CMS Contractors Verify Compliance

Published 01/18/2022

CMS employs several review contractors to measure, prevent and identify improper payments. These review contractors manually review claims against the submitted medical documentation to verify the providers’ compliance with Medicare rules and regulations. These review contractors include: Palmetto GBA, Comprehensive Error Rate Testing Contractors (CERT), Recovery Auditor Contractor (RA) and Unified Program Integrity Contractors (UPIC). With so many 'eyes' watching, ensure documentation is complete prior to submitting.

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