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AUDIT OF DURABLE MEDICAL EQUIPMENT CLAIMS


Location
West Virginia
Publication Date
03/06/2019 10:07 AM EST
Closing Date
05/03/2019 04:30 PM EDT
Issuing Organization
State of West Virginia Public Employees Insurance Agency
Solicitation Number
Description

Specifications include, but are not limited to: The objectives of the audit are to ensure that the Agency pays only covered services for eligible members; that these services are appropriate, justified and provided in accordance with Plan policies and procedures; that the services are billed within standard coding conventions, including, but not limited to ICD-9 or 10, HCPCS, and NCCI; and to identify member or prescriber outliers that may indicate potential fraud, waste or abuse. This procurement is exempt from the requirements of the West Virginia Purchasing Division pursuant to W. Va. Code ยง5A-3-10b.

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