decisionhealth Newsletters, Answer Books - 2006 Issue 3 (March)
Medicare_Program_Integrity_Manual / Chapter_3 / 3.10.6.1.1
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Article Overview
This article outlines Medicare Program Integrity Manual guidance on written notification of review and the information that should be included when a provider or supplier is selected for review. It is relevant to Medicare program integrity, audit, and compliance staff who need to understand notification timing, documentation requests, review location, appeal-related information, and general handling of review results.
Why This Topic Matters
Clear notification procedures help ensure review activities are communicated consistently and that providers and suppliers receive the required review information. This supports operational compliance for Medicare contractors, PSC-related review activities, and provider/supplier site reviews.
What You Will Learn
- What information belongs in a written notification of review
- How advance notification timing is addressed
- What documentation submission or availability timeframes are discussed
- What broad elements may be included about review location, appeal rights, and review results
- How notification differs when advance notice is or is not provided
Who Should Read This
- Medical coders
- Compliance officers
- Auditors
- Medicare contractor staff
- Program integrity staff
- Provider billing staff
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