Auditing of Delivery Payments. A delivery payment audit will be conducted periodically. If medical records do not substantiate that a delivery occurred related to the payment that was made, then ODJFS will recoup the delivery payment from the MCP. Also, if it is determined that the encounter which triggered the delivery payment was not a paid encounter, then ODJFS will recoup the delivery payment.
Appears in 8 contracts
Samples: Provider Agreement (Molina Healthcare Inc), Ohio Medical Assistance Provider Agreement for Managed Care Plan (Wellcare Health Plans, Inc.), Ohio Medical Assistance Provider Agreement for Managed Care Plan (Molina Healthcare Inc)
Auditing of Delivery Payments. A delivery payment audit will be conducted periodically. If medical records do not substantiate that a delivery occurred related to the payment that was made, . then ODJFS will recoup the delivery payment from the MCP. Also, if it is determined that the encounter which triggered the delivery payment was not a paid encounter, then ODJFS will recoup the delivery payment.
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