Scio audit reconsideration form. This form should be the first page of each submission.

Scio audit reconsideration form. After an audit, SCIO will send you its findings and instructions for appeal, if necessary. Print the completed form, which should be signed by an authorized representative. 7525. The appeals process is simple: For automated billing and compliance audits, disputed claims will be eligible for a one-step internal appeal. Do not include a copy of a claim that was previously processed. Include evidence to support why you believe the services provided were properly coded and billed correctly. . Provide additional information to support the description of the dispute. If you need to speak to a SCIO representative during the audit, call 1-866-628-3488, ext. If you do not respond to SCIO’s request for Medical Records to initiate the audit: If medical records are not provided to SCIO with the requested timeframe, the entire claim will be retrospectively denied and recouped against future claims payment from Virginia Premier. For complex, medical necessity audits, an independent external review is the second step in the appeal process. Fields with an asterisk ( * ) are required. One form must be submitted per claim. Our audit team can examine, evaluate, report, and provide actionable recommendations for the following components of your organization’s revenue cycle: We dig deep to find potential issues that are preventing your business from maximizing revenue. The use of this portal is provided with the understanding that it will be used responsibly and confidentially for the sole purpose of uploading Medical and Pharmacy Records in support of claims selected for audit. Be specific when completing the DESCRIPTION OF DISPUTE and EXPECTED OUTCOME. After an audit, SCIO will share the findings and how to ask for an appeal, if necessary. This form should be the first page of each submission. If you do not respond to SCIO’s request for Medical Records to initiate the audit: If medical records are not provided to SCIO with the requested timeframe, the entire claim will be retrospectively denied and recouped against future claims payment from Virginia Premier. jgfm yya ubok nkty tgasym haovenh sgkao lbewg nyrr bnv