Does the OIG conduct a claims review during the site visit?
The OIG typically does not conduct claims reviews during site visits. However, the OIG or a duly authorized representative does have the authority in accordance with the OIG Inspection, Audit, and Review Rights section of the CIA to conduct a claims review at any time during the course of the CIA. In the past the OIG used a contractor to perform such reviews and often these reviews were performed and finalized before the OIG went on site so the OIG could discuss the results with the provider during the site visit. The OIG continues to use the OIG’s Office of Audit Services and applicable Medicare contractors to conduct claims reviews on an as needed basis.
The OIG typically does not conduct claims reviews during site visits. However, the OIG or a duly authorized representative does have the authority in accordance with the OIG Inspection, Audit, and Review Rights section of the CIA to conduct a claims review at any time during the course of the CIA.
