Level of Services definition
Examples of Level of Services in a sentence
A clear statement of the objective intended to be achieved by the Eligibility Review and the Appropriate Level of Services Review.
Individualized case plans for each program participant shall be based on a validated risk and need assessment, using industry-recognized, state-of- the art, evidence-based tools such as: (a) LSI-R (Level of Services Inventory – Revised; (b) STRONG (Static Risk and Offender Needs Guide; and (c) COMPAS (Correctional Offender Management Profiling for Alternative Sanctions).
A narrative description of how the Eligibility Review and the Appropriate Level of Services Review were conducted and what was evaluated.
The Error Rate for the Appropriate Level of Services Review shall be the percentage of net Overpayments identified in the sample of Medicare beneficiaries.
The IRO shall provide its observations and recommendations on suggested improvements to the system(s) and the process(es) for determining eligibility for the hospice benefit or medical necessity for the Level of Services provided.
Documentation will be reviewed to ensure the appropriateness of the Level of Services billed and reimbursed.
A narrative explanation of the IRO’s findings and supporting rationale (including reasons for errors, patterns noted, concerns relating to the eligibility for hospice or appropriateness of hospice services, etc.) regarding the Eligibility Review and Appropriate Level of Services Review.
The Claims Review shall consist of two components: an Eligibility Review and an Appropriate Level of Services Review.
A description of the specific documentation relied upon by the IRO when performing the Eligibility Review and the Appropriate Level of Services Review (e.g., medical records, physician orders, certificates of medical necessity, requisition forms, local medical review policies (including title and policy number), CMS program memoranda (including title and issuance number), Medicare carrier or intermediary manual or bulletins (including issue and date), other policies, regulations, or directives).
The Appropriate Level of Services Review shall consist of a documentation review to ensure that the appropriate Level of Services was properly documented, and properly submitted to and reimbursed by Medicare.