Beneficiary Care Services Is Recruiting Physician Reviewers!
Under contract with the Centers for Medicare & Medicaid Services (CMS) Delmarva Foundation for Medical Care, the quality improvement organization (QIO) for Maryland, conducts medical reviews of the care provided to Medicare beneficiaries.
Physician reviewers determine whether the care provided to the beneficiary was medically necessary and appropriate. Reviews may include utilization, coding, or quality of care issues. The reviewer is generally from the same specialty as the physician who provided the care under review. This peer review is critical to maintain the highest possible standards of medical practice and to ensure that every Medicare beneficiary gets the right care every time. Physician reviewers are compensated for their time.
A physician reviewer must meet the following eligibility requirements:
- Have active admitting privileges at a hospital within Maryland
- Have a practice that includes Medicare patients
- Be actively engaged in patient care a minimum of 20 hours per week
- Have a current license to practice medicine within the state of Maryland
- Undergo successful credentialing by DFMC
- Complete physician reviewer training (provided by the QIO) with 100% correct answers on post-test annually
- Have access to a secure fax and email computer system
If you are interested in becoming a physician reviewer, please complete the Physician Response Form [pdf] and fax it to DFMC at 443-285-0968.
Thank you for your interest.
Toni Griffin, Director
DFMC and DFDC
Patient Care Resources:
- National Adult Day Services
- Center for Medicare & Medicaid Services Home Health Agency
- Home Health Care Companies
- U.S. Department of Health and Human Services Administration on Aging
- Adult Day Care Facilities
- Assisted Living Facilities
- Skilled Nursing Facilities