Recovery audit contractor definition

Recovery audit contractor means a medicaid recovery audit contractor selected by the department

Recovery audit contractor means a medicaid recovery audit contractor selected by the department to perform audits for the purpose of ensuring medicaid program integrity in accordance with 42 CFR, part 455.

Recovery audit contractor or “RAC” has the meaning given in Exhibit 2-B, Section 1. “Redetermination” means first level of the appeals process for a Medicare claim where a provider does not agree with the initial claim decision by Medicare. “Reference Date” has the meaning given in Section 18.2(c)(ix). “Remittance Advice” or “RA” means a document supplied by a health insurance company or government payer that provides notice of and explains reasons for payment, adjustment, denial and/or uncovered charges of a medical claim. “Reports” has the meaning given in Section 9.2(a). “Required Consents” means the consents (if any) required to be obtained: (i) to assign or transfer to Supplier, or obtain for Supplier the right to use and/or access, any Ascension Health licensed Third Party Software, Third Party Contracts or Equipment Leases; (ii) to grant Supplier the right to use and/or access the Ascension Health licensed Third Party Software in connection with providing the Services; (iii) to grant Ascension Health and the Eligible Recipients the right during the Term, the applicable Supplement Term and any Disengagement Services period to use and/or access the Supplier Owned Software, Third Party Software and Equipment acquired, operated, supported or used by Supplier in connection with providing the Services; (iv) to assign or transfer to Ascension Health, the Eligible Recipients or their designee any Developed Materials, Supplier Owned Software, Third Party Software, Third Party Contracts, Equipment Leases or other rights following the Term or the applicable Supplement Term to the extent provided in this Agreement; and (v) all other consents required from third parties in connection with Supplier’s provision of the Services or performance of its obligations hereunder. “Required Divestiture Election Notice Period” has the meaning given in Section 4.6(b). “Required Equipment” has the meaning given in Section 10.1(c)(ii). “Resources” has the meaning given in Section 4.1(c). “Replacement Period” has the meaning given in Section 18.2(c)(ix)(3). “Restricted Subcontractor” shall mean any Subcontractors that: (i) provide services or Resources that relate to: (A) Eligible Recipient banking relationships; (B) software used by Eligible Recipients for scheduling, electronic medical records, patient accounting, and the delivery of patient care; (C) payors; (D) real estate owned or leased by Eligible Recipients; or (E) products or services provided to multiple areas within Eligible Recipients with th...

Examples of Recovery audit contractor in a sentence

• Recovery audit contractor (RAC) services.Fraud, waste and abuse detection and identification of improper payments through claim/billing reviews.Medicaid policy consulting.Pharmacy claims and pharmacy benefit manager (PBM) audits.

• Recovery audit contractor means private entities with which the department contracts to audit claims for medical assistance, identify underpayments and overpayments, and recoup overpayments.

• Recovery audit contractor audits and appeals at three academic medical centers.

• Z., et al, Recovery audit contractor audits and appeals at three academic medical centers.

• The preparation of insiders‟ lists could possibly be outsourced but the issuer continues to be liable as provided for in the guidance paper under para 16.

• Recovery audit contractor means private entities with which the depart- ment contracts to audit claims for medical assistance, identify underpayments and overpayments, and recoup overpayments.

• The student’s intellectual functioning is in the moderate range of intellectual disability and reads at the level of *** grade.