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RFP- RRB-11-R-001
Attachment J-05: Government Furnished Property
| Government Furnished Property Name |
| Government Furnished Property Description |
| Related SOW Major Section Number |
| Related Major Section Name |
| # of Days After Award Property Can Be Furnished To Contractor |
| CMS Responsible Component |
| CMS ART System |
| Financial management software system that manages contractor reporting that gives the contractor the ability to submit vouchers and cost reporting data. |
| C.5.ALL |
| CMS ART |
| To Be Determined |
| CENTER FOR MEDICARE MANAGEMENT/MCMG |
| CMS Private Wide Area Network (CMSnet) |
| CMSnet is used to securely transport Medicare data between CMS and its contractors. |
| C.5.3 |
| Infrastructure Requirements |
| To Be Determined |
| OIS/TMG |
| Comprehensive Error Rate Testing (CERT) Confidential Website and CERT Claims Status Website |
| These systems provide access to all CERT related information, the error rate reduction plan data entry system, the CERT claims feedback page, and payment adjustments and appeals reporting systems. |
| C.5 ALL |
except C.5.5 and C.5.16
| All Contract Requirements except Provider Enrollment and Medicare Secondary Payer |
| To Be Determined |
| Office of Financial Management (OFM)/Provider Compliance Group (PCG) |
| Comprehensive Error Rate Testing (CERT) raw data |
| Contractor-specific raw-data used to determine error rates and causes. |
| C.5 ALL |
| All Contract Requirements |
| To Be Determined |
| Office of Financial Management (OFM)/Provider Compliance Group (PCG) |
| Contractor Administrative Budget and Financial Management System (CAFM) |
| Financial management software system that manages contractor reporting activities pertaining to all benefit payments, banking issues, and Chief Financial Officer (CFO) data. |
| C.5.1 and C.5.13 |
| Workload Transition and Financial Management of Trust Fund Dollars |
| To Be Determined |
| OFM |
| Contractor Reporting of Operational and Workload Data System (CROWD) |
| System that collects and reports on operational and contractor workload data and types of claims processed for Part A and Part B contractors. Data includes types of claims, overall number of claims, and appeals data. |
| C.5.10, C.5.16 and C.5.4.2.8.2 |
| Appeals of Medicare Initial Claims Determinations, and MSP Savings Report, and CROWD |
| To Be Determined |
| CBC and OFM |
| Provider Inquiry Evaluation System (PIES) |
| Tool designed to facilitate call center performance reporting. Contractors report performance on specified metrics by the tenth of each month. The PIES data provides the framework to assess contractor performance on a consistent basis relative to requirements as well as to each other on a comparative level. |
| C.5.4.2.8.3 |
| Provider Customer Service Program |
| To Be Determined |
| Center for Medicare Management (CENTER FOR MEDICARE MANAGEMENT) (Provider Inquiries) |
| Debt Collection System (DCS) |
| DCS is used for referring eligible delinquent debt for cross-servicing. Used to refer debt to Treasury. |
| C.5.13 and C.5.16 |
| Financial Management of Trust Fund Dollars and Medicare Secondary Payer |
| To Be Determined |
| OFM/AMG |
| EDC 3-Zone Architecture |
| CMS will use a 3-Zone enterprise architecture for its EDC. The EDC enterprise architecture for new applications is designed to facilitate robust security in three zones. The 3-Zone architecture will be implemented incrementally. As an A/B Medicare Administrative Contractor (MAC) requires services, it will work through the CMS EDC-PMO to ensure that adequate capacity and connectivity exist. Any requirements for FY 2006 will be accomplished through the CMS Data Center with transition planned into the new EDC facilities FY 2007. |
| C.5.3 |
| Infrastructure Requirements |
| To Be Determined |
| OIS/TMG |
| Electronic Correspondence Referral System (ECRS) |
| System used by contractors to transmit Coordination of Benefits information and communicate possible MSP situations to the Coordination of Benefits Contractor (COBC). The system supports all activities related to the development of MSP records and their specific periods of coverage to be reflected on CWF. COBC will use ECRS to communicate actions to the contractor. |
| C.5.16 |
| Medicare Secondary Payer (MSP) |
| To Be Determined |
| OFM/ DMSPPO |
| Enterprise Data Center (EDC) |
| The CMS EDC is comprised of both physical/technical components as well as a management structure. CMS EDC-Program Management Office (PMO) is responsible for oversight of the EDCs. The EDC PMO will serve as the customer-facing organization responsible for: |
a) Monitoring the EDCs’ relationships with all customers and assisting the them in using the EDCs and other CMS data center capabilities
b) Providing “one-stop shopping” for EDC services and the focal point for resolution of EDC-related issues
c) Oversight and program management of the deployment of new application and/or functionality to the EDCs
d) Ensuring the quality of EDC service delivery.
