Common use of Recommendations Clause in Contracts

Recommendations. The IRO’s report shall include any recommendations for improvements to Xxxxxx’x billing and coding system or to Xxxxxx’x controls for ensuring that all items and services billed to Federal health care programs are appropriately documented, based on the findings of the Claims Review.

Recommendations. The IRO’s report shall include any recommendations for improvements to Xxxxxx’x the Covered Entities’ billing and coding system or to Xxxxxx’x the Covered Entities’ controls for ensuring that all items and services billed to Federal health care programs Medicare or a state Medicaid program are medically necessary and appropriately documented, based on the findings of the Quarterly Claims Review.Review.‌

Recommendations. The IRO’s report shall include any recommendations for improvements to Xxxxxx’x Dr. Xxxxxxx’s billing and coding system or to Xxxxxx’x Dr. Xxxxxxx’s controls for ensuring that all items and services billed to Federal health care programs Medicare or a state Medicaid program are medically necessary and appropriately documented, based on the findings of the Quarterly Claims Review.Review.‌‌

Recommendations. The IRO’s report shall include any recommendations for improvements to Xxxxxx’x Dr. Muttath’s billing and coding system or to Xxxxxx’x Dr. Muttath’s controls for ensuring that all items and services billed to Federal health care programs Medicare or a state Medicaid program are medically necessary and appropriately documented, based on the findings of the Quarterly Claims Review.Review.‌‌

Recommendations. The IRO’s report shall include any recommendations for improvements to Xxxxxx’x Xxxxxx’s billing and coding system or to Xxxxxx’x Xxxxxx’s controls for ensuring that all items and services billed to Federal health care programs the Medicare program by Xxxxxx are correctly coded, appropriately documented, and medically necessary, based on the findings of the Claims Review.Review.‌

Recommendations. The IRO’s report shall include any recommendations for improvements to Xxxxxx’x TEN’s billing and coding system or to Xxxxxx’x TEN’s controls for ensuring that all items and services billed to Federal health care programs the Medicare program by TEN are correctly coded, appropriately documented, and medically necessary, based on the findings of the Claims Review.Review.‌‌

Recommendations. The IRO’s report shall include any recommendations for improvements to Xxxxxx’x LFAC’s billing and coding system or to Xxxxxx’x LFAC’s controls for ensuring that all items and services billed to Federal health care programs Medicare or a state Medicaid program are medically necessary and appropriately documented, based on the findings of the Quarterly Claims Review.

Recommendations. The IRO’s report shall include any recommendations for improvements to Xxxxxx’x the Practice’s billing and coding system or to Xxxxxx’x the Practice’s controls for ensuring that all items and services billed to Federal health care programs are Medicare or a state Medicaid program are‌‌ medically necessary and appropriately documented, based on the findings of the Quarterly Claims Review.Review.‌‌

Recommendations. The IRO’s report shall include any recommendations for improvements to Xxxxxx’x Provider’s billing and coding system or to Xxxxxx’x Provider’s controls for ensuring that all items and services billed to Federal health care programs Medicare or a state Medicaid program are medically necessary and appropriately documented, based on the findings of the Quarterly Claims Review.

Recommendations. The IRO’s report shall include any recommendations for improvements to Xxxxxx’x Provider’s billing and coding system or to Xxxxxx’x Provider’s controls for ensuring that all items and services billed to Federal health care programs the Medicare program by Provider are correctly coded, appropriately documented, and medically necessary, based on the findings of the Claims Review.Review.‌‌

Recommendations. The IRO’s report shall include any recommendations for improvements to Xxxxxx’x Align’s billing and coding system or to Xxxxxx’x Align’s controls for ensuring that all items and services billed to Federal health care programs Medicare or a state Medicaid program are medically necessary and appropriately documented, based on the findings of the Quarterly Claims Review.Review.‌‌

Recommendations. The IRO’s report shall include any recommendations for improvements to Xxxxxx’x DOCS’s billing and coding system or to Xxxxxx’x DOCS’s controls for ensuring that all items and services billed to Federal health care programs the Medicaid‌‌ program by DOCS are correctly coded, appropriately documented, and medically necessary, based on the findings of the Claims Review.Review.‌

