How will IPRO request information from the hospital regarding the SAE and what time frames will DOH and IPRO adopt in their own review process?
IPRO will send a chart request letter to the hospital once DOH notifies them about the SAE and need for review. Included with the letter will be a “checklist” that will be used by the hospital to identify the SAE and the date on which the SAE is believed to have occurred. This will assist IPRO in focusing their chart review on the specific SAE identified. The provider will have 30 days to submit the requested information. The IPRO review should be complete within 30-45 days of chart receipt. Following review, IPRO will send a preliminary notification of findings to the hospital. The hospital has 30 days to respond in disagreement with additional documentation and/or justification. If the hospital does not respond within that time period, IPRO will finalize its findings. IPRO will send written notification of the final determination to both DOH and the hospital. DOH will then process the payment adjustments accordingly.
