Discovery Samples Sample Clauses

Discovery Samples. The IRO shall randomly select a sample of 30 Paid Claims from each of the ten Subject Facilities (Discovery Samples) and conduct the MDS Review (as defined below). The Paid Claims shall be reviewed based on the supporting documentation available at Extendicare’s offices or under Extendicare’s control and applicable billing and coding regulations and guidance to determine whether the claim was correctly coded, submitted, and reimbursed. If the Error Rate (as defined above) for a Discovery Sample is less than 5%, no additional sampling is required for that Subject Facility, nor is the MDS Systems Review, required. (Note: The guidelines listed above do not imply that this is an acceptable error rate. Accordingly, Extendicare should, as appropriate, further analyze any errors identified in the Discovery Samples. Extendicare recognizes that OIG or other HHS component, in its discretion and as authorized by statute, regulation, or other appropriate authority may also analyze or review Paid Claims included, or errors identified, in the Discovery Samples or any other segment of the universe.)
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Discovery Samples. The IRO shall conduct two Discovery Samples, reviewing a total of 200 randomly selected Paid Claims (Discovery Samples). In the first Discovery Sample the IRO shall randomly select and review a sample of 100 Paid Claims from the Medicare Population. In the second Discovery Sample the IRO shall randomly select and review a sample of 100 Paid Claims from the Focus State Medicaid Population. In both Discovery Samples the Paid Claims shall be reviewed based on the supporting documentation available at ▇▇▇▇▇▇▇▇’▇ office or under ▇▇▇▇▇▇▇▇’▇ control and applicable billing and coding regulations and guidance to determine whether the claim was correctly coded, submitted, and reimbursed. If the Error Rate (as defined above) for both Discovery Samples is less than 5%, no additional sampling is required, nor is the Systems Review required. (Note: The guidelines listed above do not imply that this is an acceptable error rate. Accordingly, ▇▇▇▇▇▇▇▇ should, as appropriate, further analyze any errors identified in the Discovery Samples. ▇▇▇▇▇▇▇▇ recognizes that OIG or other HHS component, in its discretion and as authorized by statute, regulation, or other appropriate authority may also analyze or review Paid Claims included, or errors identified, in the Discovery Samples or any other segment of the universe.)
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Discovery Samples. The IRO shall randomly select eight (8) hospital units where Pediatrix provides neonatal critical and intensive care services. For each of the eight (8) units selected, the IRO shall randomly select thirty (30) Paid Claims for each unit. The IRO shall review the 240 Paid Claims selected for review (30 per unit) to determine whether the claim was correctly coded, submitted, and reimbursed based on the supporting documentation and applicable billing and coding regulations and guidance. i. If the Error Rate (as defined in Appendix B) for the Discovery Sample for any hospital unit is less than 5%, no additional sampling is required for that hospital unit, nor is the Systems Review required. (Note: The guidelines listed above do not imply that this is an acceptable error rate. Accordingly, Pediatrix should, as appropriate, further analyze any errors identified in the Discovery Sample. Pediatrix recognizes that OIG or other HHS component, in its discretion and as authorized by statute, regulation, or other appropriate authority may also analyze or review Paid Claims included, or errors identified, in the Discovery Sample or any other segment of the universe.) Pediatrix Medical Group, Inc. Corporate Integrity Agreement ii. If the Discovery Sample indicates that the Error Rate is 5% or greater for any one hospital unit, the IRO shall perform a Full Sample and a Systems Review for that hospital unit, as described below.
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Discovery Samples. The IRO shall randomly select and review a sample of 100 Paid Claims from Acute Care (Acute Care Discovery Sample) and 50 Paid Claims from Post-Acute Care (Post-Acute Discovery Sample). The Paid Claims shall be reviewed based on the supporting documentation (available at Sound’s office, at the contracted treating hospitals and post acute care facilities, and/or under Sound’s control), and applicable billing and coding regulations and guidance to determine whether the claim was correctly coded, submitted, and reimbursed. If the Error Rate (as defined above) for a Discovery Sample is less than 5%, no additional sampling is required, nor is the Systems Review required. (Note: The guidelines listed above do not imply that this is an acceptable error rate. Accordingly, Sound should, as appropriate, further analyze any errors identified in a Discovery Sample. Sound recognizes that OIG or other HHS component, in its discretion and as authorized by statute, regulation, or other appropriate authority may also analyze or review Paid Claims included, or errors identified, in a Discovery Sample or any other segment of the universe.)
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Discovery Samples. The IRO shall randomly select and review a sample of 50 Paid Claims each from LWCIT and LWCCA.
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Discovery Samples. The IRO shall randomly select and review a sample of 50 Paid Claims for one of the two Baptist hospitals (BHMC-NLR or BHMC- LR) in each reporting year (Discovery Sample). In the first reporting year, the IRO shall randomly select and review the Discovery Sample from BHMC-NLR. In the second reporting year, the IRO shall randomly select and review the Discovery Sample from BHMC-LR. In the third reporting year the IRO shall randomly select and review the Discovery Sample from BHMC-NLR. In the fourth reporting year the IRO shall randomly select and review the Discovery Sample from BHMC-LR. In the fifth reporting year the IRO shall randomly select and review the Discovery Sample from BHMC-NLR. The Paid Claims shall be reviewed based on the supporting documentation available at Baptist’s office or under Baptist’s control and applicable billing and coding regulations and guidance to determine whether the claim was correctly coded, submitted, and reimbursed. If the Error Rate (as defined above) for any Discovery Sample is less than 5%, no additional sampling is required, nor is the Systems Review required. (Note: The guidelines listed above do not imply that this is an acceptable error rate. Accordingly, Baptist should, as appropriate, further analyze any errors identified in each Discovery Samples. Baptist recognizes that OIG or other HHS component, in its discretion and as authorized by statute, regulation, or other appropriate authority may also analyze or review Paid Claims included, or errors identified, in each Discovery Sample or any other segment of the universe.)
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Discovery Samples. At the end of each Reporting Period, the IRO shall select a statistically valid random sample of six Pharmacies from the Pharmacy Population. For each Selected Pharmacy, the IRO shall select a statistically valid random sample of 100 Prescriptions from the Prescription Population (Discovery Sample). The IRO shall review whether the Schedule II Controlled Substances were dispensed in accordance with applicable provisions of the Controlled Substances Act, state statutes, and federal and state regulations and guidance, based on the supporting documentation available at the Selected Pharmacy. If the Error Rate (as defined above) for a Discovery Sample is less than 5%, no additional sampling is required, nor is the Systems Review required. (Note: The guidelines listed above do not imply that this is an acceptable error rate. Accordingly, PharMerica should, as appropriate, further analyze any errors identified in the Discovery Samples. PharMerica recognizes that OIG or other HHS component, in its discretion and as authorized by statute, regulation, or other appropriate authority may also analyze or review Paid Prescription included, or errors identified, in the Discovery Samples or any other segment of the universe.)
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Discovery Samples. For each Office Set, the IRO shall randomly select and review a sample of 60 Paid Claims selected from the aggregate population of Paid Claims for that Office Set’s Discovery Sample. The Paid Claims shall be reviewed based on the supporting documentation available at Maxim’s office or under Maxim’s control and applicable billing and coding regulations and guidance to determine whether the claim was correctly coded, submitted, and reimbursed. If the Error Rate (as defined above) for a Discovery Sample is less than 5%, no additional sampling is required, nor is a Systems Review required. (Note: The guidelines listed above do not imply that this is an acceptable error rate. Accordingly, Maxim should, as appropriate, further analyze any errors identified in any Discovery Sample. Maxim recognizes that OIG or other HHS component, in its discretion and as authorized by statute, regulation, or other appropriate authority may also analyze or review Paid Claims included, or errors identified, in any Discovery Sample or any other segment of the universe.)
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Related to Discovery Samples

