Medicare Financial Management Manual (Pub. 100-06), Ch. 5 § 400.7
Exhibit 7 - Status of MSP Accounts Receivable - HI – (Rev. 5, 08-30-02)
400.7 - Exhibit 7 - Status of MSP Accounts Receivable - HI – (Rev. 5, 08-30-02)
This is an exact duplicate of Exhibit 3, except that the data is limited to data involving Medicare as
secondary payer.
This exhibit, and Exhibit 8, Status of MSP Accounts Receivable - SMI, are identical with the following
exceptions:
•
Section B, items 5d through 5g and Section D, items 5d and 5e refer to the POR for HI reports and
refer to the POR/PSOR for the SMI report.
•
Only carriers enter the PSOR data on the SMI report.
•
The CMS Form Number for this report (HI) is CMS-M751A.
•
The CMS Form Number for the SMI report is CMS-M751B.