What do intermediaries in the Medicare system primarily do?

Intermediaries in the Medicare system primarily act as organizations that manage claims processing, specifically for hospital and institutional services. They play a crucial role in the reimbursement process, ensuring that providers are compensated for the services they deliver to Medicare beneficiaries. Their responsibilities include reviewing and processing claims, determining coverage based on Medicare guidelines, and overseeing the payment decisions for various services received by patients in medical facilities.

This role is vital in maintaining the flow of funds within the Medicare system, as intermediaries bridge the gap between healthcare providers and Medicare, making the payment system efficient and effective. Their focus on hospital services distinguishes them from other entities within Medicare that might handle outpatient claims or supplemental insurance plans.