Review Results

Upon the completion of the service-specific review sample, the claim review findings are analyzed and appropriate corrective action is taken when providers are found to be non-compliant based on the Progressive Corrective Action (PCA) philosophy. You may view information regarding the results of completed service-specific reviews below.

Latest Articles

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Widespread Review of ALS Emergency Ambulance Services: Third Quarter of FY 2019 11/26/2019
Widespread Review of BLS Non-Emergency Ambulance Services: Third Quarter of FY 2019 11/26/2019
Widespread Review of Diagnostic Radiology Chest X-Ray Services: Third Quarter of FY 2019 11/26/2019
Widespread Review of Evaluation/Management Claims for Critical Care: Third Quarter of FY 2019 11/26/2019
Widespread Review of Evaluation/Management Claims for Emergency Department Visits: Third Quarter of FY 2019 11/26/2019
Widespread Review of Evaluation/Management Claims for Initial Hospital Inpatient Care Services: Third Quarter of FY 2019 11/26/2019
Widespread Review of Evaluation/Management Claims for New Patient Office or Other Outpatient Services: Third Quarter of FY 2019 11/26/2019
Widespread Review of Evaluation/Management Claims for Subsequent Hospital Inpatient Care: Third Quarter of FY 2019 11/26/2019
Widespread Review of Evaluation/Management Claims of Subsequent Skilled Nursing Facility (SNF) Services: Third Quarter of FY 2019 11/26/2019
Widespread Review of Select Bone Mass Measurements (BMM) Services: Third Quarter of FY 2019 11/26/2019
Widespread Review of ALS Emergency Ambulance Services: Fourth Quarter of FY 2019 11/18/2019
Widespread Review of BLS Non-Emergency Ambulance Services: Fourth Quarter of FY 2019 11/18/2019
Widespread Review of Diagnostic Radiology Chest X-Ray Services: Fourth Quarter of FY 2019 11/18/2019
Widespread Review of Evaluation/Management Claims for Critical Care: Fourth Quarter of FY 2019 11/18/2019
Widespread Review of Evaluation/Management Claims for Emergency Department Visits: Fourth Quarter of FY 2019 11/18/2019
Widespread Review of Evaluation/Management Claims for Initial Hospital Inpatient Care Services: Fourth Quarter of FY 2019 11/18/2019
Widespread Review of Evaluation/Management Claims for New Patient Office or Other Outpatient Services: Fourth Quarter of FY 2019 11/18/2019
Widespread Review of Evaluation/Management Claims for Subsequent Hospital Inpatient Care: Fourth Quarter of FY 2019 11/18/2019
Widespread Review of Evaluation/Management Claims of Subsequent Skilled Nursing Facility (SNF) Services: Fourth Quarter of FY 2019 11/18/2019
Widespread Review of Select Bone Mass Measurements (BMM) Services: Fourth Quarter of FY 2019 11/18/2019
Widespread Review of Diagnostic Radiology Chest X-Ray Services: Second Quarter of FY 2019 05/14/2019
Widespread Review of Evaluation/Management Claims for Initial Hospital Inpatient Care Services: Second Quarter of FY 2019 05/14/2019
Widespread Review of Evaluation/Management Claims for New Patient Office or Other Outpatient Services: Second Quarter of FY 2019 05/14/2019
Widespread Review of Hyperkeratotic Lesion Debridement: Second Quarter of FY 2019 05/14/2019
Widespread Review of Select Bone Mass Measurements (BMM) Services: Second Quarter of FY 2019 05/14/2019
Widespread Review of ALS Emergency Ambulance Services: First Quarter of FY 2019 02/15/2019
Widespread Review of BLS Non- Emergency Ambulance Services: First Quarter of FY 2019 02/15/2019
Widespread Review of Evaluation/Management Claims for Subsequent Hospital Inpatient Care: First Quarter of FY 2019 02/15/2019
Widespread Review of Evaluation/Management Claims of Subsequent Skilled Nursing Facility (SNF) Services: First Quarter of FY 2019 02/15/2019
Widespread Review of Hyperkeratotic Lesion Debridement: First Quarter of FY 2019 02/15/2019
Widespread Review of Select Bone Mass Measurements (BMM) Services: First Quarter of FY 2019 02/15/2019
Widespread Review of BLS Non-Emergency Ambulance Services: Fourth Quarter of FY 2018 11/14/2018
Widespread Review of Diagnostic Radiology: Chest X-Ray Services: Fourth Quarter of FY 2018 11/14/2018
Widespread Review of Evaluation/Management Claims for Emergency Department Visit, with High Complexity Medical Decision Making: Fourth Quarter of FY 2018 11/14/2018
Widespread Review of Evaluation/Management Claims for Initial Hospital Inpatient Care Services: Fourth Quarter of FY 2018 11/14/2018
Widespread Review of Evaluation/Management Claims for New Patient Office or other Outpatient Services: Fourth Quarter of FY 2018 11/14/2018
Widespread Review of Evaluation/Management Claims for Subsequent Hospital Inpatient Care, Typically 25 Minutes: Fourth Quarter of FY 2018 11/14/2018
Widespread Review of Select Bone Mass Measurements (BMM) Services: Fourth Quarter of FY 2018 11/14/2018
Widespread Review Anesthesia for Extensive Spine and Spinal Cord Procedures: Third Quarter of FY 2018 08/13/2018
Widespread Review Anesthesia for Lower Intestinal Endoscopic Procedures Third Quarter of FY 2018 08/13/2018
Widespread Review of ALS Emergency Ambulance Services: Third Quarter of FY2018 08/13/2018
Widespread Review of BLS Non- Emergency Ambulance Services: Third Quarter of FY 2018 08/13/2018
Widespread Review of Diagnostic Radiology: Chest X-Ray Services: Third Quarter of FY 2018 08/13/2018
Widespread Review of Evaluation/Management Claims for Emergency Department Visit, with High Complexity Medical Decision Making: Third Quarter of FY 2018 08/13/2018
Widespread Review of Evaluation/Management Claims for Initial Hospital Inpatient Care Services: Third Quarter of FY 2018 08/13/2018
Widespread Review of Evaluation/Management Claims for New Patient Office or other Outpatient Services: Third Quarter of FY 2018 08/13/2018
Widespread Review of Evaluation/Management Claims for Subsequent Hospital Inpatient Care, Typically 25 Minutes: Third Quarter of FY 2018 08/13/2018
Widespread Review of Evaluation/Management Claims of Skilled Nursing Facility (SNF) Services: Third Quarter of FY 2018 08/13/2018
Widespread Review of Select Bone Mass Measurements (BMM) Services: Third Quarter of FY 2018 08/13/2018
Widespread Review of BLS Non-Emergency Ambulance Services: Second Quarter of FY 2018 05/14/2018
Widespread Review of Evaluation/Management Claims for Initial Hospital Inpatient Care Services: Second Quarter of FY 2018 05/14/2018
Widespread Review of BLS Non- Emergency Ambulance Services: First Quarter of FY 2018 02/05/2018
Widespread Review of Evaluation/Management Claims for Subsequent Hospital Inpatient Care, Typically 25 Minutes: First Quarter of FY 2018 02/05/2018
Widespread Review of Select Bone Mass Measurements (BMM) Services: First Quarter of FY 2018 02/05/2018
   

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