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 Machinify (FKA VARIS, LLC), one of our vendor partners, and you disagree with their findings:
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Complete the acknowledgement form
Machinify (FKA VARIS, LLC) sends the acknowledgement form along with your change notification letter. With the form, you'll need to submit additional or clarifying information to Machinify within 30 days of receipt of audit findings. If you don't have the form, you can contact Machinify by phone at 916.294.0860.
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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 Machinify (FKA VARIS, LLC) via:
Email: appeals@varis1.com
Phone: 916.294.0860
Fax: 916.294.0844
Mail: VARIS, LLC
9245 Sierra College Blvd. Ste 100
Roseville, CA 95661
SFTP: Must be established with VARIS, LLC in advance