Coding Audit definition

Coding Audit means:
Sample 1Sample 2
Coding Audit means R1’s [*****] sample based internal audit of the accuracy of the billing coding performed by R1 employees, which audit shall not (for the avoidance of doubt) include billing coding performed by any third party coding services provider (whether engaged by R1 or IMH). Cases coded by a Transitioned Employee shall be subject to the Coding Audits only after such Transitioned Employee has been employed by R1 for one full [*****]. Each R1 coder shall be audited at least [*****]. In conducting the Coding Audits, R1 shall use only personnel holding the following credentials: auditors of inpatient coding records must have at least [*****] years of hospital inpatient coding experience and auditors of outpatient coding records must have at least [*****] years of hospital outpatient coding experience. Additionally, each coding auditor must have any one or more of the following coding credentials: (i) RHIA, (ii) RHIT, (iii) CCS or (iv) CPC. This Service Level measures performance with respect to the IMH Facilities.
Sample 1
Coding Audit means: (i) [*****], random sample-based quality assurance audits, conducted by or on behalf of Supplier, of the accuracy of the billing coding performed by Supplier coder. As part of this [*****], random sample-based audit, each Supplier coder shall be audited. (ii) [*****], random sample-based quality assurance external audits, performed for Ascension Health, whether engaged by Ascension Health or Supplier. 1. With respect to each of the [*****], an external auditor will be engaged to conduct a random, sample-based audit of the [*****] audits referenced in (a) above. The purpose of this [*****], [*****], will be to confirm Supplier’s [*****] coder audits meet expectations. Supplier shall engage such auditor for [*****] and Ascension Health shall engage such auditor for [*****]. After [*****], the Parties shall reevaluate the scope and structure of any annual, random sample-based quality assurance external audits to be performed on a prospective basis. 2. For clarification, [*****], random sample-based audits will be deemed separate and distinct from the Parties’ individual or collective risk-based, focused Compliance audits, although such audits may be performed at or during the same period of time. (iii) Any auditing, including as done by external auditors, will utilize random or probability sampling commensurate with nationally-recognized audit standards and practices. (iv) Cases coded by a Transitioned Employee shall be subject to the Coding Audits only after such Transitioned Employee has been employed by Supplier for [*****]. Thereafter, Transitioned Employee Supplier coders shall be audited at [*****], consistent with the [*****] coding quality assurance audits noted in a) above. (v) In conducting the Coding Audits, Supplier shall use only personnel holding the following credentials: Auditors of inpatient coding records must have at least [*****] of hospital inpatient coding experience and auditors of outpatient coding records must have at least [*****] of hospital outpatient coding experience. Additionally, each coding auditor must have any one or more of the following credentials: (i) RHIA, (ii) RHIT, (iii) CCS, (iv) CPC, or (v) CIC.
Sample 1

Examples of Coding Audit in a sentence

  • No representation or warranty by Seller in this Agreement or in any Schedule or Exhibit to this Agreement, or any certificate furnished or to be furnished by Seller pursuant to this Agreement, contains or will contain any untrue statement of material fact, or omits or will omit to state a material fact required to be stated therein or necessary to make the statements contained therein not misleading in light of the circumstances in which made.

  • Clinical Coding Audit Whittington Health was subject to the Payment by Results clinical coding audit during the 2017/18 reporting period.

  • The Terminology and Classifications Delivery Service (by virtue of this Code of Conduct) lays down the key principles, standards and protocols which includes certain limits, boundaries and guidance which an approved clinical coding auditor is required to follow when using and applying all aspects of the national Clinical Coding Audit Methodology1.The Clinical Coding Audit Methodology is designed for auditing coded data using the clinical classifications ICD-102 and OPCS-43.

  • All other types of dispute between auditor and Trust can be raised via the Information Standards Service Desk and marked ‘for the attention of the Clinical Coding Audit Workgroup’.

  • Oaks Hospital has been subject to an internal Clinical Coding Audit.

  • The Executive Summary shall be provided to the MTF designee(s) and shall include NAVMED 6150/49 (03-2013), Outpatient/APV/IPS RNDS Coding Audit Summary; available from Naval Forms Online at: https://navalforms.documentservices.dla.mil/.

  • The full process is detailed in the current version of the Clinical Coding Audit Methodology.Where an Audit Authentication proforma has been submitted discussion of the disputed codes will be undertaken with the relevant subject matter experts.

  • West Midlands Ambulance Service was not subject to the Audit Commissions Payment by Results Clinical Coding Audit during 2013/2014.

  • To support the ongoing improvement of the service a comprehensive Audit programme is developed and undertaken throughout the year by the Clinical Coding Audit Lead.

