CMS Pub. 100-09, ch. 6, § 30

CMS strives to continuously improve Medicare customer satisfaction through the delivery of high

quality and cost-effective customer service. High quality customer service is accurate, convenient and

accessible, courteous and professional, and responsive to the needs of diverse groups.

It’s important all communication be coordinated to ensure consistent responses due to the various

communication channels available to providers. MACs shall develop a PCC offering a range of

Medicare expertise to respond to telephone, written and walk-in inquiries.

MAC PCCs play a vital role in ensuring providers receive accurate, timely, and consistent Medicare

information across all communication channels. As the primary point of contact between Medicare and

health care providers, PCCs are essential for maintaining high-quality customer service and supporting

effective program administration.

Your PCC shall include:

• Provider telephone inquiries staff

• General written inquiries staff

• Provider Relations Research Specialists (PRRS)

• Walk-in inquiries staff

Except for technologies discussed in sections 30.6.2 and 50 of this chapter and in chapter 2 of this

manual, CMS does not require the use of any specific technologies, if the MAC is able to meet all

performance standards and requirements in a cost-effective and efficient manner while providing a high

level of quality customer service to providers that includes accurate and timely information. MACs shall

ensure, at a minimum, PCC staff have readily-accessible information and tools (that is, access to claims-related information, access to and training on the MAC’s and CMS’s websites, a computer, and an

outbound telephone line) so that inquiries receive accurate and timely handling.

MACs shall identify at least two points of contact for each PCC. The contacts should understand both

telephone and written provider inquiries. MACs shall enter the following for each contact in PCID:

• Full name

• Business telephone number

• Business email address

• Type of contact type (telephone, written, technical, etc.)

See section 80.3.1 of this chapter for PCID reporting and data certification requirements.