| C.5.3 |
| Infrastructure Requirements |
| To Be Determined |
| OIS/TMG |
| Fee Schedule–Ambulance Fee Schedule |
| Software integrated into the shared system. These files are produced and distributed by CMS in order to supply fee and payment policy information on certain services performed by professional and institutional providers. The contractor will receive these files periodically (either annually or quarterly). |
| C.5 ALL |
| All Contract Requirements |
| To Be Determined |
| CENTER FOR MEDICARE MANAGEMENT/Hospital and Ambulatory Policy Group (HAPG)/DAS |
| Fee Schedule–Clinical Diagnostic Laboratory |
| Software integrated into the shared system. Produced by CMS and sent from CMS to MACs so that claims with coding for laboratory services can be correctly priced and paid by fee. This is an annual recurring instruction. |
| C.5 ALL |
| All Contract Requirements |
| To Be Determined |
| CENTER FOR MEDICARE MANAGEMENT/HAPG/DAS |
Fee Schedule–Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule referred to as Durable Medicare Equipment Fee Schedule (DMEFS) for DME MAC
| Software integrated into the shared system. System that maintains, updates, and disseminates Part B pricing data for services priced under DMEPOS fee schedules. The system generates rates for Level 2 Healthcare Common Procedure Coding System (HCPCS) codes. The system is legislatively mandated. |
| C.5 ALL |
| All Contract Requirements |
| To Be Determined |
| CENTER FOR MEDICARE MANAGEMENT/Chronic Care Policy Group (CCPG)/Division of Community Post Acute Care (DCPAC) |
| Fee Schedule–Medicare Physician Fee Schedule Data Base (MPFSDB) Fee Schedules/Abstracts |
| Software integrated into the shared system. These files are produced and distributed by CMS in order to supply fee and payment policy information on services performed by physicians or practitioners. Carriers received the entire MPFSDB annually. The file contains the new fees that are effective each year. Thereafter, carriers receive a quarterly update file that contains corrections only. Quarterly files are created and provided for MACs if needed. MACs receive subset extract files of the entire file annually via a recurring instruction. |
| C.5 ALL |
| All Contract Requirements |
| To Be Determined |
| CENTER FOR MEDICARE MANAGEMENT |
| Flash Report (relating to the Medicare Cost Report) |
| CMS uses an informal process to expeditiously communicate to contractors, software vendors, and ROs revisions to the MCR. |
| C.5.11.3 |
| Cost Reporting and Reimbursement Payment Policy |
| To Be Determined |
| OFM/FSG |
| Healthcare Integrated General Ledger Accounting System (HIGLAS) |
| HIGLAS is a single, unified general ledger accounting system that will support all MAC contractors and CMS central office administrative accounting. HIGLAS will: |
Implement one integrated accounting system to support all MACs and central office administration accounting.
Maintain standard financial processes and data classifications.
Promote consistent, standard processes for CMS and Medicare MACs.
Produce automated standardized financial statements and reports.
