Instructions for Completing the Form CMS-C751A/B, Status of

280 - Instructions for Completing the Form CMS-C751A/B, Status of Debt - Currently Not Collectible (CNC), and Form CMS-MC751A/B, Status of MSP Debt - Currently Not Collectible (CNC) - (Rev. 5, 08-30- 02) A1-1930, A1-1950, B1-4930, B1-4950 Form CMS-C751A/B and Form CMS-M751A/B are similar data entry screens used to report the following. • Form CMS-C751A to report non-MSP debt under Part A (HI) by intermediaries; • Form CMS-C751B to report non-MSP debt under Part B (SMI) by intermediaries and carriers; • Form CMS-MC751A to report MSP debt under HI by intermediaries; and • Form CMS-MC751B to report MSP debt under SMI by intermediaries and carriers; Note that currently not-collectible debt reported by Forms CMS-C751 and CMS-MC751 is reported separately for non-MSP and MSP accounts receivables. The screen heading indicates whether the CNC report is for the non-MSP or MSP subset. Samples of the screens are shown in Exhibits 5 and 6. Note that intermediaries must prepare separate reports for each category by trust find. There are separate reports and data screens for Part A, HI, and for Part B, SMI in the CAFM system. The intermediary enters data in both HI and SMI data screens (Exhibits 5 and 6). The carrier enters data in only the SMI data screens (Exhibit 6). The data for each of these reports are essentially the same. The contractor reports the CNC accounts receivable activity for FYTD for the period of the report. In order to facilitate reconciliation, balancing and error resolution, it reports the CNC accounts receivable in dollars and cents. The reports require information both for the amount and the number of accounts receivable. To provide standardization, CMS suggests the contractor use its collection process as a guide when reporting the number of accounts receivable. For example, a separate, stand alone accounts receivable collected would be reported as a quantity in the number column. Once the principal number is established, the contractor reports the interest associated with the principal amount in the same manner. There can be a difference between the principal number and the interest number because some receivables are not subject to interest.