“Livanta LLC is pleased to announce its recent award of a national claim review task order under the Centers for Medicare & Medicaid Services’ (CMS) Beneficiary and Family Centered Care – Quality Improvement Organization (BFCC-QIO) program. The BFCC-QIO claim review function is derived from Part B of Title XI of the Act and the QIO regulations in 42 CFR Parts 475, 476 and 480. Funded through the CMS Center for Clinical Standards & Quality (CCSQ), this 54-month task order supports CMS in its core functions of beneficiary oversight and protection of the Medicare Trust Fund across all 50 states, five United States territories, and the District of Columbia.”
“The BFCC-QIO claim review task order serves to decrease CMS’ paid claims error rate. Livanta will perform specific types of utilization reviews for proper payment of Medicare claims involving hospital inpatient admissions of short duration and where hospitals re-submitted certain types of inpatient claims for a higher payment than what they had billed initially. As part of the review, Livanta will evaluate whether the services performed were medically necessary and at the appropriate level of care.”
“As part of its claim review activities, Livanta will provide education services to help hospitals improve their billing accuracy; analyze claims and other data to select samples for review; issue payment determination notices; notify companies that pay the claims for Medicare when hospitals need to refund payments or make other claim adjustments; and perform outreach functions with hospital providers, beneficiaries, and other stakeholders to help safeguard the Medicare trust fund against fraud, waste, and abuse.”
“Livanta’s Chief Medical Officer, Ellen R. Evans, MD, a Board-certified Family Physician and Geriatrician, stated, ‘The Livanta team of clinicians brings exemplary experience, knowledge, understanding, and skill to this workload. Over the long months of the ongoing pandemic, our work as a Medicare Beneficiary and Family Centered Care – Quality Improvement Organization continually reveals the strength, stamina, innovation, and determination that every Medicare beneficiary, caregiving family, and healthcare provider brings to our nation. Throughout this unprecedented healthcare crisis, those we serve inspire us to provide Medicare with the highest quality of claim review services.’” Read more here.
Source: Livanta Awarded CMS Claim Review Services Contract – April 12, 2021. GlobeNewswire.