The Contractor must use HIGLAS for Medicare financial management business processes and reporting. HIGLAS is a CMS-furnished application. Contractor users access HIGLAS using a standard Web browser over HTTP. The firewall at the HIGLAS physical network boundary will allow HTTP traffic to go through, thus enabling the client access. The primary entry point into HIGLAS is the CMSnet. The CMSnet supports connectivity to HIGLAS. Based on their roles, contractor users can access certain HIGLAS online functions to support their normal job functions.
The Contractor provides PCs meeting CMS-specified requirements for using HIGLAS.
No special operating or service level agreements are required between the contractor and the HIGLAS system integrator or the ASP.
| C.5.13 |
| Financial Management of Trust Fund Dollars |
| To Be Determined |
| OFM |
| Healthcare Services Information System (HCIS) |
| System that allows users to sift through summarized Medicare information, in predetermined views, and focus analysis on areas in the Medicare program. Subject areas available for analysis include: Home Health Agency (HHA), Skilled Nursing Facility (SNF), Hospice, Inpatient, Outpatient, Clinical Lab, and Durable Medical Equipment data. |
| C.5 ALL |
| All Contract Requirements |
| To Be Determined |
| OFM |
| Healthcare Provider Cost Report Information System (HCRIS) |
| Financial management software. HCRIS includes subsystems for the Hospital Cost Report (CMS-2552-96), Skilled Nursing Facility Cost Report (CMS-2540-96), HHA Cost Report (CMS-1728-94), Renal Facility Cost Report (CMS-265-94), and Hospice Cost Report (CMS-1984-99). |
| C.5.13 |
| Financial Management of Trust Fund Dollars |
| To Be Determined |
| OFM/FSG |
| Interns and Residents Information System (IRIS) |
| Financial management software. IRIS is used to produce intern and resident data files on diskette for a cost reporting period from each teaching hospital. The diskette is sent along with Medicare cost reports for that cost reporting period to the MAC. These data files contain information for hospital counts of interns and residents for direct graduate medical education (GME) and indirect medical education (IME). There is a risk that teaching hospitals may over-report intern and resident counts for GME and IME on cost reports. MACs can reduce the impact of these counts by utilizing duplicates detection software on these data files. |
| C.5.13 |
| Financial Management of Trust Fund Dollars |
| To Be Determined |
| OFM/FSG |
| Maintainer-developed test cases and test scripts |
| A controlled outline for the contents and presentation of a Test Case Specification used by the shared system maintainers and the Beta testing contractors. |
| C.5.4. |
| Participation in Change Management Process |
| 30 days after contract award and quarterly thereafter |
| OIS/DSSM |
| Medicare audit program |
| This CMS-approved program is used to identify the audit objectives; the issues, transactions, or cost report entries to be audited, reviewed, or verified; the audit steps to be performed; and the tests to be applied. (See IOM Pub. 100-6, Chapter 8, section 50.2.) |
| C.5.13 |
| Financial Management of Trust Fund Dollars |
| To Be Determined |
| OFM/FSG |
| Medicare Cost report Desk Review Program |
| The CMS-approved program is used to analyze the provider’s cost report to determine its adequacy, completeness, and accuracy and reasonableness of the data contained therein. (See IOM Pub. 100-6, Chapter 8, section 20.) |
| C.5.13 |
| Financial Management of Trust Fund Dollars |
| To Be Determined |
| OFM/FSG |
| Medicare Coverage Database (MCD) |
| Acts as a central point of dissemination for both National and Local Medicare Coverage policies. On the national side, the MCD houses National Coverage Analyses (NCAs), Coding Analyses for Laboratories (CALs), and National Coverage Determinations (NCDs). On the local side, the MCD houses Local Coverage Determinations (LCDs), Local Medical Review Policies (LMRPs, until December 31, 2005), and contractor articles. |
Besides these policies, the MCD contains downloadable indexes and reports.
