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Last Modified: 11/24/2017 Location: FL, PR, USVI Business: Part A

Requesting a comparative billing report -- Part A providers

Comparative billing report (CBR) information is available to providers by request. The purpose of the CBR is to show comparative data Medicare considers when determining how a provider’s billing patterns contrast with other providers in the same specialty. A CBR may be a helpful tool for providers when conducting self-audits.

Comparative billing reports by type of bill

Medicare compares a Part A provider to its peers by type of bill using quantity billed per beneficiary per procedure code. This type of CBR contains billing information for a provider in intervals defined by the requester.
Since Medicare bases a CBR on dates of service and not processed dates, Medicare must allow two to three months to permit claims to be finalized before a report can be generated. For example, January data is not available until April or May.

How to request a comparative billing report

To request a CBR, providers must follow these steps:
A provider must request a CBR on office or corporate letterhead and the provider/officer signature must be affixed. A request from a corporate entity must be submitted by a corporate officer, or in the case of a hospital, the hospital administrator. If the requesting provider wants the information sent to another party, it must be noted in the letter.
The mailing address must be stated clearly and legibly in the letter, since these reports will only be sent via the U.S. mail, and not electronically.
The CBR request must include the Medicare provider number, the dates of service preferred, and the applicable type of bill. Due to the volume of data, Medicare cannot generate a report for types of bill 11X or 12X.
The request must be faxed to Statistical and Medical Data Analysis at 904-361-0543 or mailed to:
First Coast Service Options
Statistical and Medical Data Analysis
PO Box 2078
Jacksonville FL 32231-0048
There is no fee for providing these reports.
Once Medicare receives a CBR request, the report and a CBR explanation document will be mailed to the requesting provider (or authorized party) within 10 business days.
Source: CMS Pub 100-08, Medicare Program Integrity Manual, Chapter 3, Section 11.1.6
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