Medical Review Pre-/post- Payment Contractor Information
Prepayment and postpayment claim review targeted to those services with the highest improper payments is one strategy that CGS Medical Review utilizes to prevent identified program vulnerabilities. However, Medical Review is not the only CGS department or only Medicare contractor that may request supplier records either for a pre-payment or post-payment claim review. Therefore it is essential that suppliers read any correspondence related to additional documentation requests thoroughly and carefully follow the instructions for submitting the requested information. The table below lists the contractors and the types of claims they review in Jurisdiction C:
More information about Additional Development Requests (ADRs)