Revision : 2
Record Description : This record contains documentation of civil reviews by SUR analysts investigating Medicaid providers (e.g., doctors, dentists, medical suppliers, pharmacies and ambulance services) for potential over/under utilization of services. Reviews are conducted on providers from random samples of their records which must support the type of service and charges being billed. File contains, but is not limited to, records of procedures taken by analysts during an investigation; settlement agreements and adjudication orders; related correspondence, forms, logs, random samples used to identify and build cases on potential abusers; recipient complaints against providers; remittance statements; 1099 listing; and SUR subsystem reports.