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Provider
Resources, Inc. (PRI) link to website,
located in Erie, Pennsylvania, has been awarded
the CMS contract to provide review of the MSA
submissions effective July 1st through
June 30, 2012 This is a
$5,124,084.00, contract with an
option of renewal by CMS for four
additional years. A subcontractor facility
is located in Richmond,
VA. Shawn
Keough-Hartz is the PRI
President/CEO. Traditionally, PRI was a billing
company but has expanded the company services to
claim reviews for the federal Office of Workers'
Compensation Programs (OWCP) as well as contract
work with the Medicare Zone Integrity Contractors
program and has also served as a RAC Validation
Contractor.
The
Request for Proposal (RFP)by CMS called for
the following QA/CQI program initiatives that
ensured the following completion time lines from
applicants:
a.
20 day review of new cases
b. 5 day
development
notification
c.
15 day review of requested additional
documentation
The
CMS RFP also called for a timely response to be
provided to all written and telephone
inquiries. Responses that involve research
associated with initial telephone inquiries
received are to be made within 24 hours of the
inquiry. Responses to written inquiries are
to be made within 10 business days of the
inquiry.
This
is an ambitious time frame for processing over
2,000 MSA submissions per month. If PRI is able to
meet these completion time frames, we will see a
significant reduction in turn around time for
approval of our MSA submissions.
In the meantime, CMS continues to work on a
direct submission portal, which should decrease
wait time even further by allowing proposals to be
submitted electronically. As we
look forward to fewer CMS delays in the claims
resolution process, we continue to partner with
our clients in initiating innovative strategies to
reduce drug costs and MSA medical costs. If you
would like more information about Law Offices of
Beverly Manley & Associates, P.C., please send
your email and mailing address to beverly@bmanleymsa.com.
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