 processed in 31-60 calendar days. The processing time frame starts from the date of receipt of the request in the contractor’s mailroom. Line 11a. Clerical Error Reopenings Processed in More than 60 Days – Show the number of clerical error reopenings from Line 2 processed in 61 days or more. The processing time frame starts from the date of receipt of the request in the contractor’s mailroom. Line 12. Total Number of Clerical Error Reopening Requests Pending –Show the number of clerical error reopenings pending at the close of the reporting month. Line 13. Total Number of Higher Level Reopenings Requiring Adjustment by the Contractor – Show the number of claims that were reopened by the QIC, ALJ or Medicare Appeals Council that require an adjustment by the contractor. These are claims for which the contractor must effectuate the claim as a result of the reopening decision at the higher level. Line 14. Amount Awarded (Not Applicable) – Show the amount approved for services from Line 13 where the determination was reversed, either fully or partially. Show amounts that are sent to the provider. Round results to the nearest dollar. It is preferable to report the Medicare Approved Amount at the time that cases are reported on line 13. However, CMS will consider it acceptable for contractors to report the Medicare Approved Amount when adjustment claims tied to cases that are reporting or will report to line 13 finalize. 460.7 - Validation of Reports (Rev. 253, 08-06-15, Effective: 01-01-16, Implementation: 01-04-15)
The SSM shall automatically produce the CMS-2592 A/B MAC (B) appeals validation report and the A/B MAC (B) performance validation report on a daily and monthly basis without specific A/B MAC (B) maintenance or request or without A/B MAC (B) intervention. Before sending the reports to CMS, check for completeness and arithmetical accuracy. Note that the information provided below is applicable to each separate column. Use the following checklist for an arithmetical check for each column: • Line 1 equals Line 21 from previous month’s report. • For each column, Line 1 plus Line 2 equals Line 3. • Line 3 plus Line 4 minus Line 5 minus Line 6 minus line 12 equals Line 21 for each column. • Line 4.1 is equal to or greater than Line 4.a. • Line 4.2.1 is equal to or greater than Line 4.2. • The total of Line 6.1a through 6.1i equals Line 6.1. • The total of Line 7.1a through 7.1i equals Line 7.1. (Not Applicable) • The total of Line 8.1a through 8.1i equals Line 8.1. • The total of Line 9.1a through 9.1i equals Line 9.1. • The total of Line 10.1a through 10.1i equals Line 10.1. • The total of Line 11.1a through 11.1i equals Line 11.1. • Line 6.1 is equal to or greater than Line 6. • Line 7.1 is equal to or greater than Line 7. • Line 8.1 is equal to or greater than Line 8. • Line 10.1 is equal to or greater than Line 10. • Line 11.1 is equal to or greater than Line 11. NOTE: For contractors handling MSP claims, totals for Lines 6.1 through 11.1 may or may not be equal or greater to Lines 6 through 11, respectively. • Line 8 plus Line 9 plus Line 10 plus Line 11 must equal Line 6. • Line 8.2 plus Line 9.2 plus Line 10.2 plus Line 11.2 must equal Line 6.2. • Line 15 plus Line 16 plus Line 18 plus Line 19 plus Line 20 equals Line 6. • Line 15a plus Line 16a plus Line 18a plus Line 19a plus Line 20a equals Line 6.2. • Line 22 plus Line 23 plus Line 24 plus Line 25 equals Line 21. • Line 27 plus Line 28 plus Line 29 equals Line 26a. • Line 30 equals Line 47 of the previous month’s report. • Line 30 plus Line 31 equals Line 32. • Line 33b must not exceed Line 33a.
