Discovery Sample. The IRO shall select and review a Discovery Sample of Medicare beneficiaries as described below in Sections 3 and 4. The medical records for the Medicare beneficiaries selected shall be reviewed based on the supporting documentation available at Good Shepherd’s offices or under Good Shepherd’s control and applicable billing and coding regulations and guidance to determine whether the beneficiary was eligible for the hospice benefit and whether all claims for hospice services furnished to the beneficiary were correctly coded, submitted, and reimbursed.
Appears in 5 contracts
Samples: Corporate Integrity Agreement, Corporate Integrity Agreement, Corporate Integrity Agreement
