Payment Error Rate Measurement

Please review the lists that most closely match the services you provide. The Livanta lists are examples of what providers will receive in the mail if they have had a Medicaid claim chosen for review. The lists explain what documents should be included in your submittal to Livanta to support the claim. Some divisions have also made lists for providers. These may be more specific, and can be helpful in preparing for other audits or claim reviews as well as PERM. We encourage providers to look at both types of lists.

Ambulatory surgical center

• Livanta documentation checklist

Chiropractor individual, group

• Livanta documentation checklist

Dentist individual, group

• Livanta documentation checklist

Dietician and nutritionists

• Livanta documentation checklist

Durable medical equipment (DME) supplier and infusion therapy

• Livanta documentation checklist: durable medical equipment and IV therapy supplies
  
  
• Livanta documentation checklist IV therapy clinic

EPSDT (well child check-ups, immunizations)
Early Periodic Screening and Diagnostic Testing

• Livanta documentation checklist: outpatient
• Livanta documentation checklist: support service

End stage renal disease center

• Livanta documentation checklist

Family planning clinic 

• Livanta documentation checklist

Occupational therapist

• Livanta documentation checklist

Optometrist, optician

• Livanta documentation checklist

Outpatient physical therapy or speech therapy center, independent physical therapist

• Livanta documentation checklist

Nurse midwife and direct entry midwife 

• Livanta documentation checklist

Speech pathologist 

• Livanta documentation checklist

Hearing and audiology  

• Livanta documentation checklist

Hospice 

• Livanta documentation checklist

Home health agency

• Livanta documentation checklist

Infusion therapy

• Livanta documentation checklist (6)
• Livanta documentation checklist (7)
• Livanta documentation checklist (9)

Inpatient/outpatient hospital

• Livanta documentation checklist (inpatient)
• Livanta documentation checklist (outpatient)

Independent laboratory

• Livanta documentation checklist

Pharmacy  

• Livanta documentation checklist

Physician/osteopath indiv/group

• Livanta documentation checklist

Private duty nursing agency  

• Livanta documentation checklist

Prosthetic and orthotic supplier

• Livanta documentation checklist

Podiatrist individual, group

• Livanta documentation checklist

Respiratory therapist

• Livanta documentation checklist

Rural health clinic/FQHC (Federally Qualified Health Center)

• Livanta documentation checklist (Registered Nurse)
• Livanta documentation checklist (Private Duty)

Registered nurse, LPN, ANP

• Livanta documentation checklist

Ground ambulance, taxi, other transportation, airline, air ambulance

• Livanta documentation checklist

Other accommodations, hotel/motel with restaurant, hotel/motel w/o restaurant

• Livanta documentation checklist

Radiology provider

• Livanta documentation checklist

Vision group

• Livanta documentation checklist