Level I audit disputes

If you receive a DRG or APC change notification letter from VARIS, LLC, one of our vendor partners, and you disagree with their findings:

1. Complete the acknowledgement form

   With the form, you'll need to submit additional or clarifying information to VARIS within 30 days of receipt of audit findings.

2. Document the points of your disagreement

   In addition to the acknowledgement form, include:

   An explanation of why you disagree with the findings and/or the interpretation of a guideline

   Sections of the medical record that support your dispute (NOT the complete medical record)

   Query documentation if appropriate

   References as needed to support your dispute

Submitting your form

Send your acknowledgement form and documentation to VARIS via:

Fax: 916.294.0844

Mail: VARIS, LLC
3915 Security Park Drive, Ste B
Rancho Cordova, CA 95742

SFTP: Must be established with VARIS, LLC in advance

Level II audit disputes

If you exhaust the VARIS process and you still disagree with the findings, you have 45 days from the date you receive the VARIS response to submit your dispute to the Priority Health Payment Integrity department.

Documentation

With copies of the initial audit findings, your appeal letter and the VARIS response, include:

• A summary of why you disagree with the findings and/or the interpretation of a guideline
• Pertinent pieces of the medical record that support your dispute (NOT the complete medical record)
• Query documentation if appropriate
• References that support your dispute

Submitting your Level II dispute

Send your dispute to Priority Health at:

Fax: 616.975.8884

Mail: Priority Health
Attn: Payment Integrity MS 2205 
1231 East Beltline NE
Grand Rapids, MI 49525

Email: PaymentIntegrity@priorityhealth.com, indicate DRG or APC dispute in the subject line.