• Line 33c must not exceed Line 33a. • Line 33b plus 33c must equal Line 33a. • Line 36 plus Line 36a plus 37 plus Line 37a equals Line 35. • Line 41a is equal to or greater than Line 41. • Line 42a is equal to or greater than Line 42. • Line 43 plus Line 44 plus Line 45 equals Line 42a. • Line 46a must not exceed Line 46 (Not Applicable) • Line 48 plus Line 51 minus Line 52 equals Line 57. • Line 48 equals Line 57 from the previous month’s report. • Line 51a is equal to or greater than Line 51. • Line 52a is equal to or greater than Line 52. • Line 56a must not exceed Line 56. (Not Applicable) • Line 53 plus Line 54 plus Line 55 equals Line 52a. • Line 3 (Reopenings) plus Line 4 (Reopenings) equals Line 2 (Reopenings). • Line 5 (Reopenings) must not exceed Line 2 (Reopenings). • Line 5 (Reopenings) plus Line 6 (Reopenings) equals Line 2 (Reopenings) • Line 6 (Reopenings) must not exceed Line 2 (Reopenings). • Line 10 (Reopenings) plus Line 11 (Reopenings) plus Line 11a must not exceed Line 4 (Reopenings). 460.8 - Exhibit (Rev. 253, 08-06-15, Effective: 01-01-16, Implementation: 01-04-15) Column 1 Column 2 Column 3 Part A Services Part B Services Part B Services Processed by A/B MAC (A) Processed by A/B MAC (A) Processed by A/B MAC (B) or Durable Medical Equipment (DME) MAC Section I: Redeterminations 1: Opening Pending 2: Adjustments to Pending 3: Adjusted Pending 4: Requests Received 4.a Adjusted Requests Received 4.1 Number of Claims Received
4.2. Recovery Audit Contractor (RAC) Requests Received 4.2.1 Number of RAC Claims Received 5: Misrouted Requests Forwarded to Another Contractor 6: Requests Cleared 6.1 Number of Claims Cleared a. SNF b. Home Health c Inpatient Hospital d. Outpatient e. Lab f. Ambulance g. DME h. Physician i. Other 6.2. Recovery Audit Contractor (RAC) Redeterminations Cleared 6.2.1 Number of RAC Claims Involved 7: Cleared -- Evidence Submitted after Request 7.1: Number of Claims Involved a. SNF (Not Applicable) b. Home Health (Not Applicable) c. Inpatient Hospital (Not Applicable) d. Outpatient (Not Applicable) e. Lab (Not Applicable) f. Ambulance (Not Applicable) g. DME (Not Applicable) h. Physician (Not Applicable) i. Other (Not Applicable) 7.2: RAC Redeterminations Cleared With Additional Documentation 7.2.1: Number of RAC Claims Involved 8: Affirmations
8a. Waiver of Liability Amount Paid (Not Applicable) 8.1: Number of Claims Affirmed a. SNF b. Home Health c. Inpatient Hospital d. Outpatient e. Lab f. Ambulance g. DME h. Physician i. Other 8.2 RAC Redeterminations Affirmed 8.2.1: Number of RAC Claims Involved 9: Partial Reversals 9.1: Number of Claims Partially Reversed a. SNF b. Home Health c. Inpatient Hospital d. Outpatient e. Lab f. Ambulance g. DME h. Physician i. Other 9.2: RAC Redeterminations Partially Reversed 9.2.1: Number of RAC Claims Involved 10: Full Reversals 10.1 Number of Claims Fully Reversed a. SNF b. Home Health c. Inpatient Hospital d. Outpatient e. Lab f. Ambulance g. DME h. Physician i. Other 10.2: RAC Redeterminations Fully Reversed
10.2.1: Number of RAC Claims Involved 11: Dismissals/Withdrawals 11.1 Number of Claims Dismissed or Withdrawn a. SNF b. Home Health c Inpatient Hospital d. Outpatient e. Lab f. Ambulance g. DME h. Physician i. Other 11.2: RAC Redeterminations Dismissed or Withdrawn 11.2.1: Number of RAC Claims Involved 12: Number of Incomplete Redeterminations Requests Dismissed 13:Medicare Approved Amount (Not Applicable) 14: Redeterminations Processing Time –Average 15: Redeterminations Completed in 1-60 days 15a. RAC Redeterminations Completed in 1-60 days 16: Redeterminations Completed in Over 60 days 16 a. RAC Redeterminations Completed in Over 60 days 17: Redeterminations Processing Time- Average (Documentation Submitted Later) 18: Redeterminations Completed in 1-60 days (Documentation Submitted Later) 18a. RAC Redeterminations Completed in 1-60 days (Documentation Submitted Later) 19: Redeterminations Completed in 61-74 days (Documentation Submitted Later)
