Get Data Analysis Request For Information (rfi) Form. Waste, Fraud, And Abuse

Completing the Data Analysis Request For Information (RFI) Form is essential for accurately requesting data related to waste, fraud, and abuse. This guide will provide clear, step-by-step instructions to help you navigate through the various fields and sections of the form.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to access and display the form. Ensure you have a stable internet connection to facilitate a smooth online experience.
2. Select the request type from the provided options, such as RFI-Data, Invoice Reconciliation, or Other. Be sure to check all that apply, as this will guide the processing of your request.
3. Fill in the date of your request and law enforcement case number if applicable. Indicate whether this request involves HEAT (Strike Force) by selecting 'Yes' or 'No'.
4. In the requestor's information section, provide all required contact information, including your name, organization, telephone number, mobile phone, physical address, email, and facsimile number. Choose your preferred method of contact.
5. Specify the priority of your request by selecting from the options like 'Priority I (30 day fulfillment)' or 'Priority II (45 day fulfillment)'. This helps the processing team understand the urgency of your request.
6. Detail the type of data you are requesting, such as Medicare Part A, Part B, or Part D. Be sure to include the subject's name and type, providing any available identification numbers related to the request.
7. Provide a reason for your request, detailing any allegations. If necessary, you may submit additional information as an attachment.
8. Enter the dates of service relevant to your request. Keep in mind that Part D data is available starting from January 1, 2006.
9. Include any other data criteria or limitations as required. You may also attach any relevant additional information.
10. Review your entries for accuracy. You will need to sign the form as the requestor to ensure acceptance prior to submission.
11. Submit your completed form via the preferred method: faxing to the NBI Medic RFI Team, emailing as an encrypted file, or mailing to the specified address.

Complete your request and submit the form online to contribute to effective oversight.