Provider Audits definition

Provider Audits. Providers receiving funds under this Agreement, for providing A&D 81 Services, are subject to audits of all funds applicable to A&D 81 Services rendered. The purpose of these audits is to: (a) Ensure proper disbursements were made for covered A&D 81 Services; (b) Recover over-payments; (c) Discover any potential or actual instances of fraud and abuse; and (d) Verify that encounter data submissions are documented in the client file, as required and described in the “Special Reporting Requirements” above.
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Provider Audits has the meaning set forth in Section 14.1(e)(i) of the Master Agreement.
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Examples of Provider Audits in a sentence

  • OHA may apply the Division of Medical Assistance Program (DMAP) Provider Audit rules and the Fraud and Abuse rules to providers and provider sub-contractors of A&D 82 Services in accordance with OAR 410-120-1505 through 410-120-1510 Provider Audits, as such rules may be revised from time to time.

  • The Annual Audit Plan will include: (i) Operational and Financial Audits to be performed by or on behalf of Customer during such year; and (ii) the timing and scope of Provider Audits to be provided by Provider to Customer as part of the Services.

  • OHA may apply the Division of Medical Assistance Program (DMAP) Provider Audit rules and the Fraud and Abuse rules to providers and provider sub-contractors of A&D 81 Services funded through this Agreement in accordance with OAR 410-120-1505 through 410-120-1510 Provider Audits, as such rules may be revised from time to time.

  • Service requirements and performance standards applicable to the professional services component contractors of the IME, including the SURS Analysis and Provider Audits Component Contractor, are set forth in Section 6.1 of RFP MED 04-015 and are incorporated herein by reference.

  • Services requirements and performance standards specific to the SURS Analysis and Provider Audits Component Contractor are set forth in Section 6.6 of RFP MED 04-015 and are incorporated herein by reference.

  • Section 2.19 of the Company Disclosure Schedule sets forth the results of any and all Sun Solution Provider Audits of the Company or the Business (an “Audit”) as well as the results of any Audit pending, but not closed, as of the date hereof.

  • Company shall be entitled to provide input and assist in defining the scope of the Service Provider Audits, as they apply to the Services and Company audit requirements.

  • Service Provider Audits shall include an audit of any applicable Service Provider subcontractors.