Performant Recovery Discussion Period Request Form 2013 free printable template

Performant Recovery, Inc. Discussion Period Request Form Part A, Part B and DME Region A Recovery Audit (RA) Request to Open Discussion Period For instructions about completing and submitting this

How to fill out Performant Recovery Discussion Period Request Form

How to fill out Performant Recovery Discussion Period Request Form

1. Gather relevant patient information including name, date of birth, and claim number.
2. Identify the specific claim you are disputing and provide the details in the form.
3. Clearly outline the reasons for the dispute or request for discussion.
4. Include any supporting documentation that reinforces your claim.
5. Fill out your contact information for follow-up communication.
6. Review the completed form for accuracy and completeness.
7. Submit the form according to the instructions provided (via email, fax, or mail).

Who needs Performant Recovery Discussion Period Request Form?

1. Healthcare providers who have received a notice of overpayment or audit from Performant.
2. Providers seeking clarification on specific claims or billing issues.
3. Organizations involved in the review and appeal process related to Medicare or Medicaid claims.

For pdfFiller’s FAQs

Where do I find Performant Recovery Discussion Period Request Form?

The premium subscription for pdfFiller provides you with access to an extensive library of fillable forms (over 25M fillable templates) that you can download, fill out, print, and sign. You won’t have any trouble finding state-specific Performant Recovery Discussion Period Request Form and other forms in the library. Find the template you need and customize it using advanced editing functionalities.

Can I create an electronic signature for the Performant Recovery Discussion Period Request Form in Chrome?

As a PDF editor and form builder, pdfFiller has a lot of features. It also has a powerful e-signature tool that you can add to your Chrome browser. With our extension, you can type, draw, or take a picture of your signature with your webcam to make your legally-binding eSignature. Choose how you want to sign your Performant Recovery Discussion Period Request Form and you'll be done in minutes.

Can I edit Performant Recovery Discussion Period Request Form on an iOS device?

Use the pdfFiller app for iOS to make, edit, and share Performant Recovery Discussion Period Request Form from your phone. Apple's store will have it up and running in no time. It's possible to get a free trial and choose a subscription plan that fits your needs.

What is Performant Recovery Discussion Period Request Form?

The Performant Recovery Discussion Period Request Form is a document used by healthcare providers to formally request a discussion period regarding audit findings or overpayment determinations made by Performant Recovery, Inc.

Who is required to file Performant Recovery Discussion Period Request Form?

Healthcare providers or entities who wish to contest audit findings or overpayment determinations by Performant Recovery, Inc. are required to file this form.

How to fill out Performant Recovery Discussion Period Request Form?

To fill out the Performant Recovery Discussion Period Request Form, providers must complete all required fields such as their contact information, details of the audit finding or overpayment, and a summary of the reasons for the request. It is essential to provide clear and accurate information to facilitate the discussion.

What is the purpose of Performant Recovery Discussion Period Request Form?

The purpose of the Performant Recovery Discussion Period Request Form is to formally initiate a discussion with Performant Recovery regarding the provider's audit findings or overpayment issues, allowing for clarification and resolution.

What information must be reported on Performant Recovery Discussion Period Request Form?

The information that must be reported on the Performant Recovery Discussion Period Request Form includes the provider's name, NPI number, contact details, specifics of the audit or overpayment being disputed, and any relevant documentation that supports the request for discussion.