US · guidance
CMS Pub. 100-09, ch. 6, § 30.7.3
Duplicate Inquiries
If a MAC identifies that a provider submitted a duplicate written inquiry, the MAC may verify whether
the provider received a response to the initial inquiry through either telephone contact or letter. If the
MAC chooses to send a verification letter, this communication counts as an interim response. After
confirming the provider received a response to their initial inquiry, the MAC shall close the duplicate
inquiry and exclude it from workload reporting. However, if the MAC finds that the provider didn’t
receive a response to the initial inquiry, the MAC shall send a response to the duplicate inquiry and
include it in their monthly workload reporting. If the MAC doesn’t receive a response from the provider
within 14 business days after attempting to verify receipt of the initial response, the MAC shall send a
response to the duplicate inquiry and include it in their monthly workload reporting.
History
(Rev. 13683; Issued: 04-08-26; Effective: 05-08-26; Implementation: 05-08-26)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
871c221f9be749ff0863ac44075e430c17d3faeb0383e4a7f317d42659458e9f
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