  • SHOP DRAWINGS, PRODUCT DATA AND SAMPLES 4.12.1 Shop Drawings are drawings, diagrams, schedules and other, data specially prepared for the Work by the Contractor or any Subcontractor, manufacturer, supplier or distributor to illustrate some portion of the Work. 4.12.2 Product Data are illustrations, standard schedules, performance charts, instructions, brochures, diagrams and other information furnished by the Contractor to illustrate a material, product or system for some portion of the Work. 4.12.3 Samples are physical examples which illustrate materials, equipment or workmanship and establish standards by which the Work will be judged. 4.12.4 The Contractor shall review, approve and submit, with reasonable promptness and in such sequence as to cause no delay in the Work or in the work of the State or any separate contractor, all Shop Drawings, Product Data and Samples required by the Contract Documents. 4.12.5 By approving and submitting Shop Drawings, Product Data and Samples, the Contractor represents that he / she has determined and verified all materials, field measurements, and field construction criteria related thereto, or will do so, and that he / she has checked and coordinated the information contained within such submittals with the requirements of the Work and of the Contract Documents. 4.12.6 The Contractor shall not be relieved of responsibility for any deviation from the requirements of the Contract Documents by the Architect's approval of Shop Drawings, Product Data or Samples under Subparagraph 2.2.7 of these General Conditions unless the Contractor has specifically informed the Architect and the State in writing of such deviation at the time of sub- mission and the Architect and the State has given written approval to the specific deviation. The Contractor shall not be relieved from responsibility for errors or omissions in the Shop Drawings, Product Data or Samples by the Architect's approval thereof. 4.12.7 The Contractor shall direct specific attention, in writing or on resubmitted Shop Drawings, Product Data or Samples, to revisions other than those requested by the Architect on previous submittals. 4.12.8 No portion of the Work requiring submission of a Shop Drawing, Product Data or Sample shall be commenced until the submittal has been approved by the Architect as provided in Subparagraph 2.2.7 of these General Conditions. All such portions of the Work shall be in accordance with approved submittals.

