Narrative Results Sample Clauses

Narrative Results i. For the first Quarterly Claims Review Report only, a description of (a) ▇▇▇▇▇ ▇▇▇▇▇▇▇▇’s claim submission system(s), including the identification, by position description, of the personnel involved in claim submission, and (b) a description of controls in place to ensure that all prescription drugs billed to Medicare or a state Medicaid program by ▇▇▇▇▇ ▇▇▇▇▇▇▇▇ are dispensed and billed in accordance with a valid prescription and that ▇▇▇▇▇ Pharmacy maintains documentation of such prescription records. Subsequent Quarterly Claims Review Reports should describe any significant changes to items (a) and (b) or, if no significant changes were made, state that the systems and controls remain the same as described in the prior Quarterly Claims Review Report. ii. A narrative explanation of the results of the Quarterly Claims Sample, including reasons for errors, patterns noted, etc.

Narrative Results i. A description of OFX’s billing and coding system(s), including the identification, by position description, of the personnel involved in coding and billing. ii. A narrative explanation of the IRO’s findings and supporting rationale (including reasons for errors, patterns noted, etc.) regarding the Claims Review, including the results of the Discovery Sample, and the results of the Full Sample (if any).

Narrative Results i. For the first Quarterly Claims Review Report only, a description of (a) ▇▇▇▇ Clinic’s billing and coding system(s), including the identification, by position description, of the personnel involved in coding and billing, and (b) a description of controls in place to ensure that all items and services billed to Medicare or a state Medicaid program by ▇▇▇▇ Clinic are medically necessary and appropriately documented. Subsequent Quarterly Claims Review Reports should describe any significant changes to items (a) and (b) or, if no significant changes were made, state that the systems and controls remain the same as described in the prior Quarterly Claims Review Report. ii. A narrative explanation of the results of the Quarterly Claims Sample, including reasons for errors, patterns noted, etc.

Narrative Results i. A description of Good Shepherd’s hospice eligibility certification, recertification, and determination of appropriate Level of Service processes, including the identification, by position description, of the personnel involved. ii. A narrative explanation of the IRO’s findings and supporting rationale (including reasons for errors, patterns noted, concerns relating to the eligibility for hospice or appropriateness of hospice services, etc.) regarding the Eligibility Review and Appropriate Level of Services Review.

Narrative Results i. A description of Progenity’s billing and coding system(s), including the identification, by position description, of the personnel involved in coding and billing. ii. A description of controls in place at Progenity to ensure that all items and services billed to Medicare or a state Medicaid program are medically necessary and appropriately documented. iii. A narrative explanation of the IRO’s findings and supporting rationale (including reasons for errors, patterns noted, etc.) regarding the Claims Review, including the results of the Claims Review Sample.

Narrative Results. A narrative explanation of the IRO’s findings and supporting rationale (including reasons for errors, patterns noted, etc.) regarding the Additional Items Review.

Narrative Results i. A description Extendicare’s billing and coding system(s) for submission of claims to Medicare Part A, including the identification, by position description, of the personnel involved in coding and billing. ii. A narrative explanation of the IRO’s findings and supporting rationale (including reasons for errors, patterns noted, etc.) regarding the MDS Review, including the results of the Discovery Sample, and the results of the Full Sample(s) (if any).

Narrative Results i. A description of CHSI’s admission, utilization review, billing and coding system(s), including the identification, by position description, of the personnel involved in level of care decisions, utilization review, coding and billing. ii. A narrative explanation of the IRO’s findings and supporting rationale (including reasons for errors, patterns noted, etc.) regarding the Inpatient Medical Necessity and Appropriateness Review, including the results of the Discovery Sample(s), and the results of the Full Sample(s) (if any).

Narrative Results i. A description of Provider’s billing and coding system(s), including the identification, by position description, of the personnel involved in coding and billing. ii. A description of controls in place at Provider to ensure that all items and services furnished by Provider are correctly coded, appropriately documented, and medically necessary. iii. A narrative explanation of the results of the IRO’s review of the Claims Review Sample, including an explanation of all errors identified by the IRO.