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Posting Date: 04/24/2015
Privacy Act
Section 1: Introduction Privacy Act The purpose of the Privacy Act of 1974 (Act), Title 5, United States Code, Section 552a, is to balance the government’s need to maintain information about individuals with the rights of individuals to be [...]
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Posting Date: 02/14/2014
National Provider Identifier
Section 1: Introduction National Provider Identifier The NPI is a HIPAA Administrative Simplification standard. The NPI is a unique identification number for covered health care providers that have replaced the legacy provider number. [...]
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Posting Date: 11/03/2020
Legacy Provider Numbers/Provider Transaction Access Numbers (PTANs)
Section 1: Introduction Legacy Provider Numbers/Provider Transaction Access Numbers Table of Contents Legacy Provider Numbers/Provider Transaction Access Numbers State Code Facility Type Third-Digit Specialty Unit Designations [...]
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Posting Date: 05/31/2024
Medicare Administrative Contractors
Section 1: Introduction Medicare Administrative Contractors What's A MAC Who are the MACs Table of Contents Medicare Administrative Contractors Who Is National Government Services? The Focus of the Provider Outreach & Education [...]
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Posting Date: 04/24/2015
Fundamentals of Medicare: Information References
Section 1: Introduction Information References Table of Contents Information References Telephone Inquiries Interactive Voice Response Eligibility Information Claim Status Information Check and Remittance Information General [...]
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Posting Date: 04/24/2015
Fundamentals of Medicare: Glossary of Terms
Section 1: Introduction Glossary of Terms Beneficiary: An individual who is eligible for Medicare. Benefit Period: The way that Medicare measures the use of hospital and SNF inpatient days. Claim: A bill for services rendered by a provider [...]
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Posting Date: 04/24/2015
The History of Medicare
Section 2: Medicare Basics The History of Medicare During the 30 years following the passage of the SSA in 1935, many attempts were made to include health insurance as part of the Social Security system. It was not until the bill H.R. 6675 [...]
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Posting Date: 04/24/2015
What Is the Medicare Program and How Is It Funded?
Section 2: Medicare Basics What Is the Medicare Program and How Is it Funded? Medicare is a federally funded health insurance program for: People age 65 or older Certain individuals under age 65 who qualify due to disability People with [...]
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Posting Date: 04/24/2015
Medicare Eligibility and Premiums
Section 2: Medicare Basics Medicare Eligibility and Premiums The following groups of people are eligible for Medicare: Individuals aged 65 or older (or their spouse) who have worked at least 40 quarters, or ten years, in Medicare-covered [...]
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