US · guidance
CMS Pub. 100-09, ch. 6, § 40.2.1
Required Training for PCC Staff
In addition to the training topics determined by MACs, all MACs shall train their CSRs on the following
topics at least once during the contract year. If a CSR is hired after the training has occurred for the year,
MACs shall include the training as part of their new hire training. MACs shall train their CSRs on the
following:
1. How to find, navigate and use their provider education website and other self-service
tools, including the IVR system and the MAC secure internet portal.
2. How to find, navigate and use the CMS website. This includes all online education
resources provided through the MLN.
3. How to find, navigate, and use the PCSP website. This website strengthens MACs’
PCSPs by providing support information, CERT Resources and feedback mechanisms.
4. The MLN (See section 20.3.1 of this chapter.)
5. The CMS Standardized Provider Inquiry Chart categories, subcategories, and definitions,
and they shall be trained to accurately log inquiry types according to the CMS
Standardized Provider Inquiry Chart in the tracking system used by the MAC. The CMS
Standardized Provider Inquiry Chart is in the PCID database under Documentation.
6. The Privacy Act of 1974 and HIPAA
7. The use of the Desk Disclosure Reference (DDR) Guide. The DDR Guide provides
MACs with information they need to authenticate Medicare providers and the access and
disclosure guidelines to be followed when disclosing elements of PII or PHI to
authenticated Medicare providers. The DDR Guide is available in the Documentation
section of PCID.
The PRRS will need specialized training in the use of the CMS Internet-Only Manuals, the CMS website, the
Medicare.gov website, the MAC’s provider education website, regulations, laws, and other information tools
to respond accurately and completely to complex provider inquiries. (PRRS also handle complex beneficiary
inquiries. See chapter 2 of this manual for information about complex beneficiary inquiries.)
See section 80.3.2 of this chapter for the monthly PCID reporting requirements.
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
8852241c2e8e1b3d78ee80d27c99e86834c79aeb9a2e785d50ad7a12cef030d8
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