Specifications include, but are not limited to:1. Work within the confines of an approved work plan specific to audit and review; 2. Notify provider of their intention to audit and review (notification must be approved by STATE); 3. Assure providers are allowed the appropriate time as identified in an approved work plan to provide documents for the audit or review; 4. Review the documents and respond as agreed upon in the approved work plan; 5. Perform audits in accordance with Generally Accepted Auditing Standards; 6. Issue the notification letter to the provider based on the findings or lack of findings of the audit and review; 7. Maintain individual case files and include information relevant to determine the work performed, the conclusions reached, correspondence related to the case, and notes of any relevant phone conversations; 8. Pursue recovery of overpayments; 9. Make referrals to SURS as directed by STATE when suspected fraud is discovered during the process of the review or audit; and 10. Report all audit and review activity to the STATE RAC Liaison.
