Common use of Medical Record Review Clause in Contracts

Medical Record Review. Health Plan shall be entitled to perform concurrent or retrospective reviews of medical records for utilization management purposes or to verify that items and services billed to or paid for by Health Plan were provided and billed correctly in accordance with this Agreement and the Provider Manual, or were Covered Services (including that such items and services were Medically Necessary).

Medical Record Review. Health Plan shall sh all be entitled to perform concurrent or retrospective reviews of medical records for utilization management purposes or to verify that items item s and services billed to or paid for by Health Plan were provided and billed correctly in accordance with this Agreement and the Provider Manual, or were Covered Services (including that such items ite ms and services were Medically Necessary).