CMS recently announced the creation of a new role in the medical review process—a Provider Relations Coordinator. The announcement is below and can be found on the CMS website.
June 2, 2014 – CMS is pleased to announce the establishment of a Provider Relations Coordinator to help increase program transparency and offer more efficient resolutions to providers affected by the medical review process.
CMS established the Provider Relations Coordinator to improve communication between providers and CMS. Although providers should continue to take questions about specific claims directly to the Recovery Auditor or Medicare Administrative Contractor (MAC) who conducted the review, providers can raise larger process issues to the Coordinator. For example, if a provider believes that a Recovery Auditor is failing to comply with the documentation request limits or has a pattern of not issuing review results letters in a timely manner, CMS would encourage the provider to contact the Provider Relations Coordinator.
Providers can also send suggestions about how to improve the Recovery Auditor or MAC medical review process to the CMS Provider Relations Coordinator.
The CMS Provider Relations Coordinator is Latesha Walker.
Providers may contact Latesha by sending an email to:
• RAC@cms.hhs.gov (for Recovery Auditor review process concerns/suggestions); or
• MedicareMedicalReview@cms.hhs.gov (for MAC review process concerns/suggestions).