Medical Mutual Medicare
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Are you a provider? Do not fill out the attestation form below. Be sure to fill out our provider-specific version of the attestation instead.
For more information about these questions and guidelines for responding, view our FDR Attestation Guide.
* Required Information
Attachment 1: Policies and procedures that document the process used to ensure the security of Medicare Member PHI and other personal information.
Attachment 2: Policies and procedures that document the process used for the immediate termination of the subcontract upon discovery of a significant breach.
Attachment 3: The agreement (proprietary information removed) with the offshore subcontractor.
Attachment 4: Policies and procedures that document the process used for conducting annual audits, monitoring and tracking results, and resolving and identifying deficiencies.
Note: You do not need to upload documents in order to submit this form but you will still be required to send them to Medical Mutual in order for your attestation to be complete. Additional information on how to do this will be provided in your confirmation email.