Other Review Entities

Comprehensive Error Rate Testing (CERT) - View program background, request and response timeline, communication used between Noridian and providers, Provider Corrective Actions, responding to a CERT request, contact details, and resources

Office of Inspector General (OIG) - View OIG information and access the OIG website.

Quality Improvement Organization (QIO) - View QIO functions and access state QIOs.

Recovery Auditor - View RA program details, contact information, types of reviews and the options available when receiving an RA decision.

Supplemental Medical Review Contractor (SMRC) - Access current and completed projects, the discussion/education period, documentation requests and hot SMRC topics.

ZPIC - View ZPIC functions and non-functions.

Multiple CMS contractors are charged with completing reviews of medical records. This includes the Comprehensive Error Rate Testing (CERT) Contractor, Recovery Auditors (RA), and many more. See Identifying Which Entity Completed a Part A Claim Review for detailed information about each of these contractors.

Last Updated Nov 16, 2017