Recommendations. The IRO’s report shall include any recommendations for improvements to Xxxxxx’x Practitioner’s billing and coding system or to Xxxxxx’x Practitioner’s controls for ensuring that all items and services billed to Federal health care programs Medicare or a state Medicaid program are medically necessary and appropriately documented, based on the findings of the Quarterly Claims Review.Review.‌‌

Recommendations. The IRO’s report shall include any recommendations for improvements to Xxxxxx’x Providence’s billing and coding system or to Xxxxxx’x Providence’s controls for ensuring that all items and services billed to Federal health care programs Medicare or a state Medicaid program are medically necessary and appropriately documented, based on the the‌‌ findings of the Claims Review.

Recommendations. The IRO’s report shall include any recommendations for improvements to Xxxxxx’x Practitioner’s billing and coding system or to Xxxxxx’x Practitioner’s controls for ensuring that all items and services billed to Federal health care programs the Medicare program by Practitioner are correctly coded, appropriately documented, and medically necessary, based on the findings of the Claims Review.Review.‌

Recommendations. The IRO’s report shall include any recommendations for improvements to Xxxxxx’x SERA’s billing and coding system or to Xxxxxx’x SERA’s controls for ensuring that all items and services billed to Federal health care programs Medicare or a state Medicaid program are medically necessary and appropriately documented, based on the findings of the Claims Review.Review.‌‌

Recommendations. The IRO’s report shall include any recommendations for improvements to Xxxxxx’x Millcreek’s billing and coding system or to Xxxxxx’x Millcreek’s controls for ensuring that all items and services billed to Federal health care programs Medicare or a state Medicaid program are medically necessary and appropriately documented, based on the findings of the each Claims Review.Review.‌‌

Recommendations. The IRO’s report shall include any recommendations for improvements to Xxxxxx’x UHealth’s billing and coding system or to Xxxxxx’x UHealth’s controls for ensuring that all items and services billed to Federal health care programs Medicare or state Medicaid program are medically necessary and appropriately documented, and correctly coded, submitted and reimbursed (including but not limited to Place of Service coding), based on the findings of the Claims Review.

Recommendations. The IRO’s report shall include any recommendations for improvements to Xxxxxx’x the billing and coding system used to submit claims by or on behalf of Xxxxxxx USD Medical Center or to Xxxxxx’x the controls for ensuring that all items and services billed to Federal health care programs Medicare or a state Medicaid program by or on behalf of Xxxxxxx USD Medical Center are medically necessary and appropriately documented, based on the findings of the Claims Review.

Recommendations. The IRO’s report shall include any recommendations for improvements to Xxxxxx’x THM’s billing and coding system or to Xxxxxx’x THM’s controls for ensuring that all items and services billed to Federal health a state Medicaid program or Medicaid managed care programs program are medically necessary and appropriately documented, based on the findings of the Claims Review.Review.‌

Recommendations. The IRO’s report shall include any recommendations for improvements to Xxxxxx’x EPIPG’s billing and coding system or to Xxxxxx’x EPIPG’s controls for ensuring that all items and services billed to Federal health care programs Medicare or a state Medicaid program are medically necessary and appropriately documented, based on the findings of the Quarterly Claims Review.Review.‌‌

Recommendations. The IRO’s report shall include any recommendations for improvements to Xxxxxx’x EAP’s billing and coding coding‌‌ system or to Xxxxxx’x EAP’s controls for ensuring that all items and services billed to Federal health care programs a state Medicaid program or TRICARE are medically necessary and appropriately documented, based on the findings of the Claims Review.Review.‌‌

Recommendations. The IRO’s report shall include any recommendations for improvements to Xxxxxx’x Provider’s billing and coding system or to Xxxxxx’x Provider’s controls for ensuring that all items and services billed to Federal health care programs the Medicare program by Provider are correctly coded, appropriately documented, and medically necessary, based on the findings of the Claims Review.