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  • Qualified Medicare Beneficiary Status According To CMS Protocols
  • Post author
    Lacy Gaskins

Qualified Medicare Beneficiary Status According To CMS Protocols

The Centers for Medicare & Medicaid Services (CMS) requests Medicare Administrative Contractors (MACs) identify Medicare beneficiaries with Qualified Medicare Beneficiary (QMB) status according to supplied CMS protocols. CMS will allow for this in multiple claims processing systems including the Common Working File (CWF).

Full Transmittal: https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3920CP.pdf

Subject: Qualified Medicare Beneficiary Indicator in the Medicare Fee-For-Service Claims Processing System

Number: 3920

Title: 9911

Release Date: November 15, 2017

Effective Date: October 2, 2017

Implementation: July 3, 2017 -CWF: Implementation of BRs 9911.1, 9911.1.1, 9911.1.2, and 9911.1.3; Design only and draft trailer layout provided to SSMs for BR 9911.2.1;VMS, MCS: analysis, design, and coding; FISS: analysis and design; October 2, 2017 -CWF: Implementation of remaining BRs; FISS, VMS, MCS: coding, testing and implementation.; April 2, 2018 -FISS implementation of BR 9911.14

Special Notes: Transmittal 3802, dated June 28, 2017, is being rescinded and replaced by Transmittal 3920, dated November 15, 2017 to revise the MSN message number in requirement 9911.14 and to extend this requirement to the April 2018 release. All other information remains the same.

  • Post author
    Lacy Gaskins