Medicare Benefit Policy Manual (BP)

Online instruction handbook that the Centers for Medicare and Medicaid Services (CMS) makes available to Medicare carriers. It includes guidelines for processing and paying Medicare claims, preparing reimbursement forms, billing procedures, and Medicare regulations. This system has online, Internet-only manuals (IOM): National Coverage Determinations Manual, Publication 100, one-time notifications, and manual revision and update notices. This information is helpful to providers when dealing with Medicare contractors for issues such as researching information, claims processing, and appealing denials. Formerly found in Chapter II of the Medicare Carriers Manual, the Medicare Intermediary Manual and various provider manuals and program memorandums.

Medicare Benefits Notice (MBN)

Document that the patient receives after the physician files an insurance claim for Part A services in the Original Medicare Plan. It lists the services the provider billed, the Medicare-approved amount, the Medicare payment, and the amount the patient must pay. The patient may also receive a Medicare Summary Notice (MSN) (formerly known as an Explanation of Medicare Benefits [EOMB] ). See also Medicare Summary Notice (MSN), remittance advice (RA) , and Explanation of Medicare Benefits (EOMB) .