Comparative Billing Reports (CBRs) are educational tools administered by the Centers for Medicare & Medicaid Services (CMS). They are developed and disseminated under contract by eGlobalTech, a woman-owned Federal services firm based in Arlington, VA.
The CBRs are disseminated to the provider community to provide insight into billing trends across regions and policy groups. A/B Medicare Administrative Contractors (MACs) have been producing and disseminating limited numbers of CBRs to targeted providers for many years. CMS has now formalized and expanded the program to a national level. The program also includes a CBR Support Help Desk that providers can contact to ask questions regarding the CBRs. Following the release of each CBR, eGT will hold an educational teleconference or webinar to educate providers on the substance of the CBR and to provide an opportunity for providers to ask questions.
The CBR is just one tool that CMS uses in its ongoing efforts to protect the integrity of the Medicare Trust Fund. Other efforts include
• Educating providers about Medicare’s coverage, coding, and billing rules;
• Reviewing claims before they are paid to assure compliance with coverage, coding, and billing rules (called prepayment review); and
• Reviewing claims after they are paid (called post-payment review) to identify and collect overpayments made to providers.
CMS employs A/B MACs and Durable Medical Equipment (DME) MACs to enroll providers and suppliers into the Medicare program, process claims and bills, educate providers, conduct prepayment review, conduct post-payment review, and perform other tasks in accordance with the specific contract. CMS employs Recovery Audit Contractors (RACs) to perform post-payment review. CMS also learns of improper payment vulnerabilities through reports issued by the Department of Health and Human Services (HHS) Office of the Inspector General (OIG) and the Government Accountability Office (GAO) and data analysis conducted by CMS employees.