Does the post-service, prepayment audit (PPM Audit) apply to claims billed for services provided before, or after, the PPM Audits effective date period?
A. The Utilization Control Action Notice letter informs providers of the date when the PPM Audit period begins and ends. The audit applies to any claims for codes specified on Utilization Control Action Notice provider letter for the dates of service listed within the PPM Audit period, no matter when the provider submits the claim. Providers may bill electronically for services provided before and after the PPM Audit period.
Related Questions
- Does the post-service, prepayment audit (PPM Audit) apply to claims billed for services provided before, or after, the PPM Audits effective date period?
- Does the company plan on requisitioning Roger Glenns firm to provide an audit on the services provided for $250,000.00?
- Are expenses for services provided prior to my effective date in the HRA eligible for reimbursement?