19a. RAC Redeterminations Completed in 61-74 days (Documentation Submitted Later) 20: Redeterminations Completed in over 74 days (Documentation Submitted Later) 20a. RAC Redeterminations Completed in over 74 days (Documentation Submitted Later) 21: Closing Pending Redeterminations 22 Redeterminations Pending 1-30 days 23: Redeterminations Pending 31-60 days 24: Redeterminations Pending 61-74 Days 25: Redeterminations Pending Over 74 days 26: Total Effectuations 26a: Number of Claims Involved 27: Number Effectuated 1- 30 Days 28: Number Effectuated 31- 60 Days 29: Number Effectuated over 60 Days Section II: QIC Reconsiderations 30: Opening Pending 31: Adjustments to Pending 32: Adjusted Opening Pending 33: Requests For QIC Reconsideration Received by the Contractor 33a. Misrouted Requests Forwarded to QIC 33b. Misrouted Requests Forwarded Timely 33c. Misrouted Requests Forwarded Untimely 34. Requests from QIC for Case Files 35: Number of Case Files Forwarded to QIC 36: Number Forwarded in 1-5 days
36a: Number Forwarded in 6 Days 37: Number Forwarded in 7-8 Days 37a: Number Forwarded in Over8 Days 38: Average Time to Forward 39. Pending Case File Requests 40: Number of QIC Decisions Received from QIC 41: Number of QIC Decisions that Need Effectuation 41a. Number of Claims Involved 42: Total Effectuations 42a. Number of Claims Involved 43. Number Effectuated in 1-30 Days 43a. Contractor Computed Amount 44: Number Effectuated in 31-60 Days 44a. Contractor Computed Amount 45: Number Effectuated in Over 60 Days 45a: Contractor Computed Amount 46 Medicare Approved Amount (Not Applicable) 46a. Waiver of Liability Amount Paid (Not Applicable) 47: Closing Pending Reconsiderations Section III: ALJ Results 48: Opening Pending 49: Number of Appeal Requests for ALJ Hearing Misrouted to Contractor 50: Number of ALJ Decisions Received from Administrative QIC 51: Number of ALJ Decisions Received that Need Effectuation
51a Number of Claims Involved 52: Total Effectuations 52a. Number of Claims Involved 53: Number Effectuated in 1-30 Days 54: Number Effectuated in 31-60 days 55: Number Effectuated in Over 60 Days 56: Medicare Approved Amount (Not Applicable) 56a. Waiver of Liability Amount Paid (Not Applicable) 57: Closing Pending ALJ Decisions Section IV: Medicare Appeals Council Effectuations 58: Medicare Appeals Council Effectuations Clerical Error Reopenings 1: Total Number of Clerical Error Reopenings Received 2: Total Number of Clerical Error Reopenings Processed 3. Total Number Processed – Own Motion 4. Total Number Processed – Claimant Initiated 5: Total Number of Clerical Error Reopenings Resulting from Contractor Error 6: Total Number of Clerical Error Reopenings Resulting from Provider Error 7. Reserved for Future Use 8. Reserved for Future Use 9. Medicare Approved Amount (Not Applicable) 10. Clerical Error Reopenings Processed in 1- 30 days 11. Clerical Error Reopenings Processed in 31- 60 days
11.a Clerical Error Reopenings Processed in More than 60 days 12: Total Number of Clerical Error Reopening Requests Pending 13. Total Number of Higher Level Reopenings Requiring Adjustment by the Contractor 14. Amount Awarded (Not Applicable) 480 - Special Purpose Data (Rev. 175, Issued: 10-28-10, Effective: 04-01-11, Implementation: 04-04-11) 480.1 - Heading (Rev. 12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) This report, referenced as Form Y for CROWD, is used only when program requirements compel CMS to collect data on an interim basis before the data elements can be incorporated into one of the regular forms. The Medicare contractor submits the appropriate information for the reporting period for each office assigned a separate contractor number and BSI no later than the 10th day of the following month using instructions in the CROWD User Guide available via the CMS Enterprise Portal. 480.2 - Exhibit (Rev. 175, Issued: 10-28-10, Effective: 04-01-11, Implementation: 04-04-11) Exhibit - Special Purpose Data SPECIAL PURPOSE DATA CONTRACTOR NUMBER DESCRIPTION CODE COL 1 COL 2 COL 3 COL 4 COL 5 0000 0 0 0 0 0 0000 0 0 0 0 0 0000 0 0 0 0 0
