CMS to update Medicare hospital claims processing system

The Centers for Medicare and Medicaid Services plans to modernize the claims system that contractors use to process and perform payment for hospitals that provide inpatient and outpatient services to Medicare patients.

CMS will update the software for its Fiscal Intermediary Shared System, which contractors share to service Medicare claims. CMS, an agency of the Health and Human Services Department, posted the notice recently on FedBizOpps.gov.

The system currently performs data collection and validation, claims control, pricing, adjudication, correspondence, online inquiry, file maintenance, reports, reimbursement and financial processing.

Contractors and carriers who process Medicare claims for outpatient services that physicians and other professionals provide currently use a different system.

CMS anticipates releasing the request for proposals in November and awarding a contract with a base period plus four option years in August 2006.

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