CMS Pub. 100-09, ch. 6, § 70.1.4

MACs shall ensure telephone CSRs collect necessary information from callers to perform research

and respond. For callback completion and closeout, MACs shall make one attempt to reach a provider

and may leave a message requesting a return call that includes the reference number and beneficiary’s

name if appropriate, but they must not include any other PHI or PII. MACs shall not leave responses

on provider voicemail systems. If the MAC can’t leave a message, then they shall send a written

response referencing the inquiry, date and time of the callback attempt, and request the provider call

the MAC if they still need assistance resolving their inquiry. Once the MAC has attempted to reach the

provider, through either phone contact or written response, the callback is considered complete and

closed.

MACs shall complete and close all callbacks within 10 business days of receipt of the original inquiry

and document them in the inquiry tracking system, discussed in section 30.10 of this chapter. MACs

shall not have a telephone CSR callback rate greater than 10 percent for those telephone inquiries

handled by CSRs. The standard is measured monthly and is cumulative for the quarter. A callback shall

be considered completed and may be closed out if a final response has been sent to the provider or if the

MAC has informed the provider the inquiry was escalated to a different department within the MAC for

resolution. Inquiries not closed out within 10 business days of receipt of the original inquiry are

considered untimely.