US · guidance
CMS Pub. 100-09, ch. 6, § 50.2.3.4
Provider Claims Payment Alerts
MACs shall develop and regularly update a dedicated webpage that alerts providers about confirmed
system-related claims processing issues that have been identified by CMS, the MAC or the Shared
Systems Maintainer. The page shall provide information and educational announcements about
claims processing issues that are currently active and provide an archive of resolved issues. The alert
webpage should use clear, concise language that avoids technical jargon when possible. MACs
should organize issues in a logical manner, such as by recency, impact severity, or provider type, to
help providers quickly locate relevant information.
At a minimum the page shall include the following information for each reported issue:
• Date Reported
• Provider Type(s) Impacted
• Reason Codes, as applicable
• Claim Coding Impact (for example HCPCS, ICD codes etc.), as applicable
• Description of the Issue
• Action Required by the MAC, if any
• Action Required by the Provider, if any
• Proposed Resolution/Fix (including automatic reprocessing of claims or not)
• Status (Open, Closed)
• Date Resolved
MACs may include additional jurisdiction-specific information to help providers better
understand each issue. This supplementary information may include:
• Regional processing variations that affect the issue
• Contact information for specialized assistance
• Estimated timeframes for resolution when available
• Links to related resources or guidance documents
• Frequently asked questions specific to common issues
• Notification options for providers to receive updates about issue status changes
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
7645d0af2982aa7bf80227b493b3b5374a1d3c9a40f31e7f498b5f718b0663ce
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