Common use of Discovery Sample Clause in Contracts

Discovery Sample. The IRO shall randomly select and review a sample of 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 on the supporting documentation available at Dignity Health’s office or under Dignity 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, Dignity Health shall, as appropriate, further analyze any errors identified in the Discovery Sample. 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 100 50 Paid Claims (each constituting a “Discovery Sample”) from each of three randomly selected facilities owned or operated by the Population at each Covered Facility selected for reviewDIG Entities. The Paid Claims shall be reviewed based on the supporting documentation available at Dignity Health’s the DIG Entities’ office or under Dignity Health’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 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, Dignity Health shallthe DIG Entities should, as appropriate, further analyze any errors identified in the a Discovery Sample. Dignity Health recognizes The 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.)