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Medical Review

Welcome to the WPS Medicare Medical Review web page. The Medical Review Department'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.

Medical Review Address
Mailing Address Physical Address
Wisconsin Physicians Service-Medicare
Medicare Medical Review
P.O. Box 1602
Omaha, NE 68108-0310
Wisconsin Physicians Service
Medical Review Department
3333 Farnam Street, Suite 600
Omaha, NE 68131

Medical Review Information

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.

Documentation Guidelines - To access recommendations for the type of information and/or medical records to submit when we request it select from the list of services.
Bulletin Board - Information on widespread service specific errors identified during medical review and other important postings.
Submitting Medical Records - Instructions for submitting medical records to WPS for post-pay probe reviews, and pre-pay medical review.
WPS Medical Review Process

Frequently Asked Questions (FAQs)

To view the Medical Review FAQs, select the "FAQ" tab in the primary (top) navigation bar of this page. Choose "Medical Review FAQs."

Page Last Updated: Monday, 07-Nov-2011 08:52:20 CST