Auditing of Delivery Payments. A delivery payment audit will be conducted periodically. If medical records do not substantiate that a delivery occurred related to the payment that was made, then ODJFS will recoup the delivery payment from the MCP. Also, if it is determined that the encounter which triggered the delivery payment was not a paid encounter, then ODJFS will recoup the delivery payment.
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Samples: CFC Provider Agreement (Wellcare Health Plans, Inc.), Provider Agreement (Molina Healthcare Inc), Ohio Medical Assistance Provider Agreement for Managed Care Plan (Wellcare Health Plans, Inc.)
Auditing of Delivery Payments. A delivery payment audit will be conducted periodically. If medical records do not substantiate that a delivery occurred related to the payment that was made, . then ODJFS will recoup the delivery payment from the MCP. Also, if it is determined that the encounter which triggered the delivery payment was not a paid encounter, then ODJFS will recoup the delivery payment.
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