Medicare Claims Processing Manual (Pub. 100-04), Ch. 27 § 20.3.2.1

Accepted (as is) for Payment

Last amended: 2018Year: 2018Length: 141 wordsOfficial source
20.3.2.1 - Accepted (as is) for Payment (Rev. 4009, Issued: 03-23-18, Effective: 04-23-18, Implementation: 04-23-18) The claim record is posted to CWF history as submitted to the Host. The MAC pays the claim accordingly. • Disposition code 01. • Basic Reply Trailers - These are informational trailers that contain entitlement, utilization, MSP, or other information, as appropriate, and are returned with the Reply. They give the MAC the most recent information available about the beneficiary's claim history and other important data. MACs must use this information to update their own data to improve the accuracy of future claims processing. • Return Alerts - These are sent to the MAC when CWF believes that there is a potential problem or error in the claim. The presence of an alert indicates that the MAC should examine the information and make adjustments if necessary.
Medicare Claims Processing Manual (Pub. 100-04), Ch. 27 § 20.3.2.1: Accepted (as is) for Payment | Justis AI