Transmittals Issued for this Chapter
Rev # Issue Date Subject Impl Date CR# R12894FM 10/17/2024 Migration of the Contractor Reporting of Operational and Workload Data (CROWD) to the Centers for Medicare & Medicaid Services (CMS) Enterprise Portal – Internet-Only Manual (IOM) Updates 11/01/2024 12743 R12456FM 01/11/2024 New Physician Specialty Code for Epileptologists 07/01/2024 13425 R10521FM 12/16/2020 New Medicare National Uniform Billing Committee (NUBC) Type of Bill (TOB), Condition Code and implementing Billing Codes for Opioid Treatment Programs 01/04/2021 11856 R10374FM 09/25/2020 New Physician Specialty Code for Micrographic Dermatologic Surgery (MDS) and Adult Congenital Heart Disease (ACHD) and a New Supplier Specialty Code for Home Infusion Therapy Services 10/05/2020 11750 R10319FM 08/28/2020 Removal of Contractor Requirement to Submit Electronic Data Interchange (EDI) Data into the Contractor Reporting of Operational and Workload Data (CROWD) System (Form 5) 09/29/2020 11909 08/06/2020 New Medicare National Uniform Billing Committee (NUBC) Type of Bill (TOB), Condition Code and implementing Billing Codes for Opioid Treatment Programs- Rescinded and replaced by transmittal 10521 SENSITIVE/CONTROVERSIAL 01/04/2021 11856 R10124FM 05/08/2020 New Physician Specialty Code for Micrographic Dermatologic Surgery (MDS) and Adult Congenital Heart Disease (ACHD) and a New Supplier Specialty Code for Home Infusion Therapy Services- Rescinded and replaced by transmittal 10374 10/05/2020 11750 12/05/2019 New Medicare Provider Specialty Code (D5) and Billing Codes for Opioid Treatment Programs and New Place of Service Code 58 01/06/2020 11353 10/29/2019 New Medicare Provider Specialty Code (D5) and Billing Codes for Opioid Treatment Programs and New Place of Service Code 58 SENSITIVE/CONTROVERSIAL 01/06/2020 11353 09/23/2019 New Medicare Provider Specialty Code (D5) and Billing Codes for Opioid Treatment Programs and New Place of Service Code 58- Rescinded and replaced by Transmittal 329 SENSITIVE/CONTROVERSIAL 01/06/2020 11353
08/01/2019 New Medicare Provider Specialty Code (D5) and Billing Codes for Opioid Treatment Programs and New Place of Service Code 58-Rescinded and replaced by Transmittal 324 SENSITIVE/CONTROVERSIAL 01/06/2020 11353 R315FM 05/17/2019 Update to Publication (Pub.) 100-06 to Provide Language-Only Changes for the New Medicare Card Project 06/18/2019 11211 R309FM 12/20/2018 New Physician Specialty Code for Undersea and Hyperbaric Medicine 01/07/2019 10666 R304FM 04/27/2018 New Physician Specialty Code for Medical Genetics and Genomics 10/01/2018 10457 R302FM 03/30/2018 Removal of Contractor Reporting Requirements for the Physician Scarcity Area (PSA), the Health Professional Shortage Area Surgical Incentive Payment Program (HSIP) and the Primary Care Payment Incentive Program (PCIP) Quarterly Reports 07/02/2018 10406 R298FM 02/02/2018 Removal of Contractor Reporting Requirements for the Physician Scarcity Area (PSA), the Health Professional Shortage Area Surgical Incentive Payment Program (HSIP) and the Primary Care Payment Incentive Program (PCIP) Quarterly Reports Rescinded and replaced by Transmittal 302 07/02/2018 10406 R290FM 07/14/2017 New Specialty Code for Pharmacy 01/02/2018 9821 