SUBCHAPTER 22I ‑ TITLE XIX REIMBURSEMENT AND ADMINISTRATIVE REVIEW PROCESS

SECTION .0100 ‑ AUDIT REVIEW PROCESS

10A NCAC 22I .0101        AUDIT TO BE CONDUCTED

An audit of a provider may be conducted by the Division of Health Benefits, or by an auditing firm subcontracted by them.

History Note:        Authority G.S. 108A-25(b);

Eff. September 24, 1980;

Amended Eff. May 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. August 22, 2015;

Amended Eff. March 1, 2020.

10A NCAC 22I .0102        EXIT CONFERENCE

At the conclusion of the audit, the provider may request an exit conference to discuss the audit findings with the provider that shall be held by personnel of the unit conducting the audit.

History Note:        Authority G.S. 108A‑25(b);

Eff. September 24, 1980;

Readopted Eff. July 1, 2018.

10A NCAC 22I .0103        NOTICE OF PROGRAM REIMBURSEMENT

Based on the audit findings the Division of Health Benefits will issue to the provider a Notice of Program Reimbursement which shall state the amount of reimbursement, if any, payable to the Division of Health Benefits or payable to the provider.

History Note:        Authority G.S. 108A-25(b);

Eff. September 24, 1980;

Amended Eff. January 1, 1988;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. August 22, 2015;

Amended Eff. March 1, 2020.

10A NCAC 22I .0104        RECONSIDERATION REVIEW

History Note:        Authority G.S. 108A‑25(b);

Eff. September 24, 1980;

Amended Eff. January 1, 1988;

Repealed Eff. July 1, 2018.