Medicaid Ambulance, Dental, and Emergency Room Claims - 391-0716-16

Description of Agency

The primary purpose of the Medicaid ambulance program is to provide transportation for Medicaid beneficiaries that are either unable to transport themselves from one location to another or are in a life threatening situation and need immediate transportation. The Medicaid dental program provides medical/dental services to Medicaid beneficiaries to prevent acute dental problems and irreversible damage to teeth or supportive structures. Emergency room services include outpatient emergency department claims and professional emergency department services provided by a medical professional.

Audit Objectives

  1. To assess the effectiveness of the Michigan Department of Health and Human Services’ (MDHHS’s) efforts to ensure the propriety of ambulance, dental, and emergency room claim payments.

  2. To assess the effectiveness of MDHHS in ensuring that ambulance, dental, and emergency room claims are processed in a timely manner.


Timing

Estimated Release Date: May 2017


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