PI Audit definition
PI Audit each means, but is not limited to, the review of Medicaid claims for suspicious aberrancies to establish evidence that fraud, waste, or abuse has occurred, is likely to occur, or whether actions of individuals or entities have the potential for resulting in an expenditure of Medicaid funds which is not intended under the provisions of this Contract, State or Federal Medicaid regulations, and whether improper payment has occurred.
Examples of PI Audit in a sentence
Sellers shall be solely responsible for all out of pocket costs and expenses arising out of or incurred in connection with such PI Audit appeals or Commercial Payor Audits or administrative actions, including any responses required in connection therewith.
For the avoidance of doubt, in no event shall Purchaser be responsible for any liabilities arising out of a PI Audit or Commercial Payor Audit with respect to patients with dates of service prior to the Closing Date, all of which liabilities are Retained Liabilities hereunder.