What is the focus of the Supplemental Medical Review Contractor (SMRC)?

• A. Decreasing improper payments and increasing the proficiency of the medical review process
• B. Increasing hospital charges
• C. Expanding medical staff
• D. Reducing patient satisfaction

Answer: (A)

The focus of the Supplemental Medical Review Contractor is to decrease improper payments and increase the proficiency of the medical review process. This contract works to catch and prevent errors by conducting medical reviews, analyzing findings to identify patterns of improper payments, and delivering training and guidance to reviewers and providers to improve documentation and coding accuracy. By strengthening both the accuracy of reviews and the review workforce, Medicare payment integrity improves. The other options don’t align with this mission: increasing hospital charges would raise costs; expanding medical staff isn’t the central aim; and reducing patient satisfaction would undermine quality and trust in the program.