Common use of Discovery Sample Clause in Contracts

Discovery Sample. The IRO shall randomly select and review a sample of fifty (50) Paid Claims (Discovery Sample). The Paid Claims shall be reviewed based on the supporting documentation available at PALMS’s office or under PALMS’s control and applicable billing and coding regulations and guidance to determine whether the claim was correctly coded, submitted, and reimbursed. If the Error Rate (as defined above) for the Discovery Sample is less than 5%, no additional sampling is required, nor is the Systems Review required. (Note: The guidelines listed above do not imply that this is an acceptable error rate. Accordingly, PALMS should, as appropriate, further analyze any errors identified in the Discovery Sample. PALMS recognizes that OIG or other HHS component, in its discretion and as authorized by statute, regulation, or other appropriate authority may also analyze or review Paid Claims included, or errors identified, in the Discovery Sample or any other segment of the universe.)

Discovery Sample. The IRO shall randomly select and review a sample of fifty (50) 100 Paid Claims (Discovery Sample). The Paid Claims shall be reviewed based on the supporting documentation available at PALMSHome Bound’s office or under PALMSHome Bound’s control and applicable billing and coding regulations and guidance to determine whether the claim was correctly coded, submitted, and reimbursed. If the Error Rate (as defined above) for the Discovery Sample is less than 5%, no additional sampling is required, nor is the Systems Review required. (Note: The guidelines listed above do not imply that this is an acceptable error rate. Accordingly, PALMS Home Bound should, as appropriate, further analyze any errors identified in the Discovery Sample. PALMS Home Bound recognizes that OIG or other HHS component, in its discretion and as authorized by statute, regulation, or other appropriate authority may also analyze or review Paid Claims included, or errors identified, in the Discovery Sample or any other segment of the universe.)

Discovery Sample. The IRO shall randomly select and review a sample of fifty (50) 100 Paid Claims (Discovery Sample). The Paid Claims shall be reviewed based on the supporting documentation available at PALMSTri-County’s office or under PALMSTri- County’s control and applicable billing and coding regulations and guidance to determine whether the claim was correctly coded, submitted, and reimbursed. If the Error Rate (as defined above) for the Discovery Sample is less than 5%, no additional sampling is required, nor is the Systems Review required. (Note: The guidelines listed above do not imply that this is an acceptable error rate. Accordingly, PALMS Tri-County should, as appropriate, further analyze any errors identified in the Discovery Sample. PALMS Tri-County recognizes that OIG or other HHS component, in its discretion and as authorized by statute, regulation, or other appropriate authority may also analyze or review Paid Claims included, or errors identified, in the Discovery Sample or any other segment of the universe.)

Discovery Sample. The IRO shall randomly select and review a sample of fifty (50) 50 Paid Claims (Discovery Sample). The Paid Claims shall be reviewed based on the supporting documentation available at PALMSOFX’s office or under PALMS’s their control and applicable billing and coding regulations and guidance to determine whether the claim was correctly coded, submitted, and reimbursed. Corporate Integrity Agreement - Appendix B Orthofix If the Error Rate (as defined above) for the Discovery Sample is less than 5%, no additional sampling is required, nor is the Systems Review required. (Note: The guidelines listed above do not imply that this is an acceptable error rate. Accordingly, PALMS OFX should, as appropriate, further analyze any errors identified in the Discovery Sample. PALMS OFX recognizes that OIG or other another HHS component, in its discretion and as authorized by statute, regulation, or other appropriate authority may also analyze or review Paid Claims included, or errors identified, in the Discovery Sample or any other segment of the universe.)