Common use of Medicare Part A - The MCO’s MIS Clause in Contracts

Medicare Part A - The MCO’s MIS. should automatically search paid claim history and generate reports by Provider of the xxxxxxxx applicable to Medicare Part A coverage whenever Medicare Part A coverage is discovered and added to the MCO’s MIS that was unknown to the MCO at the time of payment of a claim. Providers who do not dispute the Medicare coverage should be instructed to xxxx Medicare immediately. The MCO’s MIS should recoup the previous payment from the Provider within sixty (60) days from the date the reports are sent to the Providers, if they do not dispute that Medicare coverage exists.