Who Reviewed My Claim - JF Part B
Who Reviewed My Claim
Multiple CMS contractors, identified below, are charged with completing reviews of medical record and each send out their own demand letter. It is important for providers to review the letter closely as most times the reviewing entity is indicated within body of letter. Check out the sample additional documentation letters below.
Comprehensive Error Rate Testing (CERT)
If a provider receives a letter that looks like the below, the CERT Review Contractor is performing a review. This is not a Noridian review.
Noridian Medical Review
If a provider receives a letter that looks like the below, Noridian is performing a review.
Office of Inspector General (OIG)
No letter example available
Quality Improvement Organization (QIO)
No letter example available
Recovery Auditor
If a provider receives a letter that looks like the below, the Recovery Auditor is performing a review. This is not a Noridian review.
Supplemental Medical Review Contractor (SMRC)
If a provider receives a letter that looks like the below, the SMRC is performing a review. This is not a Noridian review.
