Catherine Boerner (cboerner@boernerconsultingllc.com) is President at Boerner Consulting, LLC located in New Berlin, WI.
It’s a good idea to make sure your Health Information Management department alerts the Compliance department when requests come in from the Supplemental Medical Review Contractor (SMRC), just as you have for RAC audits. StrategicHealthSolutions, LLC[1] has been contracted as the SMRC to perform and/or provide support for a variety of tasks aimed at lowering the improper payment rates and increasing efficiencies of the medical review functions of the Medicare and Medicaid programs. One of the primary tasks will be conducting nationwide medical review projects as directed by CMS. The medical reviews will be performed on Part A, Part B, and DME providers and suppliers to determine whether Medicare claims were billed in compliance with coverage, coding, payment, and billing practices.
