CMS’ Medicare Administrative Contractors (MACs) are not impressed with some of the billing and other outsourcing firms making calls on claim issues.
 
In a message to providers Feb. 2, 2023, MACs noted that inquiries from some billing companies and outsourced agencies were not coming through online portals.
 
“Additionally, some of these individuals are not familiar with basic Medicare coverage or billing requirements,” the message stated. “A pattern we also recognize is generic, scripted questions that are asked repeatedly with the same exact response each time.”
 
Agencies need to make sure they are sharing Medicare claims processing notices with contractors. The MACs note that agencies should also ensure the contractors:
  • Employ staff that have knowledge of the Medicare program.
  • Are aware of and follow Medicare rules and regulations.
  • Have access to and understand how to use the online portals to verify patient eligibility and check claims status.
  • Take full advantage of the other self-service options.