| C.5.6 |
| Local Coverage Determinations |
| To Be Determined |
| Center for Beneficiary Choices (CBC); |
Office of Clinical Standards and Quality (OCSQ)
| Medicare Exclusion Database (MED) |
| The Medicare Exclusion Database is a standard format, cumulative exclusion database that contains information on all exclusions and reinstatement actions in Medicare, Medicaid, and other federal health care programs. CMS receives this information from the Office of Inspector General monthly. Contractors use the information contained in the MED and the GAO Debarment list to: |
Determine whether a physician/practitioner/provider or other health care supplier who seeks approval as a provider of services in the Medicare/Medicaid programs is eligible to receive payment Ensure that sanctioned providers are not being inappropriately paid.
| C.5.4.2.8.7 |
| Coordination with Program Safeguard Contractors |
| To Be Determined |
| OFM/PIG/DBIMO. |
| National Plan and Provider Enumeration System (NPPES) |
| The National Provider Identifier (NPI) will identify health care providers in electronic transactions for which the Secretary has adopted standards. These transactions include claims, eligibility inquiries and responses, claims status inquiries and responses, referrals, and remittance advices. Note: While CMS may provide an extract data to the contractor, it will not provide system access to NPPES. Currently, the NPI is scheduled to replace the Unique Physician/Practitioner Identification Number (UPIN) and Online Survey Certification and Reporting System (OSCAR) in 2007. |
| C.5.5 |
| Provider Enrollment |
| To Be Determined |
| OFM/PIG/DPSE |
| Next Generation Desktop (NGD) |
| Desktop application to allow Customer Service Representatives (CSRs) in contractors’ contact centers to respond to beneficiary claims inquiries referred by the Beneficiary Contact Center (BCC). Desktop application to allow MACs to accept referrals of complex telephone and written inquiries from the BCC and to track the case load. |
| C.5.11.2.5 |
| Responding to Complex Beneficiary Inquiries; |
Feedback
| To Be Determined |
| Center for Beneficiary Choices (CBC)/OBIS |
| Physician and Supplier Overpayment Recovery (PSOR) System |
| Financial management software. System that prepares statistical reports that enable management of physician and supplier overpayment recoveries. The system identifies, monitors, and resolves Medicare Part B provider overpayments. This system will not be used once HIGLAS is implemented. |
| C.5.13.4 and C.5.13.5 |
| Overpayment and Debt Collection |
| To Be Determined |
| OFM/FSG/DMO |
| Provider Enrollment Paper Records |
| Prior to the advent of the Provider Enrollment, Chain and Ownership System (PECOS), paper records were used to retain Medicare enrollment information. Some legacy contractors who have not yet fully transitioned to PECOS still have paper records for provider enrollment. |
| C.5.5 |
| Provider Enrollment |
| To Be Determined |
| DPSE/PIG/DPSE |
| Provider Enrollment, Chain and Ownership System (PECOS) |
| CMS system used by contractors that captures Medicare enrollment information. The PECOS database retains enrollment information and transmits enrollment status/information to contractors. |
| C.5.5 |
| Provider Enrollment |
| To Be Determined |
| DPSE/PIG/DPSE |
| Provider Overpayment Reporting (POR) System |
| Financial management software. The POR is an electronic tracking system that was implemented to maintain all Part A provider debts related to cost reports. This system will not be used once HIGLAS is implemented. |
| C.5.13.4 and C.5.13.5 |
| Overpayment and Debt Collection |
| To Be Determined |
| OFM/FSG/DMO |
| Provider Statistical and Reimbursement (PS&R) system |
| The PS&R accumulates statistical and reimbursement data related to Medicare claims processed. It is used by the contractor and institutional providers to accumulate key elements of the Medicare cost report used in final settlement. |
| C.5.13 |
| Financial Management of Trust Fund Dollars |
| To Be Determined |
| OFM/FSG |
| Provider survey |
| Medicare Contractor Provider Satisfaction Survey (MCPSS) |
| C.5.4.4 |
| Quality Improvement |
| To Be Determined |
| To Be Determined |
| Quality Call Monitoring (QCM) Database |
