In what circumstances should the reviewer review a Full Sample?
When conducting a Discovery Sample, if the net financial error rate of this sample equals or exceeds 5%, the reviewer must conduct a Full Sample. The Full Sample should consist of a sufficient number of sampling units to yield results that estimate the overpayment in the population to be within a 90% confidence and 25% precision level. Please note, if the net financial error rate of the Discovery Sample is below 5%, the review is complete. When conducting a Probe Sample, if there is at least one overpayment error in the Probe Sample, the reviewer must conduct a Full Sample. The Full Sample should consist of a sufficient number of sampling units to yield results that estimate the overpayment in the population to be within a 90% confidence and 25% precision level. If there are no errors in the Probe Sample, some more recent CIAs or Agreements require that a second Probe Sample be conducted, while older CIAs and Agreements do not. If the provider is not required to conduct a second Probe
When conducting a Discovery Sample, if the net financial error rate of this sample equals or exceeds 5%, the reviewer must conduct a Full Sample. The Full Sample should consist of a sufficient number of sampling units to yield results that estimate the overpayment in the population to be within a 90% confidence and 25% precision level. Please note, if the net financial error rate of the Discovery Sample is below 5%, the review is complete.
