Header Graphic

NHIC Home

A Medicare Part B Contractor ISO 90001:2000 Certified   Search DME MAC A
Advanced Search | Search Tips     Search Titles Only
DME MAC Jurisdiction A
 
DME Home
What's New
General Announcements
Contact Information
All Contacts
ListServe Sign-Up
Web site Feedback
Written Inquiries
Billing Support
Appeals
CMNs and Forms
Electronic Data Interchange
Enrollment Information
FAQs
Fee Schedules
Overpayments
Publications
Related Web Sites
Supplier Manual
Education
ACT Calls
Education Articles
Education Online
Events & Seminars
Glossary
Learning Network
Outreach Materials
Provider Outreach &
Education Advisory Group
Medical Review
All Medical Review
ADMC
Benefit Integrity/Fraud
Bulletins
CERT Information
HCPCS/Modifiers
LCDs
 

Effective March 1, 2008, the medical review (MR) not for benefit integrity (BI) functions that were the responsibility of the DME Program Safeguard Contractors (PSCs) were transitioned to the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) for all DME MAC Jurisdictions. This transition does not include the PSC Benefit Integrity functions and is only in relation to the transition of the PSC MR not for BI functions.

Due to the transition, the DME MACs assumed full responsibility for the following workload:

  • Performance of MR not for BI functions as outlined in MLN Matters article 5765 and the Medicare Program Integrity Manual (PIM), Chapter 5 - Items and Services Having Special DME Review Considerations;
  • Comprehensive Error Rate Testing (CERT);
  • Local Coverage Determinations (LCDs)
  • Advance Determination of Medicare Coverage (ADMC);
  • Healthcare Common Procedure Coding System (HCPCS);
  • Medical Review not for BI Claim Edits;
  • Probe Reviews;
  • Supplier Education and
  • Medical Review of Claims (not for BI purposes)

Bulletins

Medical Policies (Local Coverage Determinations(LCD))

HCPCS Codes / Modifiers

Benefit Integrity / Fraud

 

back to top

03/28/2008