| On-line database where contractors enter and manage quality written correspondence monitoring data. The QCM Chart is used to reduce the subjectivity of those reviewing the quality and accuracy of provider telephone responses. The QCM Scorecard is used to review the quality and accuracy of provider telephone responses. |
| C.5.4.2.8.8 |
| Provider Customer Service Program |
| To Be Determined |
| CENTER FOR MEDICARE MANAGEMENT/PCG/DCPC |
| Quality Written Correspondence Monitoring (QWCM) Database |
| On-line database where contractors enter and manage quality written correspondence monitoring data. The QWCM Chart is used to reduce the subjectivity of those reviewing the quality and accuracy of provider telephone responses. The QWCM Scorecard is used to review the quality and accuracy of provider written responses. |
| C.5.4.2.8.9 |
| Provider Customer Service Program |
| To Be Determined |
| CENTER FOR MEDICARE MANAGEMENT/PCG/DCPC |
| Shared Systems |
| “Shared systems” (previously known as standard system) means the systems provided by CMS to process Medicare claims. |
| C.5 ALL |
| All Contract Requirements |
| To Be Determined |
| OIS/BSOG |
| Shared Systems Module – Common Edits and Enhancements Module(s) CEM) |
| Coded and delivered by the Shared System Maintainers (one set of software for Part A and a separate set of software for the Part B processing), CEM is a editing process that prepares inbound transactions (claims and claim status) for entry to the core adjudication system. The CEM software installs in the MAC’s Local Data Center (LDC). A separate set of CEM software which processes transactions at the Enterprise Data Center (EDC) handles the Receipt and Control processes. The CEM Receipt and Control modules handle the outbound transaction(s) processing in order to send data to the LDC from the EDC. |
| C.5.3.2.2.2 |
| Common Edits and Enhancement (CEM) Software Edits |
| To Be Determined |
| OIS/BAMG/DMBP |
| Shared Systems – Common Working File (CWF) System |
| CMS supplies the shared claims processing systems, including transmission to CWF, installed at the data center that the contractor must use. |
CWF is a shared system that uses localized databases, maintained by host contractors, to validate pre-payment Medicare claims and to coordinate Medicare Part A and B benefits. The system also provides contractors with beneficiary entitlement, utilization data, and appropriate documentation. CWF also provides the beneficiary claims history to the National Claims History.
| C.5 ALL |
| All Contract Requirements |
| To Be Determined |
| OIS |
| Shared Systems – FISS |
| CMS supplies the shared claims processing systems, including transmission to CWF, installed at the data center that the contractor must use. FISS will process claims and transactions from institutional providers. The Super Op – Claims adjudication software is included within the FISS core system. |
| C.5 ALL |
| All Contract Requirements |
| To Be Determined |
| OIS |
| Shared Systems – Multi Carrier System (MCS) |
| CMS supplies the shared claims processing systems, including transmission to CWF, installed at the data center that the contractor must use. MCS will process claims and transactions from professional providers (physicians, practitioners, and suppliers). The Multi-Carrier System Desktop (MCSDT) is a part of the base MCS. |
| C.5 ALL |
| All Contract Requirements |
| To Be Determined |
| OIS |
| Shared Systems Module – Clinical Diagnostic Laboratory Edit Table |
| Software integrated into the shared system. Produced by CMS and sent from CMS to MACs so that claims with laboratory services can be correctly edited and paid. |
| C.5 ALL |
| All Contract Requirements |
| To Be Determined |
| OCSQ |
| Shared Systems Module – Code Editors |
| Software integrated into the shared system. Code Editors enforce proper use of procedural and diagnostic coding on institutional Medicare fee-for-service claims, and are programmed and produced under contract to CMS by the 3M Corporation on routine annual or quarterly basis. CMS produces instructions that require the shared system maintainers to update these modules. |
| C.5 ALL |
| All Contract Requirements |
| To Be Determined |
| Center for Medicare Management / Provider Communications Group / Division of Institutional Claims Processing |
| Shared Systems Module – Correct Coding Initiative (CCI) Edits |
| Software integrated into the shared system. These edits are designed to assure correct coding is used in billing services. Originally, Medicare implemented these edits on carrier claims. For carriers, the edits are distributed by CMS through quarterly instructions. For MACs, some of these edits are incorporated into Outpatient Code Editor (OCE) software |
