MARS: Medicare Audit Review System
R-C Healthcare Management uses the CMS computer system to calculate the expected payment amount for each of the hospital's Medicare inpatient claims since the inception of the PPS program (10/1/83).

The expected payment is traced to the actual amount paid using both the hospital's copy of the Remittance Advice and the fiscal intermediary's (FI's) PS&R Claims Paid Summary.

All claims with a difference between the calculated expected payment and the actual payment, if over $1,000, are individually researched at the hospital for documentation supporting a claim refiling.

Supportable claims are refiled by R-C Healthcare Management. When the hospital is paid by CMS, the hospital pays R-C Healthcare Management.