US · guidance
CMS Pub. 100-04, ch. 27, § 20.3.2.1
Accepted (as is) for Payment
The claim record is posted to CWF history as submitted to the Host. The MAC pays the
claim accordingly.
• Disposition code 01.
• Basic Reply Trailers - These are informational trailers that contain entitlement,
utilization, MSP, or other information, as appropriate, and are returned with the
Reply. They give the MAC the most recent information available about the
beneficiary's claim history and other important data. MACs must use this
information to update their own data to improve the accuracy of future claims
processing.
• Return Alerts - These are sent to the MAC when CWF believes that there is a
potential problem or error in the claim. The presence of an alert indicates that the
MAC should examine the information and make adjustments if necessary.
History
(Rev. 4009, Issued: 03-23-18, Effective: 04-23-18, Implementation: 04-23-18)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
6044376da1dd4a2a41699717880af2008d2f32c10efb143939be170ef282e2bc
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