Common use of Systems Review Clause in Contracts

Systems Review. If Hill-Rom’s Discovery Sample identifies an Error Rate of 5% or greater, Hill-Rom’s IRO shall also conduct a Systems Review. The Systems Review shall consist of the following: a. a review of Hill-Rom’s billing and coding systems and processes relating to claims for reimbursement for Group 2 and Group 3 support surfaces submitted to the Medicare program (including, but not limited to, the operation of the billing system, the process by which claims are coded, safeguards to ensure proper coding, claims submission and billing; and procedures to identify and correct inaccurate coding and billing); b. for each claim in the Discovery Sample and Full Sample that resulted in an Overpayment, the IRO shall review the system(s) and process(es) that generated the claim and identify any problems or weaknesses that may have resulted in the identified Overpayments. The IRO shall provide its observations and recommendations on suggested improvements to the system(s) and the process(es) that generated the claim.

Systems Review. If Hill-Rom’s the Friendship Entities’ Discovery Sample 1 or Discovery Sample 2 identifies an Error Rate of 5% or greater, Hill-Rom’s the Friendship Entities’ IRO shall also conduct a Systems Review. The Systems Review shall consist of the following: a. a review of Hill-Rom’s the Friendship Entities’ billing and coding systems and processes relating to claims for reimbursement for Group 2 and Group 3 support surfaces submitted to the Medicare program Federal health care programs (including, but not limited to, the operation of the billing system, the process by which claims are coded, safeguards to ensure proper coding, claims submission and billing; and procedures to identify and correct inaccurate coding and billing); b. for each claim in the Discovery Sample Samples and Full Sample Samples that resulted in an Overpayment, the IRO shall review the system(s) and process(es) that generated the claim and identify any problems or weaknesses that may have resulted in the identified Overpayments. The IRO shall provide its observations and recommendations on suggested improvements to the system(s) and the process(es) that generated the claim.

Systems Review. If HillXxxxxxx-Rom’s Xxxxxx’x Discovery Sample identifies an Error Rate of 5% or greater, HillHarmony-Rom’s Xxxxxx’x IRO shall also conduct a Systems Review. The Systems Review shall consist of the following: a. a review of HillXxxxxxx-Rom’s Xxxxxx’x billing and coding systems and processes relating to claims for reimbursement for Group 2 and Group 3 support surfaces submitted to the Medicare program Federal health care programs (including, but not limited to, the operation of the billing system, the process by which claims are coded, safeguards to ensure proper coding, claims submission and billing; and procedures to identify and correct inaccurate coding and billing); b. for each claim in the Discovery Sample and Full Sample that resulted in an Overpayment, the IRO shall review the system(s) and process(es) that generated the claim and identify any problems or weaknesses that may have resulted in the identified Overpayments. The IRO shall provide its observations and recommendations on suggested improvements to the system(s) and the process(es) that generated the claim.

Systems Review. If Hill-Rom’s Xx. Xxxxxxxx’x Discovery Sample identifies an Error Rate of 5% or greater, Hill-Rom’s Xx. Xxxxxxxx’x IRO shall also conduct a Systems Review. The Systems Review shall consist of the following: a. a review of Hill-Rom’s Xx. Xxxxxxxx’x billing and coding systems and processes relating to claims for reimbursement for Group 2 and Group 3 support surfaces submitted to the Medicare program Federal health care programs (including, but not limited to, the operation of the billing system, the process by which claims are coded, safeguards to ensure proper coding, claims submission and billing; and procedures to identify and correct inaccurate coding and billing); b. for For each claim in the Discovery Sample and Full Sample that resulted in an Overpayment, the IRO shall review the system(s) and process(es) that generated the claim and identify any problems or weaknesses that may have resulted in the identified Overpayments. The IRO shall provide its observations and recommendations on suggested improvements to the system(s) and the process(es) that generated the claim.