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pdfOMB Control No.: 0938-1237
Expiration Date: XX/20XX
Open Payments
Review and Dispute Notification Email Texts
Centers for Medicare & Medicaid Services
December 2016
Prepared under contract to Centers for Medicaid & Medicare Services by CGI Federal Inc. and subject to
FAR Clause 52.227-17, Rights in Data- Special Works.
OMB Control No.: 0938-1237
Expiration Date: XX/20XX
Open Payments: Review & Dispute Email Notifications
Centers for Medicare & Medicaid Services
December 2016
Table of Contents
Open Payments System - System Notification E-mails Content ................................................................. 1
01. Dispute Initiated by the Physician or Teaching Hospital - EML_RD_001 .............................................. 1
02. Dispute Acknowledged by the Applicable Manufacturer or Applicable Group Purchasing
Organization (GPO) - EML_RD_002 ...................................................................................................... 3
03. Dispute Resolved No Change by the Applicable Manufacturer or Applicable Group Purchasing
Organization (GPO) - EML_RD_003 ...................................................................................................... 4
04. Dispute Withdrawn by the Physician or Teaching Hospital - EML_RD_003.......................................... 5
05. Dispute Resolved by the Applicable Manufacturer or Applicable Group Purchasing Organization
(GPO) - EML_RD_004 ............................................................................................................................ 6
Appendix A: Summary of changes............................................................................................................... 7
ii
OMB Control No.: 0938-1237
Expiration Date: XX/20XX
Open Payments: Review & Dispute Email Notifications
Centers for Medicare & Medicaid Services
December 2016
Approvals
The undersigned acknowledge that they have reviewed the OPS Registration Functional Requirements
workbook and agree with the information presented within this document. Changes to this OPS
Registration Functional Requirements workbook will be coordinated with, and approved by, the
undersigned, or their designated representatives.
Signature:
Print Name:
Title:
Role:
Signature:
Print Name:
Title:
Role:
Signature:
Print Name:
Title:
Role:
Date:
Submitting Organization’s Approving Authority
Date:
CMS’ Approving Authority
Date:
CMS Business Owner
iii
OMB Control No.: 0938-1237
Expiration Date: XX/20XX
Open Payments: Review & Dispute Email Notifications
Centers for Medicare & Medicaid Services
September 2014
Revision Log
The table below provides a log of each revision of the document that has been issued.
Version
Description
Author
01.02.01
Gap analysis
completed between
System email and
this document
content for Release
15.1
G. Singh
01.02.02
Added Appendix A
01.02.03
Reviewer
Review
Date
2/11/15
T. Nettimi
2/17/2015
G.Singh
2/15/15
T. Nettimi
2/20/2015
PPQA Review
G. Singh
2/20/15
C. Williams
2/20/2015
01.02.04
Outreach review
G.Singh
2/23/15
Outreach
2/23/2015
01.03.01
PPQA Review
Reviewed all
emails and revised
document to reflect
R17.2
G. Singh
2/24/15
C. Williams
2/24/2015
C.Falaiye
12/2/2016
02.00.00
Issue Date
iv
Deadline Date
OMB Control No.: 0938-1237
Expiration Date: XX/20XX
Open Payments: Review & Dispute Email Notifications
Centers for Medicare & Medicaid Services
December 2016
Open Payments System - System Notification E-mails Content
Below are templates of emails to be sent out to applicable manufacturers, applicable group purchasing
organizations (GPOs) (collectively referred to as “entities”), and teaching hospitals and physicians during
the review and dispute process.
01. Dispute Initiated by the Physician or Teaching Hospital EML_RD_001
Email Conditions: The applicable manufacturer or applicable GPO (entity) shall receive an email when
the physician or teaching hospital initiates a dispute of certain payments or other transfers of value, or
ownership or investment interests.
Email Subject Line: Open Payments Dispute Initiated
Body:
A dispute has been initiated in relation to a record of a payment or other transfer of value, or ownership
or investment interests reported by for the program
year. The dispute was initiated regarding the following record:
•
•
•
•
Record ID: XXXX [dynamic text]
Payment or Other Transfer of Value Date: XXXX [dynamic text]
Payment Amount or Dollar Amount Invested: XXXX [dynamic text]
Payment Category: XXXX [dynamic text]
The dispute was initiated by:
•
First name Last name
Dispute ID: XXXX
Dispute Details
You may acknowledge receipt of the dispute by logging in to the Open Payments system, navigating to
the "Review and Dispute" tab, and selecting "Acknowledge Dispute." The physician or teaching hospital
who initiated the dispute will receive an email acknowledging your receipt of the dispute.
You may review the details of the dispute by navigating to the "Review and Dispute" tab of the Open
Payments system and searching for the disputed record using the Record ID or Dispute ID noted above.
You may resolve the dispute by submitting and attesting to the corrected data. After reviewing the
disputed information, if you determine that no change is required to the data, you may dismiss the
dispute or request the physician or teaching hospital who initiated the dispute to withdraw it. If you
have questions or require any further information about this dispute, please contact directly.
1
OMB Control No.: 0938-1237
Expiration Date: XX/20XX
Open Payments: Review & Dispute Email Notifications
Centers for Medicare & Medicaid Services
September 2014
Recipients: Submitter
2
OMB Control No.: 0938-1237
Expiration Date: XX/20XX
Open Payments: Review & Dispute Email Notifications
Centers for Medicare & Medicaid Services
September 2014
02. Dispute Acknowledged by the Applicable Manufacturer or Applicable
Group Purchasing Organization (GPO) - EML_RD_002
Email Conditions: The physician or teaching hospital shall receive an email when the applicable
manufacturer or applicable GPO (entity) acknowledges the dispute of certain payments or other
transfers of value, or ownership or investment interests.
