Claims Review Findings. a. Narrative Results. i. A description of Numotion’s billing and coding system(s), including the identification, by position description, of the personnel involved in coding and billing. ii. A description of controls in place at Numotion to ensure that all items and services furnished by Numotion are correctly coded, appropriately documented, and medically necessary. iii. A narrative explanation of the results of the IRO’s review of the Claims Review Sample, including an explanation of all errors identified by the IRO. b. Quantitative Results. i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Numotion differed from what should have been the correct coding. ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented. iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that were not medically necessary. iv. Total dollar amount of Paid Claims included in the Claims Review Sample and the net Overpayment associated with the Claims Review Sample. v. Error Rate in the Claims Review Sample.
Appears in 1 contract
Samples: Corporate Integrity Agreement
Claims Review Findings. a. Narrative Results.
i. A description of Numotion’s Xx. Xxxxx’x billing and coding system(s), including the identification, by position description, of the personnel involved in coding and billing.
ii. A description of controls in place at Numotion Xx. Xxxxx to ensure that all items and services furnished by Numotion Xx. Xxxxx are correctly coded, appropriately documented, and medically necessary.
iii. A narrative explanation of the results of the IRO’s review of the Claims Review Sample, including an explanation of all errors identified by the IRO.
b. Quantitative Results.
i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Numotion Xx. Xxxxx differed from what should have been the correct coding.
ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented.
iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that were not medically necessary.
iv. Total dollar amount of Paid Claims included in the Claims Review Sample and the net Overpayment associated with the Claims Review Sample.
v. Error Rate in the Claims Review Sample.
Appears in 1 contract
Samples: Integrity Agreement
Claims Review Findings. a. Narrative Results.
i. A description of NumotionSilver Lake’s billing and coding system(s), including the identification, by position description, of the personnel involved in coding and billing.
ii. A description of controls in place at Numotion Silver Lake to ensure that all items and services furnished by Numotion Silver Lake are correctly coded, appropriately documented, and medically necessary.
iii. A narrative explanation of the results of the IRO’s review of the Claims Review Sample, including an explanation of all errors identified by the IRO.
b. Quantitative Results.
i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Numotion Silver Lake differed from what should have been the correct coding.
ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented.
iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that were not medically necessary.
iv. Total dollar amount of Paid Claims included in the Claims Review Sample and the net Overpayment associated with the Claims Review Sample.
v. Error Rate in the Claims Review Sample.
Appears in 1 contract
Samples: Corporate Integrity Agreement
Claims Review Findings. a. Narrative Results.
i. A description of NumotionTauth’s billing and coding system(s), including the identification, by position description, of the personnel involved in coding and billing.
ii. A description of controls in place at Numotion Tauth to ensure that all items and services furnished by Numotion Tauth are correctly coded, appropriately documented, and medically necessary.
iii. A narrative explanation of the results of the IRO’s review of the Claims Review Sample, including an explanation of all errors identified by the IRO.
b. Quantitative Results.
i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Numotion Tauth differed from what should have been the correct coding.
ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented.
iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that were not medically necessary.
iv. Total dollar amount of Paid Claims included in the Claims Review Sample and the net Overpayment associated with the Claims Review Sample.Sample.
v. Error Rate in the Claims Review Sample.
Appears in 1 contract
Samples: Integrity Agreement
Claims Review Findings. a. Narrative Results.
i. A description of NumotionDOCS’s billing and coding system(s), including the identification, by position description, of the personnel involved in coding and billing.
ii. A description of controls in place at Numotion DOCS to ensure that all items and services furnished by Numotion DOCS are correctly coded, appropriately documented, and medically necessary.
iii. A narrative explanation of the results of the IRO’s review of the Claims Review Sample, including an explanation of all errors identified by the IRO.IRO.
b. Quantitative Results.
i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Numotion DOCS differed from what should have been the correct coding.
ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented.
iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that were not medically necessary.
iv. Total dollar amount of Paid Claims included in the Claims Review Sample and the net Overpayment associated with the Claims Review Sample.
v. Error Rate in the Claims Review Sample.
Appears in 1 contract
Samples: Integrity Agreement
Claims Review Findings. a. Narrative Results.
i. A description of NumotionCFS’s billing and coding system(s), including the identification, by position description, of the personnel involved in coding and billing.
ii. A description of controls in place at Numotion CFS to ensure that all items and services furnished by Numotion CFS are correctly coded, appropriately documented, and medically necessary.
iii. A narrative explanation of the results of the IRO’s review of the Claims Review Sample, including an explanation of all errors identified by the IRO.
b. Quantitative Results.
i. Total number and percentage of instances in which the IRO determined that the coding of the Paid Claims submitted by Numotion CFS differed from what should have been the correct coding.
ii. Total number and percentage of instances in which the IRO determined that a Paid Claim was not appropriately documented.
iii. Total number and percentage of instances in which the IRO determined that a Paid Claim was for items or services that were not medically necessary.
iv. Total dollar amount of Paid Claims included in the Claims Review Sample and the net Overpayment associated with the Claims Review Sample.
v. Error Rate in the Claims Review Sample.
Appears in 1 contract
Samples: Integrity Agreement