| C.5 ALL |
| All Contract Requirements |
| To Be Determined |
| Center for Medicare Management / Provider Communications Group / Division of Institutional Claims Processing (DICP) |
| Shared Systems Module – Direct Data Entry (DDE) |
| Embedded in the shared system, DDE is a mode of transmitting claims and obtaining beneficiary eligibility and claim status information using secure, dedicated hardware and communications lines. |
| C.5.8 |
| Claims Processing |
| To Be Determined |
| OIS/DSSM |
| Shared Systems Module – GROUPER Software |
| Software integrated into the shared system. GROUPER software is used to bundle services that are part of specific Medicare benefits into groups for prospective payment. Not all prospective payment systems require GROUPER software. When providers submit payment groups, grouping software is found embedded at the provider site, not in Medicare systems (i.e., HHA, SNF, Inpatient Rehabilitation Facility, or IRF). However, within CMS, the term “GROUPER” most often refers to GROUPER software produced by 3M under contract to CMS used on inpatient hospital claims, distributed with Medicare Code Editor (MCE). |
| C.5 ALL |
| All Contract Requirements |
| To Be Determined |
| Center for Medicare Management / Provider Communications Group / DICP |
| Shared Systems Module – HCPCS File |
| Software integrated into the shared system. CMS is the code set owner for these procedural codes, including codes for both items and services, used on Medicare and non-Medicare claims, which are Level Two of the same greater code set that includes Current Procedural Terminology (CPT) codes which are copyrighted by the American Medical Association. HCPCS codes are used on professional and institutional claims, and CMS publishes fee schedules for codes in this and the CPT code set when Medicare provides fee-for-service reimbursement. HCPCS codes can be created any time during the year. These are distributed quarterly as needed via change requests, but an annual file is released to Medicare contractors every October, available electronically, and the codes are effective each January 1. HCPCS codes are also posted on the CMS website. |
| C.5 ALL |
| All Contract Requirements |
| To Be Determined |
| Center for Medicare Management / CCPG / DCPAC |
| Shared Systems Module – Medicare Secondary Payer (MSP) Pay module |
| Software integrated into the shared system. MSP Pay modules calculate Medicare secondary payments. Periodic updates are issued based on policy and regulation changes. |
| C.5.16 |
| Medicare Secondary Payer |
| To Be Determined |
| OFM/DMBC |
| Shared Systems Module – PRICER software |
| Software integrated into the shared systems. PRICERS are software modules programmed and produced by CMS on a routine annual or quarterly basis—unless legislation requires special quarterly implementation. These modules price benefits/services that receive bundled, prospective payment under Medicare law. PRICERS are most often updated often in relation to regulatory payment policy notices or instructions. CMS directly releases PRICERS to the institutional shared system maintainers. |
| C.5.13 |
| Financial Management of Trust Fund Dollars |
| To Be Determined |
| CENTER FOR MEDICARE MANAGEMENT / PBG / DICP & Division of Data Systems (DDS) |
| Shared Systems Module – Zip Code File |
| Software integrated into the shared system. This file is primarily intended to (1) map Zip Codes to CMS carriers and localities, and also (2) maps zip codes to their States; (3) contains an urban, rural or low density (qualified) area Zip Code indicator. Distributed as frequently as quarterly through recurring instructions. |
| C.5 ALL |
| All Contract Requirements |
| To Be Determined |
| Center for Medicare Management / Provider Billing Group / Division of Supplier Claims Processing (DSCP) |
| Survey Programming Module |
| Website satisfaction survey programming module to be inserted into the contractor’s website. |
| C.5.7 |
| Provider Customer Service |
| To Be Determined |
| Center for Medicare Management / Provider Communications Group / Division of Contractor Provider Communications |
| System Tracking Audit and Reimbursement (STAR) System |
