Program Support

CMS Standardized Provider Inquiry Chart

The CMS Standardized Provider Inquiry Chart provides common inquiry categories and definitions for contractors to use when tracking and reporting the nature of provider inquiry types for telephone and written inquiries. These categories are to be used to capture the reason for the inquiry. Standardized Provider Inquiry Chart

Contractor-Specific Subcategories Report

Contractors may create contractor-specific subcategories to capture additional levels of detail, if necessary, to assist in the identification of provider education or customer service representative (CSR) training needs.  This report is due monthly, 15 calendar days after the end of the month and needs to be submitted to the provider services mailbox with the subject line, Contractor-Specific Subcategories Report.

Contingency Plan Checklist

The Contingency Plan Checklist outlines the steps contractors will take to provide the best possible customer service when their contact center operations are impacted by natural disasters or technical issues.  Contractors can access the checklist at  Contingency Plan Checklist

Education Activity Report (EAR) Template

Contractors are required to prepare and submit a semi-annual EAR in accordance with section 20.7.2 of IOM Pub-100-9, Chapter 6. The revised EAR template was effective January 1, 2012.  EAR Template [PDF, 74KB] - Revised 11/16/11

Provider Service Plan (PSP) Template

In accordance with TDL 12012, CMS suspended the annual submission of the PSP for Legacy Title XVIII and already implemented Medicare Administrative Contractors (MACs) required by the Internet Only Manual (IOM) 100-09, Chapter 6, Section 20.7.1.  Newly awarded MACs shall submit a PSP in accordance with the deliverable schedule. The most recent format was effective January 1, 2012.  PSP Template [PDF, 71KB] - Revised 11/16/11
 

Provider Inquiries Evaluation System (PIES)

PIES is a tool designed to facilitate contractor contact center performance reporting.  It provides the framework to assess contractor performance on a consistent basis.  This contractor-only accessible database can be found at
https://www.pie-system.com.

Provider Customer Service Program Contractor Information Database (PCID)

PCID is a secure web-based system that captures and stores information about contractors’ PCSP activities and provides on-line contractor reporting capability for Inquiry Tracking Reports.  This contractor-only accessible database can be found at https://www.p-cid.com.

Quality Call Monitoring (QCM) Database

The QCM database is an on-line database where contractors enter and manage data related to the quality of responses to provider telephone inquiries.  This contractor-only accessible database can be found at https://www.qcmscores.com

Quality Written Correspondence Monitoring (QWCM) Database

The QWCM database is an on-line database where contractors enter and manage data related to the quality of responses to provider written inquiries.  This contractor-only accessible database can be found at https://www.qwcmscores.com

Direct Monitoring/Remote Monitoring (DM/RM) Database

The DM/RM database is a secure web-based system that is used to capture CSR responses to questions for accuracy, consistency and timeliness. This database allows all contact centers to have the ability to retrieve their DM/RM Reports, file rebuttals, ask questions, make suggestions, etc.  This contractor-only accessible database can be found at http://portal.dmrm.info/

If you are a Medicare fee-for-service provider/supplier and are looking for the most up-to date outreach and education information, please visit the Medicare Learning Network ® (MLN).  A link is provided in the Related Links within CMS section below.