Good Morning!

I am reaching out to communicate about letters that many of our customers are receiving from Noridian Healthcare Services- your CMS Medicare Administrative Contractor. The letters have been coming via the US Postal Services and are addressed to the administrator. In some cases, Noridian has made a follow up call to ensure receipt.

The letters include a Comparative Billing Report (CBR). Many of you may be unfamiliar with CBRs.

• CBRs are ONLY educational tools. They are NOT ADRs (or Notices/Requests for reviews), and they are NOT Review Results indicating that reviews have already been completed and/or that billing/medical necessity/or other issues have been found.
• CBRs are ONLY driven from data-mining and, as such, are only able to identify billing patterns. No records or documentation have been reviewed. Thus, receiving a CBR does not mean that billing (or services) are occurring incorrectly.

The CBR indicates provider action is required including a written response. It is important to note:

• Responses are requested within ten business days of receipt.
• Specific information included in your response may be used by Noridian to guide future pre-pay and post-pay ADRs, denials, and reviews.
• Consonus is already completing all of the requested action items in the letter as part of our regular and ongoing compliance processes.

If you receive a CBR letter, we hope you will reach out to us immediately so we can be aware of the contents and also help you prepare a complete but concise response that will ensure you are compliant yet minimize risk of further review or audit. Please contact your Area Director and provide a copy of the letter and we will be glad to assist.

Thank you,

Tracy Fritts, PT

Vice President Quality and Outcomes