| Financial management software. STAR is an automated system developed by CMS for the purpose of streamlining the Medicare cost reporting process. STAR captures historical and current Medicare provider and cost report information and tracks time spent in audit and reimbursement activity of each cost report. The STAR Users Manual serves as the instructions for implementing the program functions within the STAR system. The STAR system is also used to upload data to the contracting audit settlement report (CASR) subsystem on the CMS mainframe. |
| C.5.13 |
| Financial Management of Trust Fund Dollars; |
| Systems documentation from maintainers |
| To Be Determined |
| C.5.8 |
| Claims Processing |
| To Be Determined |
| OIS/DSSM |
| The Electronic Change Information Management Portal (eChimp) |
| The eChimp is a user-friendly, Web-based Extranet application that was developed by the Centers for Medicare & Medicaid Services’ (CMS’) Division of Change Management (DCM) to help streamline and automate the Change Management process. eChimp provides Change Request (CR) authors with the ability to complete and validate change request forms on-line, and provides them with a tool to track their CR from draft to finalization. In addition, the system provides reviewers with a Point of Contact (POC) Review Forum, which consolidates the comments received from multiple reviewers for a particular CR into a single, easy to read conversation-based forum. |
| C.5.4.8.1 |
| Review and Comment on Draft Change Requests |
| To Be Determined |
| CENTER FOR MEDICARE MANAGEMENT/MCMG/DCM |
| Toll-free telephone service |
| Toll-free network service provided through the FTS2001 Network Services Contract, which provides access to telecommunications services using rates in the General Services Administration’s (GSA’s) central telecommunications contract. The replacement to FTS2001 will be called Networx. |
| C.5.3 and C.4.1 |
| Infrastructure Requirements; |
Customer Service
| To Be Determined |
| Center for Medicare Management / Provider Communications Group / Division of Contractor Provider Communications; |
Office of Operations Management
| Training material (national) |
| Under development. |
| C.5.4.4 |
| Quality Improvement |
| When developed |
| To Be Determined |
| Training materials |
| Training materials used for provider customer service staff provided on an ad-hoc basis. |
| C.5.7 |
| Provider Customer Service |
| To Be Determined |
| Center for Medicare Management / Provider Communications Group / Division of Contractor Provider Communications |
| Transitory Database |
| CMS database used to populate PECOS with legacy information when changes, updates, or corrections to enrollment information occur. |
| C.5.5 |
| Provider Enrollment |
| To Be Determined |
| DPSE/PIG/DPSE |
| Uniform Desk Review (UDR) program |
| Financial management software. The UDR is a tool used to: analyze data submitted on the provider’s cost report to identify problem areas warranting additional review and where appropriate to resolve some of those problems/exceptions; reconcile settlement data; make a determination that the cost report can be finalized without further review; or plan the field audit. |
| C.5.13 |
| Financial Management of Trust Fund Dollars |
| To Be Determined |
| OFM/FSG |
| UPIN Registry |
| Database of physician UPINs and associated practice settings (offices). A UPIN uniquely identifies a physician across all practice settings. The system is used for ad hoc studies and UPIN validation. Over the next 18 months, CMS will de-scope the UPIN Registry. Based on current operating assumptions, the UPIN Registry will cease to exist on or before September 30, 2007. |
| C.5.5 |
| Provider Enrollment |
| To Be Determined |
| OFM |
| Wage index review program |
| The wage index measures relative differences in the average hourly wage for the hospitals in each labor market area compared to the national average hourly wage. http://www.cms.hhs.gov/providers/hipps/ippswage.asp |
| C.5.13 |
| Financial Management of Trust Fund Dollars |
| To Be Determined |
| Center for Medicare Management |
| Website Satisfaction Survey Trigger Code |
| The code that a contractor shall place in its provider website code to allow for a website satisfaction survey to pop up for a sample of users. |
| C.5.7.1 |
| Provider Outreach and Education |
Center for Medicare Management / Provider Communications Group / Division of Contractor Provider Communications
Railroad Retirement Board