CMS: Who Are They?

The Center for Medicare and Medicaid Services or CMS is a Federal agency within the United States Department of Health and Human Services.

What does the Center for Medicare and Medicaid Services do?

Its job is to administer the Medicare program, a national social insurance program that covers Americans aged 65 and above who have worked and paid into the system. CMS also works in partnership with the state governments to administer Medicaid, a social health care program for those families and individuals who have low income and very limited resources. This applies to all ages, given the condition that the persons’ resources could not suffice for paying health care services. Aside from Medicare and Medicaid, CMS also administers the State Children’s Health Insurance Program or SCHIP, a program that provides matching funds to states for coverage of health insurance to families, with children, whose incomes do not qualify for Medicaid assistance.

The center’s other services and responsibilities include the administrative simplification of standards from the Health Insurance Portability and Accountability Act of 1996.

The Workforce

Over six thousand employees are hired who are distributed in regional offices and headquarters throughout the United States. The head of the CMS is the administrator and whoever handles the position is appointed by the President himself and confirmed by the Senate.

Since there is an ongoing rise in the demand for healthcare and an increase in the peoples’ dependence towards insurance in order to pay the services that they have rendered, the healthcare system continuously creates systems that can help with easing the burden on the healthcare provider. By the people increasing the use of insurance, it means that the healthcare provider must be able to maintain the detailed information of the patients, such as their medical history, treatment and the nature of the claim form the insurance company.

Given the continuously improving healthcare system, even the insurance forms have been undergoing major changes over the years of use. Before technology took over, people were used to paper forms. But nowadays, since the world has already evolved much, traditional paper claim forms have slowly started to fade and be replaced by electronic claim forms. This is to ensure the accuracy and efficiency in filing the claims as well as in the reimbursement of such claims.In connection with this, a new form has been made and introduced: the new cms 1500 claim form.