DRG, APC, Clinical Validation and Readmission Guideline audits by VARIS, LLC

Please don’t submit a replacement claim once a claim has been selected for a pre- or post-payment review.

Level I audit disputes

As of Mar. 19, 2023, providers have one audit appeal right.

When two different facilities are involved with the readmissions, the right to appeal this audit belongs to the provider who submitted the original claim and whose reimbursement is being impacted.

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

    VARIS sends the acknowledgement form along with your change notification letter. With the form, you'll need to submit additional or clarifying information to VARIS within 30 days of receipt of audit findings. If you don't have the form, you can contact VARIS by phone at 916.294.0860.

  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:

Email: appeals@varis1.com

Phone: 916.294.0860

Fax: 916.294.0844

9245 Sierra College Blvd. Ste 100 
Roseville, CA 95661

SFTP: Must be established with VARIS, LLC in advance