Jun 15, 2010 | Medical billing basics
What It Is Medical Review PCA is a concept designed by the Centers for Medicare & Medicaid Services (CMS) for Medicare contractors to use when deploying resources and tools to conduct medical re- views. PCA ensures that medical review activities are targeted at...
Jun 15, 2010 | Medical billing basics
Overview All Medicare contractors are required to ensure that reimbursement is made only for those services that are reasonable and necessary. To ensure that payment is made only for reasonable and necessary services, each Medicare contractor is required to...
Jun 11, 2010 | Medical billing basics
Local Medical Review Policy (LMRP) Development Medical review decisions are made in accordance with both national and local policies. These policies are the foundation of the review process. LMRP is a formal statement developed through a specific process that: *...
