Medicare agency to seek claims processing help

Medicare agency to seek claims processing help

The Centers for Medicare and Medicaid Services plans to issue a request for proposals in early November to update and maintain its medical claims processing system for Medicare Part B, which covers physician care, durable medical equipment and other outpatient services. The notice appeared yesterday at the FedBizOps site.

CMS, which is an agency of the Health and Human Services Department, contracts with insurance carriers and other third parties to process claims for Medicare benefits. The Medicare Part B Claims Processing System, now known as the Multi-Carrier System, is a shared software system that carriers use. Other fiscal intermediaries provide claims services for inpatient hospital services under Medicare Part A.

The claims processing system performs data collection and validation, claims control, pricing, adjudication, correspondence, online inquiry, file maintenance, reports, reimbursement and financial processing.

CMS expects to award a contract in August of next year.

About the Author

Mary Mosquera is a reporter for Federal Computer Week.

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