The objective of this article is to review the role of Medicare Administrative Contractors (MACs) and resources available through MACs to support Medicare providers in successful program participation, provider education, claims filing, reimbursement, and payer advocacy.
What Is the Centers for Medicare and Medicaid Services?
The Centers for Medicare and Medicaid Services (CMS) is a federal government agency that is part of the U.S. Department of Health and Human Services. CMS is responsible for administration of the Medicare program to over 63 million beneficiaries (Tarazi et al, 2022). This article primarily addresses how clinicians interact with Medicare, which is a federally funded health insurance program primarily for individuals aged 65 years and older or with other qualifying disabilities. Medicare is the largest payer of health care in the United States. Medicare differs from Medicaid, which is a state-coordinated health insurance program (with federal requirements and partially funded by the federal government) for eligible low-income adults and children.
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