Are there documentation requirements that must be satisfied before the CMS Regional Office can provide a written opinion on the sufficiency of a Medicare Set-aside?
A44. Yes. CMS has provided a checklist of requirements that are necessary to conduct a review of the proposed Medicare Set-aside which can be found at: http://www.cms.hhs.gov/WorkersCompAgencyServices/Downloads/wcchecklist.pdf At a minimum, the following documentation must be submitted to CMS prior to the approval of any Medicare Set-aside.1. Injured party’s name2. Injured party’s date of birth3. HICN (Medicare health insurance claim number) or SSN (Social Security number) if the injured party is not yet entitled to Medicare4. Injured party’s address or telephone number5. Injured party’s CMS Consent to Release authorization6. Name of injured party’s attorney’s name, address and telephone number7. Name of workers’ compensation carrier’s attorney’s name, address and telephone number8. Entitlement information. Indicate if the injured party is currently enrolled in Parts A, B or D. Attach a copy of the injured party’s Medicare card. If the injured party is not currently enrolled in Medicar
Related Questions
- Are there documentation requirements that must be satisfied before the CMS Regional Office can provide a written opinion on the sufficiency of a Medicare Set-aside?
- Are there documentation requirements that must be satisfied before CMS can provide a written opinion on the sufficiency of a Medicare Set-aside?
- What are the requirements for countersignature by the collaborating physician on prescriptions and documentation written by an APRN?
