Medical Review (MR) - Part A
Medical Review
Medical Review's goal is to reduce the contractor's claims payment error rate by identifying patterns of inappropriate billing through data analysis, performing medical review of claims, and developing local policy to address program vulnerabilities.
To access recommendations for the type of information and/or medical records to submit when we request it select from the list of services.
FAQs regarding coverage and medical review related claim and billing considerations.
Information on widespread service specific errors identified during medical review and other important postings.
Instructions for submitting medical records to WPS for post-pay probe reviews, and pre-pay medical review.
Page Last Updated: Thursday, 07-Aug-2008 10:59:30 CDT
