Common use of Discovery Sample Clause in Contracts

Discovery Sample. The IRO shall randomly select and review a sample of 50 Paid Claims (Discovery Sample). The Paid Claims shall be reviewed based Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement- Appendix B on the supporting documentation available at the Provider’s office or under Provider’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 the 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, the Provider should, as appropriate, further analyze any errors identified in the Discovery Sample. The Provider 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.)

Discovery Sample. The IRO shall randomly select and review a sample of 50 100 Paid Claims (each constituting a “Discovery Sample)”) from the Population at each Covered Facility selected for review. The Paid Claims shall be reviewed based Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement- Appendix B on the supporting documentation available at the ProviderDignity Health’s office or under ProviderDignity Health’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 the Discovery Sample for any Covered Facility 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, the Provider shouldDignity Health shall, as appropriate, further analyze any errors identified in the Discovery Sample. The Provider Dignity Health 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.)

Discovery Sample. The IRO shall randomly select and review a sample of 50 Paid Claims (each constituting a “Discovery Sample)”) at each CHSI Covered Facility selected for review. The Paid Claims shall be reviewed based Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement- Appendix B on the supporting documentation available at the ProviderCHSI’s office or under ProviderCHSI’s control and applicable billing and coding coding, regulations and guidance to determine whether the claim was correctly coded, submitted, and reimbursed. If the Error Rate (as defined above) for the any Discovery Sample for any CHSI Covered Facility 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, the Provider CHSI should, as appropriate, further analyze any errors identified in the Discovery Sample. The Provider CHSI 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.)

Discovery Sample. The IRO shall randomly select and review a sample of 50 100 Paid Claims (Discovery Sample)) from the Population at each Review Facility selected for review. The Paid Claims shall be reviewed based Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement- Appendix B on the supporting documentation available at the ProviderCHN’s office or under ProviderCHN’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 the Discovery Sample for a selected Review Facility is less than 5%, no additional sampling is required, nor is the Systems Review requiredrequired for that Review Facility. (Note: The guidelines listed above do not imply that this is an acceptable error rate. Accordingly, the Provider shouldCHN shall, as appropriate, further analyze any errors identified in the Discovery Sample. The Provider CHN 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.)

Discovery Sample. The IRO shall randomly select and review a sample of 50 Paid Claims (Discovery Sample)) from each of three randomly selected facilities owned or operated by the DIG Entities. The Paid Claims shall be reviewed based Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement- Appendix B on the supporting documentation available at the Provider’s DIG Entities’ office or under Provider’s the DIG Entities’ 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 the 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, the Provider DIG Entities should, as appropriate, further analyze any errors identified in the a Discovery Sample. The Provider recognizes DIG Entities recognize that OIG or other another 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 a Discovery Sample or any other segment of the universe.)