Coordinate with CMS and other FFS contractors. Review medical records for selected claims.Establish local coverage determinations (LCD’s).Educate providers about Medicare FFS billing requirements.Handle redetermination requests (1st stage appeals process).Handle provider reimbursement services and audit institutional provider cost reports.Enroll providers in the Medicare FFS program.Make and account for Medicare FFS payments.MACs are multi-state, regional contractors responsible for administering both Medicare Part A and Medicare Part B claims. CMS relies on a network of MACs to serve as the primary operational contact between the Medicare FFS program and the health care providers enrolled in the program. Relationships between MACs and Functional ContractorsĪ Medicare Administrative Contractor (MAC) is a private health care insurer that has been awarded a geographic jurisdiction to process Medicare Part A and Part B (A/B) medical claims or Durable Medical Equipment (DME) claims for Medicare Fee-For-Service (FFS) beneficiaries.
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