Inpatient Recovery Audit

The scope of this contract is to perform a retrospective review for improper payments to include both over and under payments, of eligible VA payments for inpatient care provided by Non-VA providers during fiscal years 2007 through 2011. VA fiscal year begins each October 1st and ends each September 30th. The contractor shall complete reviews and establish cases on overpayments for all claims within one year of receipt of the final claims payment data from VA. The review includes collecting and analyzing the payment and medical supporting documentation for VA payments on contractor selected cases, determining improper payments, reporting results, establishing debts, and completing follow-up actions. The contract will be conducted at the contractor facilities.