Corporate

MR Contractors Medical Review Contractors

The Centers for Medicare & Medicaid Services (CMS) utilizes a number of contractors to conduct medical review of claims and documentation, including:

  • Medicare Administrative Contractors (MACs), including CGS
  • Comprehensive Error Rate Testing (CERT) contractors
  • Recovery Auditors (RAs)
  • Zone Program Integrity Contractors (ZPICs)/UPIC
  • Supplemental Medical Review Contractor (SMRC)

CERT

Comprehensive Error Rate Testing (CERT) contractors

Recovery Auditors

Recovery Auditors (RA's)

SMRC

Supplemental Medical Review Contractor

ZPICS

Unified Program Integrity Contractor (UPIC)

MCR

Medicare Claim Review ProgramsExternal PDF

 

Updated: 11.29.18

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