What else does a provider need to submit for a post-service, prepayment audit (PPM Audit)?
A. Claims submitted for a PPM Audit must contain documents required to substantiate the nature, extent and medical necessity of the services claimed. There are special signed statements that must be attached and other specific documentation requirements as described in your Utilization Control Action Notice provider letter. For example, if a provider has 10 claims, they should send 10 original paper billing form claims with separate supporting documents for each claim.
Related Questions
- Who can a provider talk to for questions concerning post-service, prepayment audit (PPM Audit) documentation requirements for specific claims?
- Who can a provider talk to for other questions concerning the post-service, prepayment audit (PPM Audit) process?
- What else does a provider need to submit for a post-service, prepayment audit (PPM Audit)?
