Quantitative Results i. Total number and percentage of instances in which the IRO determined that the Paid Claims submitted by CHSI (Claim Submitted) differed from what should have been the correct claim (Correct Claim), regardless of the effect on the payment.
Quantitative Results i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims differed from what should have been the correct coding and in which such difference resulted in an Overpayment.
Quantitative Results i. Total number and percentage of instances in which the IRO determined that the Paid Claims submitted by Dignity Health (Claim Submitted) differed from what should have been the correct claim (Correct Claim), regardless of the effect on the payment.
Quantitative Results i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by CHN differed from what should have been the correct coding.
Quantitative Results i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Progenity differed from what should have been the correct coding and in which such difference resulted in an Overpayment to Progenity.
Quantitative Results. For each Claims Review Sample, the IRO shall provide the following information:
Quantitative Results i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by LHMC differed from what should have been the correct coding and in which such difference resulted in an Overpayment to LHMC.
Quantitative Results i. Total number and percentage of instances in which the IRO determined that the documentation for a Medicare beneficiary did not support that the beneficiary was eligible for the Medicare hospice benefit or did not support that the beneficiary received the appropriate Level of Services based on medical necessity, regardless of the effect on the payment.
Quantitative Results i. Total number and percentage of instances in which the IRO determined that the Paid Claims submitted by Xxxxx was improperly coded, submitted, reimbursed, or was not medically necessary or appropriate (Claim Submitted) differed from what should have been the correct claim (Correct Claim), regardless of the effect on the payment.
Quantitative Results i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Practitioner differed from what should have been the correct coding and in which such difference resulted in an Overpayment to Practitioner.
