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Scenario Red Flag - Assessment
Red Flag:
Description:
Path: Provider Compliance - Submission of Accurate Claims and Information > Billing - Patient not present > Billing for services not provided - Using phantom or deceased persons' names
       
Red Flag Assessment (edit)
1. Assessment Performed By  
2. Assessment Date  
3. Red Flag Frequency  
4. Red Flag Risk  
 
       
 
Red Flag Evaluation
 
Audit Procedure Results
 
Procedure Procedure Description Red Flag Frequency Red Flag Risk Risk Narrative
Perform review of selected patient files Moderate Moderate
 
Test Results
 
Test Test Description Red Flags Frequency Red Flags Risk Risk Narrative
Test patient files Test Moderate Moderate
 
 
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