Medicare Claims Processing Manual (Pub. 100-04), Ch. 21 § 10.3.4

Specifications for Header for Other Pages

Last amended: 2012Year: 2012Length: 232 wordsOfficial source
10.3.4 - Specifications for Header for Other Pages (Rev. 2522, Issued: 08-21-12, Effective: 07-01-12 (Analysis and Design) 10-01-12 (Final Design Testing) 01-03-13(Final Implementation), Implementation: 07-01-12 (Analysis and Design) 10-01-12 (Final Design Testing) 01-03-13(Final Implementation) This element repeats at the top of every page of the MSN, except for the first page. It contains the beneficiary’s name, a notification, and page numbering. POSITION This subsection is of a fixed size. It does not vary in overall width or length. It begins (0˝, 0˝) and is full-page or 540 points in width. The first content unit, the beneficiary’s name, is flush left. The second content unit, containing the notification text and page numbering, is flush right. FORMATTING [TB 2.2] beneficiary name [TB 2.2] “This Is Not a Bill”, all caps, right aligned [TB 2.1] ”|”, then page number, right aligned DYNAMIC RULES This section contains two dynamic elements, the beneficiary’s name and the page numbering. The beneficiary’s name should be printed with the given name first, followed by any middle initial(s), the family name, then any suffixes (e.g., Jr.) The page number indicator, in the format {Page # of #}, must include the number of the page on which the element appears and, in the second numeric position, the total page count for the notice. CONTENT {Beneficiary’s Given Name}{Beneficiary’s Middle Initials}{Beneficiary’s Family Name}{Beneficiary’s Suffix} THIS IS NOT A BILL | {Page # of #}
Medicare Claims Processing Manual (Pub. 100-04), Ch. 21 § 10.3.4: Specifications for Header for Other Pages | Justis AI