Corrections

A. The CMS figure is wrong

Services, beneficiaries and payments are shown as CMS published them. ClaimLight does not edit CMS figures, so a figure that is wrong in CMS's file is corrected at the source. We record your request; the route is:

1. The services, beneficiaries and payments in CMS's file come from the claims your billing entity submitted to Medicare. A claim that was billed or paid in error is corrected through your Medicare Administrative Contractor (a reopening or adjustment); CMS's file reflects corrected claims in a later release.
2. A name, practice address or taxonomy that is wrong at the source is updated in NPPES; enrollment, reassignment and group membership are updated in PECOS, which feeds CMS's Doctors and Clinicians data.
3. Questions about the dataset itself go to the CMS dataset contact.
4. ClaimLight does not edit CMS figures. When CMS publishes a corrected file, the next data load picks it up.

• Find your Medicare Administrative Contractor (cms.gov)
• NPPES, to update the NPI record (name, practice address, taxonomy)
• PECOS, to update Medicare enrollment and reassignments (feeds Doctors and Clinicians)
• Medicare Physician & Other Practitioners, by Provider and Service (data.cms.gov)
• CMS dataset contact (Medicare Provider Data, OEDA): IPAG_Data_Products@cms.hhs.gov

B. ClaimLight got it wrong

Our matching, labels and calculations can be wrong even when CMS's figures are right: the wrong person, specialty, affiliation or location, a code mapping, a work RVU, a formula or the way a figure is presented.

• You get an acknowledgement email with a ticket number.
• A reviewer decides by the written rule for the category; our target is 10 business days.
• While a reviewer has the page under review, its figures and rank are hidden and the page says so.
• An error of ours is fixed with a logged override or a method fix for everyone, never by editing CMS rows. The outcome is recorded and emailed to you.