Common use of Chart Review Clause in Contracts

Chart Review. The IRO shall review diagnosis code data submitted by BMG to Medicare Advantage organizations and the medical records for certain Medicare beneficiaries enrolled in Medicare Advantage plans to determine whether any diagnosis code data submitted to a Medicare Advantage organization for risk adjustment payment purposes is supported by and documented in the medical record and coded correctly (Chart Review) and shall prepare a Chart Review Report, as outlined in Appendix B to this CIA, which is incorporated by reference.‌

Chart Review. The IRO shall review diagnosis code data submitted by BMG Sutter to Medicare Advantage organizations and the medical records for certain Medicare beneficiaries enrolled in Medicare Advantage plans to determine whether any diagnosis code data submitted to a Medicare Advantage organization for risk adjustment payment purposes is supported by and documented in the medical record and coded correctly (Chart Review) and shall prepare a Chart Review Report, as outlined in Appendix B to this CIA, which is incorporated by reference.‌