Medicare Claims Processing Manual (Pub. 100-04), Ch. 17 § 100.1.3
Physician Information for the Vendors
100.1.3 - Physician Information for the Vendors
(Rev. 866, Issued: 02-17-06, Effective: 07-01-06, Implementation: 07-03-06)
One month before the beginning of the calendar year, the designated A/B MAC (B) shall
transmit the following information to each vendor on the physicians who have elected
that particular vendor: the name, the street address, city, state, zip code, and phone
number of each practice address/shipping address (physical location where the drugs will
be administered), UPIN (or NPI when effective), e-mail address (if available) of the
physicians who have elected to participate in CAP with that vendor and the drugs they
have chosen. If the mailing/correspondence address (where the participating CAP
physician can be contacted directly) is different from the practice/shipping address, the
mailing/correspondence shall be included. If the group or individual practice has more
than one practice location where drugs are administered, each practice address/shipping
location where drugs will be administered shall also be included. (NOTE: For the 2006
claims processing period, the information must be sent by June 1, 2006).
For group practices that elect to participate in CAP, the individual UPINs (NPI when
effective) shall be included.
Each year the date the designated A/B MAC (B) shall transmit information to each
vendor on the physicians who have elected that particular vendor shall be 7 calendar days
after the final date the A/B MACs (B) forward to the designated A/B MAC (B) the list of
all the physicians who have elected to participate in CAP. Should that date fall on a
weekend, it shall be extended to the following Monday.
The designated A/B MAC (B) shall not send a vendor any information pertaining to other
vendors.