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Prepay Medicare Review Part B
Documentation Requirements
This web page has been specifically designed by Prepay Medical Review, Part B, for providers to offer assistance regarding the documentation requirements Medicare needs to adjudicate your claims. The intent is to provide education and information on
the medical review process and to explain why the carrier may request copies of medical documentation from providers in carrying out medical review activities.
A link to all PrePay audits implemented by the carrier (except provider specific audits) are listed on this web page. Please click on the link for detailed information. Included is an explanation of why each audit is in place, the purpose of the
audit, the documentation requirements necessary to support medical necessity and one or more references for the requirements. The information in this section will be updated as changes are made.
As your Medicare Carrier, our goal is to pay the claim correctly the first time and it is our hope that this effort will be user friendly and helpful to you. In addition, you are encouraged to regularly monitor your state Medicare web site at
http://www.rimedicare.com , for the Latest Updates, new policies, revised policies, retired policies, and draft policies. The draft policies offer you the opportunity to comment on- line regarding proposed
policies before they are finalized.
All of this information and much more is available by going to your state website, clicking on "Providers" and then selecting the topic of interest to you.
Our Medicare workshops are also posted on this site, as well as our Web based training for you and your staff. These are valuable educational tools that you and your office
staff cannot afford to miss.
We would appreciate any comments/feedback you might offer to improve this site and encourage your comments. |
