Program Integrity Unit

# of Providers Proactively Audited

0SFQ1 2021

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Notes on Methodology

The target for this measure is 50.

Partners
  • Medicaid Providers
  • DXC
  • Provider Member Relations Unit
  • Clinical Operations Unit
  • OneCare Vermont
Story Behind the Curve

One of PIU most important goals is to interact with as many providers as possible.  The more providers PIU encounters the more cost avoidance can be realized.  PIU seeks to measure the effectiveness of PIU contact with providers to determine if the provider changed their billing patterns going forward after PI involvement. 

 

Last updated:  10/15/2020

Strategy

Data analytics or other leads will identify potential subject area and providers to audit.  PIU strives to audit a variety of providers, educate as appropriate, and recover funds when necessary.

Scorecard Result Container Indicator Measure Action Actual Value Target Value Tag S R I P PM A m/d/yy m/d/yyyy