Narrative Results i. For the first Quarterly Claims Review Report only, a description of (a) Xxxx Clinic’s billing and coding system(s), including the identification, by position description, of the personnel involved in coding and billing, and (b) a description of controls in place to ensure that all items and services billed to Medicare or a state Medicaid program by Xxxx Clinic are medically necessary and appropriately documented. Subsequent Quarterly Claims Review Reports should describe any significant changes to items (a) and (b) or, if no significant changes were made, state that the systems and controls remain the same as described in the prior Quarterly Claims Review Report. ii. A narrative explanation of the results of the Quarterly Claims Sample, including reasons for errors, patterns noted, etc.
Audit Results If an audit by a Party determines that an overpayment or an underpayment has occurred, a notice of such overpayment or underpayment shall be given to the other Party together with those records from the audit which support such determination.