• Who Processes Your Medicare Claims? Providers see Medicare patients and file claims to Medicare daily. But do you know who  processes those claims? The answer is - your Local CMS MAC. Knowing what MAC your practice is in and understanding rules for proper claim submission is crucial for expeditious and consistent processing of your claims.

• What is a Local MAC? MAC stands for Medicare Administrative Contractor, a private healthcare insurer that processes the fee-for-services claims for Medicare Part A/B beneficiaries, Home Health + Hospice, and DME claims. According to CMS.gov as of 2019 there are 13 Medicare A/B MACs and 4 DME MACs. They are responsible for processing  claims for ” nearly 68% of Medicare population.

• What Else Do MACs Do Besides Processing Claims? MACs provide LCDs (Local Coverage Determinations) for products and services prescribed and performed by providers.  By contacting their local MACs providers can find out if a procedure, product or medication is covered and will be reimbursed. This step will help providers reduce the number of unnecessary claim denials and shrink A/R.  

ANI can help providers with verifying coverage for every wound care patient and procedure.

Below are the most current A/B MAC and DME MAC jurisdictions.