Serco, the international provider of critical government services, has been awarded a contract in the US by the Centers for Medicare & Medicaid Services (CMS) to support the agency's crucial Comprehensive Error Rate Testing (CERT) program.
The contract, which has a total value of more than £80 million ($109 million), is for seven years and will see Serco check the validity of claims.
Serco will deploy a team of independent medical reviewers, supported by intelligent document processing and advanced artificial intelligence (AI), to validate compliance with Medicare coverage, coding, and billing rules. Work will be performed virtually and at Serco facilities in the Richmond, Virginia area.
This award builds upon Serco's established expertise in large-scale government programmes by directly supporting CMS's mission to ensure millions of Americans have access to quality health care services while safeguarding the integrity and financial sustainability of the Medicare program. The contract extends Serco's more than 12-year history of supporting CMS.
Anthony Kirby, Serco Group Chief Executive said:
"I am delighted that we have been selected to deliver this important contract. We have a long history of working successfully with CMS and this win is proof of the strength of that relationship.
"Serco will help ensure that millions of Americans who use Medicare can be sure that the system is robust and being scrutinised to make sure benefits are getting to the people who need them the most, quickly and securely."
The CMS CERT program is a vital compliance initiative that measures and reports the improper payment rate for the Medicare Fee-for-Service program, which processes over $1 trillion in total medical expenditures annually for nearly 70 million Americans.