CIMRO of Nebraska Case Review team's responsibilities include the following different types of medical record reviews:

• Utilization, quality and DRG validation
• Beneficiary complaints – medical record review and mediation
• Hospital-Issued Notices of Non-coverage (HINNs) [Important Message from Medicare]
• Notices of Discharge & Medicare Appeal Rights (NODMAR)
• Hospital requests for higher-weighted DRGs
• Alleged anti-dumping violations (EMTALA review)
• Referrals

The CIMRO of Nebraska Case Review team consists of experienced and qualified physicians, nurses and licensed healthcare professionals that examine the medical record for medical necessity, quality and coding.  Physician reviewers evaluate medical records that do not meet the non-physician reviewer criteria.  If a physician reviewer agrees that there is a concern with coding, quality or utilization, communication is sent to the provider allowing a period of response to add clarifying or additional information pertinent to the case.