US · guidance
CMS Pub. 100-04, ch. 1, § 40.5
FI/Carrier/DMERC Responsibilities for Informing Providers of
Changes
(Rev. 1, 10-01-03)
A3-3600.7
Contractors must inform providers in writing of changes in policy and procedures and the
effective date before making changes. They must send these notices at least thirty days
before changes are put into effect to give providers time to adjust. When a shorter
implementation schedule is unavoidable, the contractor must provide the notice as soon
as it is available.
For electronic data interchange (EDI) instructions, the contractor must notify providers of
changes at least 60 to 90 days in advance.
Contractors must conduct provider training on an as needed basis and initiate regular
contact with the provider community through organizations that represent them. It must
develop continuing staff contacts with these organizations to resolve issues of mutual
concern.
The contractor must provide adequate telephone service so that providers can receive
prompt answers to claims status and processing questions. It must implement procedures
and training in telephone units to ensure that its employees furnish consistent and correct
information and make appropriate referrals for specialized information.
History
(Rev. 1, 10-01-03)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
5b540a1f3e67445cfa0c9f44faa27714501d4bcaa73bea675d3fe3bfaabfaffd
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