Postpayment review definition

Postpayment review means an analysis of paid food instruments redeemed by authorized retailers in order to determine if pricing and redemption discrepancies exist. Based upon this analysis, a vendor claim against the retail store may be established by the state agency.
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Examples of Postpayment review in a sentence

  • Postpayment review of claims may be conducted to verify the validity of the insurance denial.

  • Postpayment review of claims is a review of claims after payment has been made.

  • Postpayment review results in either no change to the initial determination or a “revised determination” indicating that an overpayment or underpayment has occurred.

  • Prepayment review always results in an “initial determination” Postpayment review occurs when a reviewer makes a claim determination after the claim has been paid.

  • Post-payment review is conducted for a random sample of stays following reimbursement to the hospital for the care provided.

  • Post-payment review does not influence payment as does prepayment review.

  • Postpayment review occurs when a reviewer makes a claim determination after the claim has been paid.

  • Post-payment review may result in refund to Arkansas Blue Medicare and Health Advantage Medicare Advantage in cases when medical necessity could not be established.

  • Post-payment review may result in refund to Arkansas Blue Medicare in cases when medical necessity could not be established.

  • Post-payment review or audit refers to claims that were initially paid by Medicare and subsequently reopened and reviewed by, for example, a UPIC, RAC, MAC, or Comprehensive Error Rate Testing (CERT) contractor, and revised to deny coverage, change coding, or reduce payment.

Related to Postpayment review

  • 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;

  • payment initiation service means a service to initiate a payment order at the request of the payment service user with respect to a payment account held at another payment service provider;

  • 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.

  • Final Report means the report described as a final report in 14 RCW 42.17.080(2).

  • Project Management Report means each report prepared in accordance with Section 4.02 of this Agreement;

  • Rebate Analyst means the person or firm selected by the Issuer to calculate the Rebate Amount, which person or firm shall either be a firm of attorneys or independent certified public accountants with expertise in the calculation of the Rebate Amount.

  • Concurrent review means utilization review conducted during

  • 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.

  • 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.

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

  • Premium payment plan means a benefit plan whereby state and

  • Payment card means a credit card, charge card, debit card, or any other card that is issued to an authorized card user and that allows the user to obtain, purchase, or receive goods, services, money, or anything else of value from a merchant.

  • Payment request means any request for contract financing payment or invoice payment submitted by the contractor under this contract.

  • Assessment Report : means the assessment report referred to in Articles 32(2) and 33(3) of Regulation (EC) No 834/2007 drawn up by an independent third party fulfilling the requirements of ISO Standard 17011 or by a relevant competent authority, which includes information on document reviews, including the descriptions referred to in Articles 4(3)(b) and 11(3)(b) of this Regulation, on office audits, including critical locations and on risk-oriented witness audits conducted in representative third countries.

  • Alternative Compliance Payment or "ACP" means a payment of a certain dollar amount per megawatt hour, which a Retail Electricity Supplier may submit in lieu of supplying the minimum percentage of RECs required under Section 3.3.5 of this Regulation.

  • Monthly Reports shall have the meaning specified in Section 5.16(b) of the Indenture.

  • Application for Payment means Contractor’s monthly partial invoice for payment that includes any portion of the Work that has been completed for which an invoice has not been submitted and performed in accordance with the requirements of the Contract Documents. The Application for Payment accurately reflects the progress of the Work, is itemized based on the Schedule of Values, bears the notarized signature of Contractor, and shall not include subcontracted items for which Contractor does not intend to pay.

  • Payment Date Statement means a report prepared by the Administrator setting forth certain information relating to the Reference Pool, the Notes, the Reference Tranches and the hypothetical structure described in the Offering Memorandum, which will be in such form as is required under the Offering Memorandum and otherwise as agreed upon between the Administrator and the Indenture Trustee.

  • MONTHLY KILOMETREAGE STATEMENT CUM BILL means the format specified by the Company.

  • Summary Subcontract Report (SSR) Coordinator, as used in this clause, means the individual at the department or agency level who is registered in eSRS and is responsible for acknowledging or rejecting SSRs in eSRS for the department or agency.

  • Request for Payment means a payment application or declaration of expenditure submitted by the Member State to the Commission;

  • Benchmarking Report means the report produced by the Supplier following the Benchmark Review and as further described in this Framework Schedule 7;

  • 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.

  • Payment Item means each check, draft or other item of payment payable to a Borrower, including those constituting proceeds of any Collateral.

  • Statement Cycle means the period of time for which our credit union provides a summary of the financial activities and transactions that post and settle to the accountholder's account.