Medical Review


We are experts in MAC, RAC, ZPIC, CERT, and TPE levels of appeals.

QRM Medical Review can optimize your Medicare, Medicaid, and Managed Care reimbursement opportunities through onsite and offsite coding, billing and clinical documentation analysis. We provide customized strategies to improve the efficiencies and accuracy of your claims management process which reduce risk and decrease error rates.

Our team of RAC certified specialists offer guidance on the following:


  • System implementation to reduce and prevent denials

  • Management of MAC diagnosis edit denials

  • Management of documentation requests

  • ADR packet preparation, organization and submission

  • Management of appeals

  • Pre and post-payment probe review and ZPIC guidance

  • Monthly reporting of your medical review activity and claim status

  • Proactive updates on industry denial trends



Let our QRM Medical Review team guide you through the management of your ADRs, denials and appeals from start to finish to reduce the threat of payment delays and possible recoupment. 


Contact QRM for your medical review needs at and 800.506.6925.

Contact QRM for a free analysis