CMS Final Call Letter 2016

by Medversant Staff Writer


Posted on January 07, 2016


provider directory tool

On Friday, November 13, 2015, the Federal Centers for Medicare and Medicaid Services or CMS released updates to the previous 2016 Call Letter and Medicare Marketing Guidelines (MMG).

Medicare Advantage Organization (MAOs) and Medicare-Medicaid plans (MMPs) must contact providers quarterly instead of monthly, as previously required. This revision was due to the comments they received from industry groups: that the monthly communication may impose an undue burden on providers; and that it may not guarantee more accurate provider data.

These ongoing quarterly communications will ensure accurate "real time" provider directory information and that there are no changes in the following data requirements:

  • Ability to accept new patients
  • Practice location
  • Phone number
  • Specialty
  • Affiliations
  • Hours of operation
  • Any other modifications that would affect availability to patients

The phrase to produce accurate data in "real time" was defined as a 30-day time frame to implement provider information changes.

Our Solution

Medversant has developed ProviderIQ™ Provider Directory Solution a patented technology platform that delivers continuously verified provider data through a combination of primary source data verification and a distinctive provider outreach process. This cleansed data can be embedded directly into the health organization's online provider directory, producing a provider directory that meets federal and state requirements.

If you have any questions about Medversant's ProviderIQ™ Provider Directory Solution or about provider data accuracy, please reach out directly to patricw@medversant.com

https://www.cms.gov/Medicare/Health-Plans/ManagedCareMarketing/Downloads/2016-Medicare-Marketing-Guidelines-Updated.pdf

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