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Tag: Medical review


Also Noted

CGS launches review of No. 1 product category for CERT errors

March 22, 2021HME News Staff

NASHVILLE, Tenn. – CGS will be conducting complex post-pay, service-specific medical review of lower limb prostheses, L5700 and L5701, the contractor announced on March 19. “This review will be conducted because data analysis revealed that Jurisdiction C’s allowed dollars for L5700 and L5701 were significantly above expected amounts,” CGS stated. “Additionally, the orthotics policy group ranked No. 1 in total comprehensive error rate testing (CERT) errors.”...

Audits, CGS, Medical review, Prostheses


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Also Noted

Noridian named new SMRC contractor

March 23, 2018HME News Staff

FARGO, N.D. - Noridian Healthcare Solutions has been awarded a $227 million Supplemental Medical Review Contractor (SMRC) contract by CMS. The primary role of the SMRC is to conduct nationwide medical review of Part A, Part B and DME providers as directed by CMS. Its responsibility is to review medical records and related documentation to ensure that claims are processed in accordance with CMS guidelines. The SMRC contract was previously held by StrategicHealthSolutions. To support the new contract,...

Audits, Medical review, Noridian, SMRC


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