Another Audit Contractor —
Strategic Health Solutions, LLC, is the Supplemental Medical Review Contractor (SMRC) under contract with the Centers for Medicare &Medicaid Services (CMS) to perform and/or provide support for a variety of tasks aimed at lowering the improper payment rates and increasing efficiencies of the medical review functions of the Medicare and Medicaid programs.
This will be a Nation wide Medical Review contractor and one of it’s first focus for SMRC directed by CMS is to review claims for PMDs instates that are not part of the Prior Authorization project.
The web site for this new supplemental medical review contractor is http://www.strategichs.com/home-smrc/
We have had some results back from this contractor and if you have already been audited by another entity for the same claims the SMRC will release their audit if you send them proof of previous Complex Medical Review.