Current ZPIC contracts analyze all claim types including Part A, Home Health, Hospice, Part B, Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS), and perform Medicare and Medicaid Data Matching.
Zones and states are as follows:
- Zone 1 - California, Nevada, American Samoa, Guam, Hawaii, the Northern Mariana Islands, Palau, Marshall Islands, and the Federated States of Micronesia.
- Zone 2 - Alaska, Washington, Oregon, Montana, Idaho, Wyoming, Utah, Arizona, North Dakota, South Dakota, Nebraska, Kansas, Iowa and Missouri.
- Zone 3 - Minnesota, Wisconsin, Illinois, Indiana, Michigan, Ohio, and Kentucky.
- Zone 4 - Colorado, New Mexico, Oklahoma, and Texas.
- Zone 5 - Alabama, Arkansas, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia and West Virginia.
- Zone 6 - Pennsylvania, New York, Maryland, Washington D.C., Delaware, Maine, Massachusetts, New Jersey, Connecticut, Rhode Island, New Hampshire, and Vermont.
- Zone 7 - Florida, Puerto Rico and Virgin Islands.
Working together to promote the integrity of the Medicare and Medicaid programs, SafeGuard Services LLC continues to maintain strong relationships with Centers for Medicare and Medicaid Services (CMS), the Department of Health and Human Services (DHHS), Office of Inspector General (OIG), United States Attorney's Offices (USAO), Office of Attorney General (OAG), Office of Investigations (DHHS, OIG and OI), the Federal Bureau of Investigations (FBI), State Medicaid Teams, the Medicare Affiliated Contractors (MACs), the Medicare Drug Integrity Contractors (MEDICs), and other Program Safeguard Contractors (PSCs), and ZPIC contractors.
For ZPIC contracts, the Electronic Submission of Medical Documents (esMD) system gives providers a mechanism to submit medical documentation electronically. Records are sent through a CMS certified Health Information Handler (HIH) and not through SGS. Benefits of esMD include: an electronic trail is created when records are submitted; reports are available to assess when the contractor received the medical records; files are sent via a secure connection directly to the recipient; and the volume of paper is reduced. For more information about esMD, please refer to the CMS website at www.cms.gov/esMD.