______ is a Medicare claim reviewer.

• A. Blue Cross Blue Shield
• B. American Medical Contractor
• C. Zone Program Integrity Contractors
• D. Independent Contractors

Answer: (C)

Medicare relies on dedicated program integrity resources to review claims for fraud, waste, and abuse. Zone Program Integrity Contractors are the CMS entities assigned to monitor and audit Medicare claims, identify improper payments, and conduct investigations across regions. They function specifically as the reviewers within Medicare’s program integrity framework. Private insurers like Blue Cross Blue Shield handle some Medicare Advantage claims but are not the standard reviewers for traditional Medicare. The other option names aren’t CMS program integrity reviewers. So, this is the entity described as a Medicare claim reviewer.