R283FM 04/28/2017 New Physician Specialty Code for Advanced Heart Failure and Transplant Cardiology, Medical Toxicology, and Hematopoietic Cell Transplantation and Cellular Therapy 10/02/2017 9957 R276FM 11/25/2016 New Physician Specialty Code for Hospitalist 04/03/2017 9716 R274FM 10/28/2016 New Physician Specialty Code for Hospitalist – Rescinded and replaced by Transmittal 276 04/03/2017 9716 R269FM 06/22/2016 New Physician Specialty Code for Dentist 07/05/2016 9355 R268FM 06/15/2016 New Physician Specialty Code for Dentist – Rescinded and replaced by Transmittal 269 07/05/2016 9355 R265FM 03/16/2016 Contractor Reporting of Operational and Workload Data (CROWD) Form 5 Update with Revisions to Pub. 100-06 Medicare Financial Management Manual, Chapter 6 07/05/2016 8998
R263FM 02/05/2016 Contractor Reporting of Operational and Workload Data (CROWD) Form 5 Update with Revisions to Pub. 100-06 Medicare Financial Management Manual, Chapter 6 – Rescinded and replaced by Transmittal 265 07/05/2016 8998 R262FM 01/29/2016 New Physician Specialty Code for Dentist – Rescinded and replaced by Transmittal 268 07/05/2016 9355 R253FM 08/06/2015 Update the Contractor Reporting of Operational and Workload Data (CROWD) CMS-2592 Report to Indicate Requests Received in Claims and Requests Received That Are Recovery Audit Related 01/04/2015 9157 R248FM 12/19/2014 Revision of Pub. 100-06 - Medicare Financial Management Manual, Chapter 6 - Intermediary and Carrier Financial Reports, and Pub. 100-09 - Medicare Contractor Beneficiary and Provider Communications, Chapter 6 - Provider Customer Service Program 01/23/2015 8906 R238FM 08/22/2014 New Physician Specialty Code for Interventional Cardiology 01/05/2015 8812 R221FM 06/12/2013 New Non-Physician Code for Complimentary Insurer 10/07/2013 8282 R219FM 05/03/2013 New Non-Physician Code for Complimentary Insurer – Rescinded and replaced by Transmittal 221 10/07/2013 8282 R216FM 12/14/2012 Modification/Addition of Group Codes/Specialty Codes 01/15/2013 8090 R212FM 08/10/2012 New Non-Physician Specialty Code for Centralized Flu 01/07/2012 7884 R209FM 04/27/2012 New Physician Specialty Code for Sleep Medicine and Sports Medicine 10/01/2012 7600 R195FM 09/30/2011 To Create Form 9 Within the Contractor Reporting of Operational and Workload Data (CROWD) System for the Reporting of Primary Care Incentive Payments (PCIP) and HPSA Surgical Incentive Payments (HSIP) 07/05/2011 7285 R191FM 07/13/2011 Add Physician Specialty Codes for Cardiac Electrophysiology (21) and Sports Medicine (23) to CROWD Forms “F” (ParDoc) and “8” (OptOut) – Rescinded and replaced by Transmittal 191 07/05/2011 7233 R188FM 04/22/2011 Modify CROWD Form K to Allow the Submission of Additional Medicare Summary Payer (MSP) Savings Information 07/05/2011 and 10/03/2011 7291 R183FM 02/04/2011 To Create Form 9 Within the Contractor Reporting of Operational and Workload Data (CROWD) System for the Reporting of Primary Care Incentive Payments (PCIP) and HPSA Surgical Incentive Payments (HSIP) – Rescinded and replaced by Transmittal 195 07/05/2011 7285 R181FM 01/04/2011 Add Physician Specialty Codes for Cardiac Electrophysiology (21) and Sports Medicine (23) to CROWD Forms “F” (ParDoc) and “8” (OptOut) – Rescinded and replaced by Transmittal 191 07/05/2011 7233
