Facility Advance Letter Billing Offices

DEPARTMENT OF HEALTH & HUMAN SERVICES
Centers for Medicare & Medicaid Services

Dear [Billing Office Representative]:

[Month], [Year]

I am writing to request your assistance as we conduct an important study called the Medicare Current
Beneficiary Survey (MCBS). This assistance would include your participation in the collection of billing
information on behalf of [(a facility)/(facility name)], for which your office manages billing.
Since 1991, the Centers for Medicare and Medicaid Services (CMS), part of the U.S. Department of
Health and Human Services, have conducted the MCBS in order to better understand the needs of
Americans enrolled in Medicare. It is the nation’s primary source of information about how Medicare
affects the people it serves, and we intend to use the information collected to improve the Medicare
program. Because we cannot interview everyone on Medicare, a sample of 16,000 Medicare
beneficiaries was selected to represent all of those on Medicare.
A portion of the selected Medicare beneficiaries reside in long-term care facilities. These beneficiaries
are extremely important to the study because long-term care issues are at the forefront of the national
health policy agenda. We have already spoken to the facility in which a beneficiary resides to collect
their health care utilization information. We now need your help to collect information on the health
care costs of this beneficiary in [(a facility)/(facility name)], for which your office manages the
billing.
For the most recent public version of the questions you may be asked, you may visit: cms.gov/ResearchStatistics-Data-and-Systems/Research/MCBS/Questionnaires
All of the information your organization provides will be kept private to the extent permitted by law, as
prescribed by The Federal Privacy Act of 1974. Your participation is voluntary, and your relationship
with programs administered by CMS will not be affected by whether you elect to participate or not.
NORC at the University of Chicago, a respected social science research organization, has been
contracted to conduct the MCBS. A professional interviewer will contact you within the next few weeks
to schedule an interview time.
If you have any questions about the study or would like to schedule an appointment, please call NORC
toll-free at 1-844-777-2151, or email NORC at [email protected]. The Medicare Current Beneficiary
Survey is important. Please help us in this national effort to improve the Medicare program.
Sincerely,

Marina Vornovitsky
Director, Medicare Current Beneficiary Survey
Centers for Medicare and Medicaid Services

Enclosure
OMB No. 0938-0568 | Expires 8/31/2025