Medical Review: Try These 5 Tips To TPE Success
Do you know the difference between your charge error rate and your claim error rate? Whether you want to avoid Targeted Probe & Educate review or get off TPE once … Continue Reading →
Category: Medical Review
Targeted Probe & Educate: It’s Getting Worse: 91% Bomb TPE So Far
One MAC releases new stats about the medical review program. As Targeted Probe & Educate rolls on, home health agencies are increasingly getting flattened by the new medical review program. … Continue Reading →
Audits: Know Your Facts: Audit Contractors
TPE net reportedly catches lots of home care providers. Scrutiny of home health and hospice claims is on the rise, and you’d better know where that scrutiny may be coming … Continue Reading →
Review Choice Demonstration: Will Your State Be Next On Pre-Claim Review List?
Medicare to spend nearly $400 million on RCD project, it says. While recently released documents on the Review Choice Demonstration for Home Health Services are shedding some lights on a … Continue Reading →
Medical Review: Illinois HHAs Hope For Generous Exemptions To RCD
Even agencies that qualify for exemption will be subject to 5% ‘spot check.’ One of the most pressing questions for the home health agencies scheduled to undergo the relaunched Pre-Claim … Continue Reading →
Know Your Facts: Live Discharge Rate Dropped Again In 2017
LOS ticks upward. You have only a matter of days left to give Medicare your two cents on its proposed rule for hospice payment for next year. Consider these 2017 … Continue Reading →
Medical Review: Industry Mobilizes For Pre-Claim Review Opposition
Learn from original PCR run, trade group tells Medicare officials. Unlike with the original Pre-Claim Review demonstration, home health agencies are hoping to head off the medical review project before … Continue Reading →
Medical Review: Revise Your Thinking On TPE Rounds
Round timing is provider-specific under new initiative. Getting a clear picture of the Targeted Probe & Educate program’s impact on the home care industry is complicated by “round” confusion. Old … Continue Reading →
Compliance: Use These 7 Tips To Protect Your Claims Against TPE Denials
Ignoring ADRs pretty much guarantees more review, expert warns. The consequences for not performing well under Targeted Probe & Educate review can be harsh — and eventually fatal to your … Continue Reading →
Targeted Probe & Educate: Nearly 1/3 Of Claims Fail Palmetto TPE Review So Far
Plan of Care denials top Palmetto GBA’s list. Another HHH MAC has released preliminary Targeted Probe & Educate review results, and they again bode ill for home health agencies. HHH … Continue Reading →