What role does a fiscal intermediary play in the Medicare program?

A fiscal intermediary plays a crucial role in the Medicare program by managing claims for Medicare in specific areas. This involves processing and paying claims submitted by healthcare providers for services rendered to Medicare beneficiaries. They act as a bridge between the healthcare providers and Medicare, ensuring that claims are handled efficiently and accurately.

In this capacity, fiscal intermediaries review the submitted claims to ensure they meet Medicare's coverage criteria, apply relevant coding, and verify that the services billed were provided to eligible patients. Their responsibility includes determining the appropriate reimbursement amount based on regulations and guidelines set forth by Medicare.

Other roles, such as providing emergency medical services, serving as an insurance agent for patients, or approving medical procedures, are not within the scope of a fiscal intermediary’s responsibilities in the Medicare program. These functions belong to other entities or professionals within the healthcare system. Thus, the management of Medicare claims by fiscal intermediaries is essential for maintaining the integrity and efficiency of the Medicare payment process.