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Text of Recommendation
Enhance its prisoner medical request and medical claim review training. Specifically, the USMS should : (1) ensure all remaining district office personnel responsible for processing prisoner medical requests and medical claim reviews receive formal training from POD-OMO; (2) revise its procedures to ensure newly assigned prisoner medical request and medical claim review personnel also receive the same training prior to assuming these responsibilities; and (3) provide appropriate medical billing training to help district office personnel more easily match medical services to preauthorization's and identify medical claim deficiencies.
Recommendation Number
8
Date Issued
Status
Resolved
Component
United States Marshals Service
Report
Audit of the U.S. Marshals Service’s Prisoner Medical Request and Medical Claim Review Processes through its National Managed Care Contract with Heritage Health Solutions, Inc.