Email Subject Line: Open Payments Dispute Acknowledged
Body:
has acknowledged its receipt of your dispute (Dispute ID ) regarding the
following record:
•
•
•
•
Record ID: XXXX [dynamic text]
Payment or Other Transfer of Value Date: XXXX [dynamic text]
Payment Amount or Dollar Amount Invested: XXXX [dynamic text]
Payment Category: XXXX [dynamic text]
You may view the updated status of this record by logging in to the Open Payments system and
navigating to the "Review and Dispute" tab. If you have questions pertaining to this dispute, please
contact directly.
Recipients: Physician, physician authorized representative, teaching hospital authorized official,
teaching hospital authorized representative.
3
OMB Control No.: 0938-1237
Expiration Date: XX/20XX
Open Payments: Review & Dispute Email Notifications
Centers for Medicare & Medicaid Services
September 2014
03. Dispute Resolved No Change by the Applicable Manufacturer or
Applicable Group Purchasing Organization (GPO) - EML_RD_003
Email Conditions: The physician or teaching hospital shall receive an email when the applicable
manufacturer or applicable GPO (entity) resolves the dispute with no change to the data for the dispute
of certain payments or other transfers of value, or ownership or investment interests.
Email Subject Line: Open Payments Dispute Resolved with No Change
Body:
has resolved your dispute (Dispute ID ) regarding the following record
with no change to the data:
•
•
•
•
Record ID: XXXX [dynamic text]
Payment or Other Transfer of Value Date: XXXX [dynamic text]
Payment Amount or Dollar Amount Invested: XXXX [dynamic text]
Payment Category: XXXX [dynamic text]
specified the following reason(s) for dismissal:
You may view the updated status of this record by logging in to the Open Payments system and
navigating to the "Review and Dispute" tab. If you disagree with this Dispute Resolution with no change
to the data, you may dispute this transaction again.
If you have questions pertaining to this dispute, please contact directly.
Recipients: Physician, physician authorized representative, teaching hospital authorized official,
teaching hospital authorized representative.
4
OMB Control No.: 0938-1237
Expiration Date: XX/20XX
Open Payments: Review & Dispute Email Notifications
Centers for Medicare & Medicaid Services
September 2014
04. Dispute Withdrawn by the Physician or Teaching Hospital EML_RD_003
Email Conditions: The applicable manufacturer or applicable GPO (entity) shall receive an email when
the physician or teaching hospital withdraws the dispute of certain payments or other transfers of value,
or ownership or investment interests.
Email Subject Line: Open Payments Dispute Withdrawn
Body:
has withdrawn a dispute (Dispute ID ) regarding the following record:
•
•
•
•
Record ID: XXXX [dynamic text]
Payment or Other Transfer of Value Date: XXXX [dynamic text]
Payment Amount or Dollar Amount Invested: XXXX [dynamic text]
Payment Category: XXXX [dynamic text]
No further action is required on this record at this time. You may view the updated status of this record
by logging in to the Open Payments system and navigating to the "Review and Dispute" tab.
Recipients: Submitter
5
OMB Control No.: 0938-1237
Expiration Date: XX/20XX
Open Payments: Review & Dispute Email Notifications
Centers for Medicare & Medicaid Services
September 2014
05. Dispute Resolved by the Applicable Manufacturer or Applicable
Group Purchasing Organization (GPO) - EML_RD_004
Email Conditions: The physician or teaching hospital shall receive an email when the applicable
manufacturer or applicable GPO (entity) resolves the disputed payments or other transfers of value, or
ownership or investment interests.
Email Subject Line: Open Payments Dispute Resolved
Body:
has updated the information for the following payment or other transfer of
value, or ownership or investment interest record you have disputed:
•
•
•
•
Record ID: XXXX [dynamic text]
Payment or Other Transfer of Value Date: XXXX [dynamic text]
Payment Amount or Dollar Amount Invested: XXXX [dynamic text]
Payment Category: XXXX [dynamic text]
The following disputes associated with this record are now considered resolved:
•
•
•
Dispute ID: XXXX initiated on XXXX
Dispute ID: XXXX initiated on XXXX
Dispute ID: XXXX initiated on XXXX
You may view the updated record details by logging into the Open Payments system and navigating to
the "Review and Dispute" tab. If you are not satisfied with this resolution, you may dispute this
transaction again. If you have questions pertaining to this dispute, please contact directly.
Recipients: Physician, physician authorized representative, teaching hospital authorized official,
teaching hospital authorized representative.
6
OMB Control No.: 0938-1237
Expiration Date: XX/20XX
Open Payments: Review & Dispute Email Notifications
Centers for Medicare & Medicaid Services
September 2014
Appendix A: Summary of changes
1.
Dispute Initiated by the Physician or Teaching Hospital - EML_RD_001 email: Replace
physician or teaching hospital name with First name Last name
2.
Dispute Initiated by the Physician or Teaching Hospital - EML_RD_001 email: If you have
questions or require any further information about this dispute, please contact directly.
Dispute Withdrawn by the Physician or Teaching Hospital - EML_RD_003 email: In the body of
the email, replace physician or teaching hospital name with First name Last name
4.
Dispute Withdrawn by the Physician or Teaching Hospital - EML_RD_003 has withdrawn a dispute (Dispute ID ) regarding the following record:
Text changes- highlighted in yellow. By has been changed to by. physician has been changed to
Physician. Submitter has been changed to Submitter
3.
5.
7
| File Type | application/pdf |
| File Title | Open Payments-Review_and_Dispute_Email_Notifications_Content_MASTER |
| Author | Babatunde Shittu |
| File Modified | 2021-02-01 |
| File Created | 2017-02-23 |