  • Rotherham Hospice was not subject to the Audit Commissions, Payment by Results Clinical Coding Audit during 2017/18.


More Definitions of Coding Audit

Coding Audit means R1’s [*****] sample based internal audit of the accuracy of the billing coding performed by R1 employees, which audit shall not (for the avoidance of doubt) include billing coding performed by any third party coding services provider (whether engaged by R1 or IMH). Cases coded by a Transitioned Employee shall be subject to the Coding Audits only after such Transitioned Employee has been employed
Sample 1

Related to Coding Audit

  • the Auditors means the auditors from time to time of the company or, in the case of joint auditors, any one of them;

  • Audit means the examination of a person or the inspection of the books, records, memoranda, or accounts of a person, ordered to appear before the Tax Administrator, for the purpose of determining liability for a municipal income tax.

  • Independent Auditor has the meaning specified in Section 6.01(a).

  • Independent Auditors has the meaning set forth in Section 3.2.

  • Independent Accounting Firm has the meaning set forth in Section 2.05(c).

  • cost accountant means a cost accountant as defined in clause (b) of sub-section (1) of section 2 of the Cost and Works Accountants Act, 1959 (23 of 1959) and who has obtained a certificate of practice under sub-section (1) of section 6 of that Act;

  • Neutral Auditor means Ernst & Young or, if Ernst & Young is unable to serve, an impartial nationally recognized firm of independent certified public accountants other than Seller’s accountants or Purchaser’s accountants, mutually agreed to by Purchaser and Seller.

  • Independent testing laboratory means an independent organization, accepted by the Contracting Officer, engaged to perform specific inspections or tests of the work, either at the site or elsewhere, and report the results of these inspections or tests.

  • Participating Certified Clinical Nurse Specialist means a Certified Clinical Nurse Specialist who has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Root Cause Analysis Report means a report addressing a problem or non-conformance, in order to get to the ‘root cause’ of the problem, which thereby assists in correcting or eliminating the cause, and prevent the problem from recurring.

  • Independent Accountant has the meaning set forth in Section 2.04(c)(iii).

  • Neutral Accountant means a national independent accounting firm selected by Buyer and reasonably acceptable to Sellers.

  • Practical examination means a demonstration through application of the safety rules and principles in industrial radiography including use of all procedures and equipment to be used by radiographic personnel.

  • CREFC® Operating Statement Analysis Report The monthly report in the “Operating Statement Analysis Report” format substantially in the form of and containing the information called for therein for the Mortgage Loans, or such other form for the presentation of such information as may be approved from time to time by the CREFC® for commercial mortgage securities transactions generally.

  • Non-Participating Certified Clinical Nurse Specialist means a Certified Clinical Nurse Specialist who does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Compliance Audit means the procedure (in a form advised by the GLA from time to time) by which an auditor independent of the Grant Recipient certifies (at the Grant Recipient's cost) whether the Named Projects developed or Rehabilitated pursuant to this Agreement satisfy the GLA's procedural compliance requirements (as described in the Affordable Housing Capital Funding Guide);

  • Approved Auditor means a person who is:

  • CMSA Operating Statement Analysis Report means a report substantially in the form of, and containing the information called for in, the downloadable form of the "Operating Statement Analysis Report" available as of the Closing Date on the CMSA Website or in such other form for the presentation of such information and containing such additional information as may from time to time be approved by the CMSA for commercial mortgage-backed securities transactions generally.

  • Operating Statement Analysis Report format substantially in the form of and containing the information called for therein for the Mortgage Loans, or such other form for the presentation of such information as may be approved from time to time by the CREFC® for commercial mortgage securities transactions generally.

  • Initial determination means the first child custody determination concerning a particular child.

  • Testing laboratory means a laboratory, facility, or entity in the state that offers or performs tests of cannabis or cannabis products and that is both of the following:

  • Performance audit means an objective and systematic assessment of a state agency or agencies or any of their programs, functions, or activities by the state auditor or designee in order to help improve agency efficiency, effectiveness, and accountability. Performance audits include economy and efficiency audits and program audits.

  • Examination Criteria means the loan classification criteria employed by, or any applicable regulations of, the Assuming Institution’s Chartering Authority at the time such action is taken, as such criteria may be amended from time to time.

  • Independent Expert means a Person or entity with no material current or prior business or personal relationship with the Advisor or the Directors and who is engaged to a substantial extent in the business of rendering opinions regarding the value of assets of the type held by the Company.

  • qualified auditor means a person who is qualified to be appointed as an auditor under section 198;

  • Appraisal review means the act or process of developing