Exception review definition

Exception review means a review conducted of an ICFIID by qualified intellectual disability professionals, registered nurses, or other licensed or certified health professionals employed by or under contract with the department for purposes of identifying inaccuracies related to the individual assessment form data submitted by the ICFIID in accordance with rule 5123-7-20 of the Administrative Code, which result in inaccurate case mix scores being used to calculate an ICFIID's direct care rate. Exception reviews shall be conducted before the annual rates are established pursuant to section 5124.15 of the Revised Code. Exception reviews shall be conducted in accordance with applicable provisions of the medicaid program.
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Exception review means a review conducted of selected intermediate care facilities by appropriate health professionals employed by or under contract with the department for purposes of identifying inaccuracies related to the individual assessment form data submitted in accordance with rule 5123:2-7-20 of the Administrative Code, which result in inaccurate case mix scores being used to calculate an intermediate care facility's direct care rate. Exception reviews shall be conducted before the annual rates are established pursuant to section 5124.15 of the Revised Code. Exception reviews shall be conducted in accordance with applicable provisions of the medicaid program.
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Examples of Exception review in a sentence

  • The permitting and approvals process for the airborne geophysical survey has experienced some local administrative delays.

  • The Registered Nurses performing the audit/Statewide Utilization Review/Long Term Care Immediate and Exception review functions cannot perform the Retrospective Review and PACER authorizations, MDCH expects the Contractor to designate separate staff for each.

  • Exception review sample An exception review shall be conducted of a pre-selected random, targeted, or combination sample of completed individual assessment forms from the reporting quarter.

  • The Land Use Code provides a Special Exception review process for over height light standards for illumination of athletic fields at public school sites.

  • If one does not approve then the exception is considered denied.2. Service staff on receipt of notices of approval or denial of a request for an exception from the SOTA and the designated fed- eral agency shall place the notices in the patient’s case record.(e) Exception review.

  • A copy of the Review Coordinator’s summary for the LTC Telephonic Exception review must be stored electronically for seven (7) years.

  • The Committee was formed after some citizens at a Board hearing concerning a communications tower Special Exception review stated that they did not have enough time after receiving mailed notification of the hearing to fully research the case and provide a complete response that the hearing.

  • Exception review tolerance level" is the level of variance between the facility andODJFS ODM in MDS assessment item responses affecting the resource utilization groups, version III (RUG III) classification of a facility's residents.

  • The Living Area shall be depicted on the subdivision plan creating the Estate Lot, as well as on any exhibit submitted for Special Exception review.

  • The Commission requested clarification about the related floodplain alteration waiver application that the Department of Building and Development would review following the Special Exception review process.

Related to Exception review

  • Utilization review plan or "plan" means a written procedure for performing review.

  • Architectural Review Committee or “ARC” shall mean the architectural review committee established by the Organization to review plans submitted to the Organization for architectural review.

  • Expedited review means an examination, in accordance with

  • Utilization review means the prospective (prior to), concurrent (during) or retrospective (after) review of any service to determine whether such service was properly authorized, constitutes a medically necessary service for purposes of benefit payment, and is a covered healthcare service under this plan. WE, US, and OUR means Blue Cross & Blue Shield of Rhode Island. WE, US, or OUR will have the same meaning whether italicized or not. YOU and YOUR means the subscriber or member enrolled for coverage under this agreement. YOU and YOUR will have the same meaning whether italicized or not.

  • independent review committee means the independent review committee of the investment fund established under National Instrument 81-107 Independent Review Committee for Investment Funds;

  • Application Review Start Date means the later date of either the date on which the District issues its written notice that the Applicant has submitted a completed Application or the date on which the Comptroller issues its written notice that the Applicant has submitted a completed Application and as further identified in Section 2.3.A of this Agreement.

  • Clinical review criteria means the written screening procedures, decision abstracts, clinical protocols, and practice guidelines used by a health carrier to determine the necessity and appropriateness of health care services.

  • 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.

  • Independent review organization means an entity that is accredited to conduct independent external reviews of adverse benefit determinations.

  • Utilization review organization means an entity that conducts utilization review, other than a health carrier performing a review for its own health benefit plans.

  • Review Criteria has the meaning assigned to that term in Section 12.02(b)(i).

  • Drug utilization review means an evaluation of a prescription drug order and patient records for

  • Supervisory Review means ongoing clinical case reviews in accordance with procedures developed by ADMINISTRATOR, to determine the appropriateness of Diagnosis and treatment and to monitor compliance to the minimum ADMINISTRATOR and Medi-Cal charting standards. Supervisory review is conducted by the program/clinic director or designee.

  • Compliance Review means an inspection of the home, grounds, and files to determine compliance with these regulations.

  • Performance Review means a summative evaluation of a teacher other than a beginning teacher and used to determine whether the teacher’s practice meets school district expectations and the Iowa teaching standards, and to determine whether the teacher’s practice meets school district expectations for career advancement in accordance with Iowa Code section 284.7.

  • Due Diligence Review shall have the meaning as set forth in Section 2.5.

  • 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.

  • Benchmark Review means a review of the Services carried out in accordance with paragraphs 2.1 to 2.3 of Schedule 7 (Value for Money) of this Framework Agreement to determine whether those Services represent Good Value;

  • Records Review means any assessment the Province conducts pursuant to section A.7.4 (Records Review).

  • Prospective review means utilization review conducted prior to an admission or a course of treatment.

  • Review Board has the meaning provided in Section 2.1(f)(i) of this Commercial Shared-Loss Agreement.

  • Peer review means evaluation of professional services rendered by a professional practitioner.

  • Asset Review Quorum In connection with any solicitation of votes to authorize an Asset Review as described in Section 11.01(a), the Holders of Certificates evidencing at least 5% of the aggregate Voting Rights represented by all of the Certificates.

  • Periodic Review means a review conducted by Ofwat for the purpose of determining one or more Price Controls in accordance with Part III of Condition B, but so that references in Part IV of Condition B to a Periodic Review shall exclude any review carried out under paragraph 11 of that Condition and shall include the determination by the Competition and Markets Authority of the relevant questions or, as the case may be, the disputed determination referred to it under paragraph 16 of Condition B;

  • Training Plan means the plan that outlines what training and assessment will be conducted off-the-job and what will be conducted on-the-job and how the Registered Training Organisation will assist in ensuring the integrity of both aspects of the training and assessment process.