Instructions For Completing The Form CMS-750A/B, Contractor

210 - Instructions For Completing The Form CMS-750A/B, Contractor Financial Reports - (Rev. 5, 08-30-02) A1-1910, B1-4910 There are separate reports and data screens for Part A, Hospital Insurance (HI), and Part B, Supplementary Medical Insurance (SMI) in the Contractor Administrative-Budget and Financial Management (CAFM) system. The intermediary enters data in both HI and SMI data screens (see Exhibits 1 and 2). The carrier enters data in the SMI data screens (see Exhibit 2). The data for the report is HI and SMI financial information as defined in the Medicare Account Definitions (see Exhibit 11). In order to facilitate reconciliation, balancing and error resolution, the contractor shall report all data in dollars and cents. The data on the report may not equate on a one-to-one basis with data reported to CMS in other reports, such as Draws on Letter of Credit, reported on Form CMS-1521. The contractor must maintain records that will allow reconciliation of Form CMS-750A/B with those other reports.