New Form for Re-determination of Claims
Effective May 5, 2005,CMS replaced the 1964 form with the CMS 20027 form.
This form is used for requesting a re-determination of a claim. The CMS 20027 form is not mandatory but it is recommended
since it provides the necessary information for the appeals process. The form can be found here (PDF) or on the newsletter links page.
New Information Regarding the National Provider Identifier (NPI)
The CMS Administrator, Dr. Mark McClellan announced on May 23, 2005 the start of enumeration for NPI. The NPI is the standard
unique health identifier for health care providers that was adopted by the Secretary of Health and Human Services under the
Health Insurance Portability and Accountability Act (HIPAA) of 1996. The Administrator's announcement letter informs health
care providers about the NPI, describes three ways to obtain an NPI, and gives guidance as to what should be done once they
have obtained their NPI.
The NPI letter, which also provides contacts and resources should health care providers have questions about the NPI,
can be viewed here on the newsletter links page.
Clarification of Revised Medicare Benefit Policy Manual
To ensure accurate and timely processing of therapy claims, be familiar with instructions and requirements described in the
CMS Manual System related to such claims. Further clarification of these requirements can be viewed here (PDF) or on the newsletter links page.
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