Livanta to begin conducting Medicare claim reviews

Although Beneficiary and Family Centered Care – Quality Improvement Organizations (BFCC-QIOs) like Livanta routinely provide case review services for Medicare beneficiaries, claim review services are additional activities provided by BFCC-QIOs and are funded by CMS. In 2019, CMS put claim review services on temporary hold as the agency began to modify the program for coordination by a single national contractor.

Livanta will soon begin conducting these claim reviews for CMS, which include short stay reviews, higher-weighted diagnosis related group (HWDRG) reviews and other reviews, as directed by CMS.

Livanta is authorized to conduct this work on a national scale, including in all 50 states, five U.S. territories and Washington, D.C. Click here to read Livanta’s recently published Provider Bulletin for more information about this important change and other critical updates.