Quarterly Claims Review. The IRO shall conduct a review of Xxxxx’s claims submitted to and reimbursed by the Medicare and Medicaid programs, to determine whether the items and services furnished were medically necessary and appropriately documented, and whether the claims were correctly coded, billed, and reimbursed, for each three-month period during the term of this IA (Quarterly Claims Review) and prepare a report for each Quarterly Claims Review performed. The first three-month period shall begin 30 days following the Effective Date of this IA.
Quarterly Claims Review. The IRO shall conduct a review of Xx. Xxxxxx-Xxxxxx D.P.M.’s claims submitted to and reimbursed by the Medicare and Medicaid programs, to determine whether the items and services furnished were medically necessary and appropriately documented, and whether the claims were correctly coded, billed, and reimbursed, for each three-month period during the term of this IA (Quarterly Claims Review) and prepare a report for each Quarterly Claims Review performed. The first three-month period shall begin 30 days following the Effective Date of this IA.
Quarterly Claims Review. The IRO shall conduct a review of LCPCC’s claims submitted to and reimbursed by the Medicare and Medicaid programs, to determine whether: (1) the prescription drugs furnished by LCPCC were dispensed according to a valid prescription, (2) LCPCC maintained appropriate documentation of a valid prescription for each drug dispensed (including any refills of such drug), and (3) whether the claims were correctly billed and reimbursed, for each three-month period during the term of this IA (Quarterly Claims Review) and prepare a report for each Quarterly Claims Review performed. The first three-month period shall begin 30 days following the Effective Date of this IA.
Quarterly Claims Review. The IRO shall conduct a review of Hanflink’s claims submitted to and reimbursed by the Medicare and Medicaid programs, to determine whether the items and services furnished were medically necessary and appropriately documented, and whether the claims were correctly coded, billed, and reimbursed, for each three-month period during the term of this IA (Quarterly Claims Review) and prepare a report for each Quarterly Claims Review performed. The first three-month period shall begin 30 days following the Effective Date of this IA.
Quarterly Claims Review. The IRO shall conduct a review of Xxxxx Xxxxxxxx’s claims submitted to and reimbursed by the Medicare and Medicaid programs, to determine whether: (1) the prescription drugs furnished by Xxxxx Xxxxxxxx were dispensed according to a valid prescription, (2) Xxxxx Pharmacy maintained appropriate documentation of a valid prescription for each drug dispensed (including any refills of such prescription), (3) the claims were correctly billed and reimbursed, and (4) Xxxxx Pharmacy appropriately collected or waived cost-sharing amounts, for each three-month period during the term of this IA (Quarterly Claims Review) and prepare a report for each Quarterly Claims Review performed. The first three-month period shall begin 30 days following the Effective Date of this IA.
Quarterly Claims Review. The IRO shall conduct a review of LFAC’s claims submitted to and reimbursed by the Medicare and Medicaid programs, to determine whether the items and services furnished were medically necessary and appropriately documented (including that underlying records are not duplicated or cloned), and whether the claims were correctly coded, billed, and reimbursed, for each three-month period during the term of this IA (Quarterly Claims Review) and prepare a report for each Quarterly Claims Review performed. The first three-month period shall begin 30 days following the Effective Date of this IA.
Quarterly Claims Review. The IRO shall conduct a review of Xxxxx’x coding, billing, and claims submission to the Federal health care programs, and the reimbursement received, for each three-month period during the term of this IA (Quarterly Claims Review) and prepare a report for each Quarterly Claims Review performed. The first three-month period shall begin 30 days following the Effective Date of this IA.
Quarterly Claims Review. The IRO shall conduct a review of Krentel’s coding, billing, and claims submission to the Federal health care programs, and the reimbursement received, for each three-month period during the term of this IA (Quarterly Claims Review) and prepare a report for each Quarterly Claims Review performed. The first three-month period shall begin 30 days following the Effective Date of this IA.
Quarterly Claims Review. The IRO shall conduct a review of Xx. Xxxxxxxx’x claims submitted to and reimbursed by the Medicare and Medicaid programs, to determine whether the items and services furnished were medically necessary and appropriately documented, and whether the claims were correctly coded, billed, and reimbursed, for each three-month period during the term of this IA (Quarterly Claims Review) and prepare a report for each Quarterly Claims Review performed. The first three-month period shall begin 30 days following the Effective Date of this IA.
Quarterly Claims Review. The IRO shall conduct a review of DLDC’s claims for procedures performed at Memorial Hermann Endoscopy and Surgery Center North Houston LLC submitted to and reimbursed by the Medicare and Medicaid programs, to determine whether the items and services furnished were medically necessary, medically appropriate, and appropriately documented, and whether the claims were correctly coded, billed, and reimbursed, for each three-month period during the term of this IA (Quarterly Claims Review) and prepare a report for each Quarterly Claims Review performed. The first three-month period shall begin 30 days following the Effective Date of this IA.