  • Product Testing No later than [**] prior to a scheduled Delivery ARIAD US shall send to ARIAD SWISSCO the Delivery Documents for review. Following such review, unless within [**] of receipt of the Delivery Documents ARIAD SWISSCO gives written notice of rejection of the Product to be delivered, stating the reasons for such rejection, the Delivery shall proceed, and both Parties shall organize the same. Upon arrival at ARIAD SWISSCO nominated site it shall visually inspect the shipment of the Product to identify any damage to the external packaging. ARIAD SWISSCO may reject any shipment (or portion thereof) of the Product that is damaged by providing to ARIAD US reasonable evidence of damage within [**] after Delivery of such Product. If ARIAD SWISSCO does not so reject any shipment (or portion thereof) of the Product within [**] of Delivery of such Product, ARIAD SWISSCO shall be deemed to have accepted such shipment of the Product; provided, however, that in the case of the Product having any Latent Defect, ARIAD SWISSCO shall notify ARIAD US promptly once it becomes aware that a Product contains a Latent Defect and subsequently may reject such Product by giving written notice to ARIAD US of ARIAD SWISSCO’s rejection of such Product and shipping a representative sample of such Product or other evidence of Non-Conformance to ARIAD US within [**] after becoming aware of such Latent Defect, which notice shall include a description of the Latent Defect.

  • Review of Materials During the term of this Agreement, Client shall ensure that all prospectuses, statements of additional information, registration statements, proxy statements, reports to shareholders, advertising and sales literature or other materials prepared for distribution to Fund shareholders or the public, which refer to the Subadviser in any way, prepared by employees or agents of Client or its affiliates are consistent with information previously provided by Subadviser. Subadviser shall promptly notify the Client of any changes to information pertaining to the Subadviser and stated in the materials described in this Section 6(g).

  • Samples The Contractor shall submit the following samples of Materials and relevant information to the Authority’s Engineer for pre-construction review: (a) manufacturer's test reports and standard samples of manufactured Materials; and (b) samples of such other Materials as the Authority’s Engineer may require.

  • RE-WEIGHING PRODUCT Deliveries are subject to re- weighing at the point of destination by the Authorized User. If shrinkage occurs which exceeds that normally allowable in the trade, the Authorized User shall have the option to require delivery of the difference in quantity or to reduce the payment accordingly. Such option shall be exercised in writing by the Authorized User.