Which of the following is a Medicare claim review contractor?

• A. Medicare Administrative Contractor (MAC)
• B. National Institute of Standards and Technology (NIST)
• C. Centers for Medicare & Medicaid Services (CMS)
• D. Medicare Payment Advisory Commission (MedPAC)

Answer: (A)

The main idea is identifying who actually processes and reviews Medicare claims. Medicare Administrative Contractors are the entities CMS hires to handle claims processing and payment for Part A and Part B in specific regions. They adjudicate claims and can conduct reviews to ensure medical necessity and integrity of payments. The other options don’t fit this role: NIST is a standards-focused agency, CMS is the federal agency that oversees the program but does not act as the regional claim processor, and MedPAC is a congressional advisory commission that analyzes payments and policies rather than processing claims. So, the claim review contractor role belongs to the Medicare Administrative Contractor.