Quarterly Claims Review. The IRO shall conduct a review of Xxxxxxxx’x claims submitted to and reimbursed by the Medicare and Medicaid programs, to determine whether the items and services furnished were medically necessary and appropriately documented, and whether the claims were correctly coded, billed, and reimbursed, for each three-month period during the term of this IA (Quarterly Claims Review) and prepare a report for each Quarterly Claims Review performed. The first three-month period shall begin 30 days following the Effective Date of this IA.
Quarterly Claims Review. The IRO shall conduct a review of Xx. Xxxxxxxx and Fleckner, P.C.’s claims submitted to and reimbursed by the Medicare and Medicaid programs, to determine whether the items and services furnished were medically necessary and appropriately documented, and whether the claims were correctly coded, billed, and reimbursed, for each three-month period during the term of this IA (Quarterly Claims Review) and prepare a report for each Quarterly Claims Review performed. The first three-month period shall begin 30 days following the Effective Date of this IA.
Quarterly Claims Review. The IRO shall conduct a review of I&L’s claims submitted to and reimbursed by the Medicare and Medicaid programs, to determine whether: (1) the prescription drugs furnished by I&L were dispensed according to a valid prescription, (2) I&L maintained appropriate documentation of a valid prescription for each drug dispensed (including any refills of such drug), and (3) whether the claims were correctly billed and reimbursed, for each three-month period during the term of this IA (Quarterly Claims Review) and prepare a report for each Quarterly Claims Review performed. The first three-month period shall begin 30 days following the Effective Date of this IA.
Quarterly Claims Review. The IRO shall conduct a review of MMW’s claims submitted to and reimbursed by the Federal health care programs, to determine whether the items and services furnished were medically necessary and appropriately documented, and whether the claims were correctly coded, billed, and reimbursed, for each three-month period during the term of this IA (Quarterly Claims Review) and prepare a report for each Quarterly Claims Review performed. The first three-month period shall begin 30 days following the Effective Date of this IA.
Quarterly Claims Review. The IRO shall conduct a review of Dr. Muttath’s claims submitted to and reimbursed by the Medicare and Medicaid programs, to determine whether the items and services furnished were medically necessary and appropriately documented, and whether the claims were correctly coded, billed, and reimbursed, for each three-month period during the term of this IA (Quarterly Claims Review) and prepare a report for each Quarterly Claims Review performed. The first three-month period shall begin 30 days following the Effective Date of this IA.
Quarterly Claims Review. The IRO shall conduct a review of Hanflink’s claims submitted to and reimbursed by the Medicare and Medicaid programs, to determine whether the items and services furnished were medically necessary and appropriately documented, and whether the claims were correctly coded, billed, and reimbursed, for each three-month period during the term of this IA (Quarterly Claims Review) and prepare a report for each Quarterly Claims Review performed. The first three-month period shall begin 30 days following the Effective Date of this IA.
Quarterly Claims Review. The IRO shall conduct a review of Xxxxx Pharmacy’s claims submitted to and reimbursed by the Medicare and Medicaid programs, to determine whether: (1) the prescription drugs furnished by Xxxxx Pharmacy were dispensed according to a valid prescription, (2) Xxxxx Pharmacy maintained appropriate documentation of a valid prescription for each drug dispensed (including any refills of such prescription), (3) the claims were correctly billed and reimbursed, and (4) Xxxxx Pharmacy appropriately collected or waived cost-sharing amounts, for each three-month period during the term of this IA (Quarterly Claims Review) and prepare a report for each Quarterly Claims Review performed. The first three-month period shall begin 30 days following the Effective Date of this IA.
Quarterly Claims Review. The IRO shall conduct a review of GLML’s claims submitted to and reimbursed by the Medicare, Medicaid, and Medicaid Managed Care programs, to determine whether the items and services furnished were medically necessary and appropriately documented, and whether the claims were correctly coded, billed, and reimbursed, for each three-month period during the term of this IA (Quarterly Claims Review) and prepare a report for each Quarterly Claims Review performed. The first three-month period shall begin 30 days following the Effective Date of this IA.
Quarterly Claims Review. The IRO shall conduct a review of Xx. Xxx and Interventional Cardiology’s claims submitted to and reimbursed by the Medicare and Medicaid programs, to determine whether the items and services furnished were medically necessary (including, but not limited to, a consideration of whether or not the care at issue was consistent with professionally recognized standards of care, and any other applicable federal and state statutes, regulations, and directives) and appropriately documented, and whether the claims were correctly coded, billed, and reimbursed, for each three-month period during the term of this IA (Quarterly Claims Review) and prepare a report for each Quarterly Claims Review performed. The first three-month period shall begin 30 days following the Effective Date of this IA.
Quarterly Claims Review. The IRO shall conduct a review of Kumar’s claims submitted to and reimbursed by the Medicare and Medicaid programs, to determine whether the items and services furnished were medically necessary and appropriately documented, and whether the claims were correctly coded, billed, and reimbursed, for each three-month period during the term of this IA (Quarterly Claims Review) and prepare a report for each Quarterly Claims Review performed. The first three-month period shall begin 30 days following the Effective Date of this IA.
