Tag: Post-Payment Reviews

WASHINGTON – Noridian Healthcare Solutions, the Supplemental Medical Review Contractor for CMS, is conducting post-payment reviews of claims for surgical dressings billed on dates of service from Jan. 1, 2019, through Dec. 31, 2019. Surgical dressings are ranked in the top four categories with the highest improper payment rate at 62.8%, according to the 2019 Comprehensive Error Rate Testing Improper Payment Report. Medicare provides reimbursement for surgical dressings under the DMEPOS benefit,...

WASHINGTON – The Medicare Administrative Contractors may now begin conducting post-payment medical reviews for dates of service later than March 2020, CMS has announced.  In August 2020, the MACs resumed post-payment reviews of items and services with dates of service before March 2020.  The Targeted Probe and Educate program, which involves intensive education to assess provider compliance through up to three rounds of review, will restart at a later date, CMS says.  The...