Tag: Supplemental Medical Review Contractor (SMRC)
Noridian to review cath claims
December 9, 2024HME News Staff
WASHINGTON – Noridian Healthcare Solutions, as the Supplemental Medicare Review Contractor (SMRC), is conducting post-payment review of intermittent urinary catheter claims billed with dates of service from Jan. 1, 2022, through Dec. 31, 2023. It’s reviewing HCPCS codes A4351, A4352 and A4353. Noridian noted that in February 2024, the Washington Post published an article alerting readers of an investigation into utilization for intermittent urinary catheters. As a result of the investigation,...
SMRC audits orthopedic footwear
January 18, 2022HME News Staff
WASHINGTON – Noridian Healthcare Solutions, the Supplemental Medical Review Contractor for CMS, is conducting post-payment reviews for orthopedic footwear claims from Jan. 1, 2019, through Dec. 31, 2019. Orthopedic footwear is covered under the “leg, arm, back and neck braces, and artificial legs, arms and eyes” benefit. Coverage is provided when coverage, coding and documentation requirements are met. The reviews will include base and accessory codes. Noridian noted that this service...
SMRC reviews on schedule
July 29, 2016HME News Staff
WASHINGTON - The Supplemental Medical Review Contractor has completed 14,000 PAP reviews and is on schedule to finish all 30,000 PAP reviews by late September, says AAHomecare. The SMRC is expected to complete a total of 50,000 nebulizer reviews by the end of July and 50,000 oxygen reviews by the end of September. AAHomecare has also learned that Additional Development Requests (ADRs) for all three product categories have been sent out and some suppliers are starting to receive response letters from...
Is SMRC cherry-picking old claims?
June 6, 2014Theresa Flaherty, Managing Editor
YARMOUTH, Maine - StrategicHealthSolutions is digging deep in its latest round of post-pay reviews, industry stakeholders say: diabetes supply claims from 2011-2012.
“We had to go to the pallets in the warehouse and find these,” said Marcus Suess, CEO of All-States Medical Supply in Fletcher, N.C. “We've been electronic for a while but we boxed up the EOBs—we're too busy to scan everything.”
Medicare contracted with the Omaha, Neb.-based StrategicHealthSolutions...
Is CMS preparing for hunting season?
April 11, 2014HME News Staff
As Elmer Fudd would say “Be vewwy, vewwy quiet...I'm hunting wabbits!” The Centers for Medicare and Medicaid Services (CMS) may not be hunting rabbits, but they're hunting the very elusive greenbacks.
On September 1, 2012, CMS implemented the prior authorization (PA) for power mobility devices (PMDs) demonstration in seven states: Cal., Fla., Ill., Mich., N.C., N.Y. and Texas. CMS claims that spending per month on power mobility devices in the seven demo states has decreased...