R178FM 12/03/2010 Add Physician Specialty Codes for Cardiac Electrophysiology (21) and Sports Medicine (23) to CROWD Forms “F” (ParDoc) and “8” (OptOut) - Rescinded and replaced by Transmittal 181 07/05/2011 7233 R177FM 12/03/2010 Add Supplier Specialty Code 95 (Advanced Diagnostic Imaging (ADI) Accreditation) to CROWD Form F (Participating Physician/Supplier Report) – Rescinded and not replaced. 07/05/2011 7226 R176FM 11/12/2010 Clarification for Data Entry on Health Professional Shortage Area Reports 12/13/2010 7223 R175FM 10/28/2010 Change the Name of Physician Specialty Code 12 from Osteopathic Manipulative Therapy to Osteopathic Manipulative Medicine 04/04/2011 7093 R173FM 10/15/2010 Update to the Quarterly Opt Out Reporting Form (Form 8) in the Contractor Reporting of Operational Workload Data (CROWD) 11/16/2010 7165 R171FM 05/28/2010 Expansion of Form 5 of the Contractor Reporting of Operational and Workload Data (CROWD) 10/04/2010 6969 R170FM 05/21/2010 Cardiac Rehabilitation and Intensive Cardiac Rehabilitation 10/04/2010 6850 R163FM 12/04/2009 Add Physician Specialty Code 27 (Geriatric Psychiatry) to CROWD Form F (Participating Physicians/Supplier Report) 04/05/2010 6613 R159FM 10/09/2009 Add Physician Specialty Code 27 (Geriatric Psychiatry) to CROWD Form F (Participating Physicians/Supplier Report) – Rescinded and replaced by Transmittal 163 04/05/2010 6613 R157FM 08/21/2009 Add Specialty Codes to CROWD Form F (Participating Physicians Data) 01/04/2010 6580 R155FM 07/31/2009 New Reporting Requirements for the Quarterly Opt Out Report in Contractor Reporting of Operational Workload Data (CROWD) 01/04/2010 6562 R144FM 11/28/2008 Revisions to the Monthly Statistical Report on Intermediary and Carrier Part A and Part B Appeals Activity Form (CMS-2592) to Capture Data on Recovery Audit Contractor (RAC) Redeterminations 04/06/2009 6251 R131FM 09/21/2007 Participating Physicians Report – Deletion of Requirement to Forward a Memorandum to CMS Detailing Adjustments for Form F Column 1 (PAR Prior) (from previous enrollment period) 01/07/2008 5697 R130FM 08/31/2007 “Revisions” of the CROWD Report 01/07/2008 5555 R126FM 07/13/2007 Manual Revision Re: MSN Workload Reporting 01/07/2008 5642 R123FM 06/08/2007 Contractor CROWD Form 5 Completion Changes 10/01/2007 4274 R121FM 05/02/2007 Contractor CROWD Form 5 Completion Changes – Replaced by Transmittal 123 10/01/2007 4274
R119FM 04/20/2007 Contractor CROWD Form 5 Completion Changes - Replaced by Transmittal 121 10/01/2007 4274 R98FM 06/16/2006 Correction of CROWD Form 5 Reporting for Internet Pilot Carriers 07/17/2006 5120 R96FM 05/26/2006 Development of New Report to Capture BIPA and MMA Appeals Data 07/03/2006 5056 R88FM 01/06/2006 Clarification to IOM 100-06, Sections 290.7 and 290.8 02/06/2006 4198 R86FM 12/02/2005 Development of New Report to Capture BIPA and MMA Appeals Data – Replaced by Transmittal 96, CR 5056 07/03/2006 4148 R85FM 11/17/2005 Expansion of Form 5 of the Contractor Reporting of Operational and Workload Data (CROWD) – Replaced by Transmittal 85 04/03/2006 3864 R82FM 10/31/2005 Expansion of Form 5 of the Contractor Reporting of Operational and Workload Data (CROWD) – Replaced by Transmittal 85 04/03/2006 3864 R76FM 08/12/2005 Development of New Report to Capture BIPA and MMA Appeals Data – Replaced by Transmittal 86, CR 4148 04/03/2006 3837 R65FM 02/25/2005 Revised Reporting Requirements for Contractor Reporting of Operational and Workload Data (CROWD) Physician Scarcity Area (PSA) Quarterly Report (CMS Form-1565F, CROWD Form 6) 07/05/2005 3673 R57FM 10/22/2004 Revised Reporting Requirements for Contractor Reporting of Operational and Workload Data (CROWD) Health Professional Shortage Area (HPSA) Quarterly Report (CMS Form-1565E, CROWD Form S) 04/04/2005 3472 R56FM 10/22/2004 Revision to Balancing Requirements on Form 5, Line 10 of the Contractor Reporting of Operational and Workload Data (CROWD) 11/22/2004 3486 R45FM 05/28/2004 Workload Reporting N/A 3246 R40FM 04/30/2004 Medicare Contractor Transaction Report 10/04/2004 3257 R36FM 03/12/2004 Medicare Contractor Transaction Report (FormCMS-5) N/A 2249 & 2547 R06FM 08/30/2002 Initial Publication of Chapter N/A N/A Back to top of Chapter
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