{"id":578,"date":"2018-12-13T16:03:50","date_gmt":"2018-12-13T16:03:50","guid":{"rendered":"https:\/\/advantagehcconsulting.com\/blog\/?p=578"},"modified":"2018-12-13T16:03:51","modified_gmt":"2018-12-13T16:03:51","slug":"take-these-steps-to-combat-tpe","status":"publish","type":"post","link":"https:\/\/advantagehcconsulting.com\/blog\/2018\/12\/13\/take-these-steps-to-combat-tpe\/","title":{"rendered":"Take These Steps To Combat TPE"},"content":{"rendered":"\n<figure class=\"wp-block-image\"><img loading=\"lazy\" decoding=\"async\" width=\"1000\" height=\"746\" src=\"https:\/\/advantagehcconsulting.com\/blog\/wp-content\/uploads\/2018\/12\/Take-these-steps.jpg\" alt=\"\" class=\"wp-image-579\" srcset=\"https:\/\/advantagehcconsulting.com\/blog\/wp-content\/uploads\/2018\/12\/Take-these-steps.jpg 1000w, https:\/\/advantagehcconsulting.com\/blog\/wp-content\/uploads\/2018\/12\/Take-these-steps-300x224.jpg 300w, https:\/\/advantagehcconsulting.com\/blog\/wp-content\/uploads\/2018\/12\/Take-these-steps-768x573.jpg 768w, https:\/\/advantagehcconsulting.com\/blog\/wp-content\/uploads\/2018\/12\/Take-these-steps-210x157.jpg 210w\" sizes=\"auto, (max-width: 1000px) 100vw, 1000px\" \/><\/figure>\n\n\n\n<p><strong><em>Don\u2019t forget about appeals.<\/em><\/strong><\/p>\n\n\n\n<p>Home health agencies affected by Targeted Probe and Educate review, or those just wanting to stay off the TPE radar, should focus on the program\u2019s top denial reasons.<\/p>\n\n\n\n<p>\u201cMost all areas relate to poor documentation or knowledge deficit, particularly regarding face-to-face, plan of care, and&nbsp;recerts&nbsp;for home health,\u201d highlights&nbsp;<strong>Sharon Litwin&nbsp;<\/strong>with&nbsp;<strong>5 Star Consultants&nbsp;<\/strong>in Camdenton, Missouri.<\/p>\n\n\n\n<p>Litwin advises providers to:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>make sure they have a good intake process for F2F;<\/li><li>follow up and work with physicians to ensure they have all required documentation; and<\/li><li>ensure the F2F reason is consistent with the home health primary reason\/diagnosis.<\/li><\/ul>\n\n\n\n<p>And, as always, HHAs should be certain \u201cof course, that the plan of care is patient-specific, has measurable goals, and has appropriate interventions,\u201d Litwin adds.<\/p>\n\n\n\n<p><strong>Don\u2019t forget:&nbsp;<\/strong>Recerts&nbsp;must indicate a continued skilled need, Litwin advises. HHAs that are having difficulty with these requirements may need outside help to get up to speed, she suggests.<\/p>\n\n\n\n<p>HHAs facing TPE denials can zero in on their particular problem areas by carefully analyzing the feedback they get in their one-on-one education calls from the MAC. Remember, \u201cproviders found to be non-compliant at the completion of Round 1 will advance to Round 2 of TPE at least 45 days from completion of the 1:1 post probe education call date,\u201d HHH Medicare Administrative Contractor&nbsp;<strong>CGS&nbsp;<\/strong>says in its TPE results article.<\/p>\n\n\n\n<p>\u201cThe education calls will be very important for all agencies to do to see exactly what the issue is,\u201d Litwin stresses.<\/p>\n\n\n\n<p>But don\u2019t wait until you are on TPE to play defense, urges consultant&nbsp;<strong>Joe Osentoski&nbsp;<\/strong>with&nbsp;<strong>QIRT&nbsp;<\/strong>in Troy, Michigan. \u201cThe moral\u201d of the latest results \u201cis to not get targeted,\u201d he says.<\/p>\n\n\n\n<p>In that vein, \u201cCGS offers education at any time for providers,\u201d the MAC says in the TPE results article. \u201cProviders do not have to be identified for TPE to request education. CGS encourages providers to request education and conduct self-monitoring based on our posted Medical Review Activity Log and using tools such as Comparative Billing Reports (CBRs) offered through our web portal.\u201d<\/p>\n\n\n\n<p><strong>Plus:&nbsp;<\/strong>If you find denials under TPE are unfounded, exercise your right to appeal, Litwin urges. \u201cIf all agencies do this and can \u2026 have them overturned,&nbsp;<em>maybe&nbsp;<\/em>that will show CMS\/OIG that the TPE system is the flaw,\u201d she exclaims.<\/p>\n\n\n\n<p>There should be fertile ground for appeals, expects\u00a0<strong>Lynn Olson<\/strong>, owner of billing company\u00a0<strong>Astrid Medical Services\u00a0<\/strong>in Corpus Christi, Texas. For example, AMS has seen \u201cproviders informed the FTF was not included with the documentation, even though many of the providers had included the documents. There was not a clarification if the FTF was incomplete, date errors, etc. When providers resubmitted the FTF, unchanged, it was accepted and the claim paid,\u201d Olson relates.<\/p>\n\n\n\n<p><strong><em><a href=\"https:\/\/www.supercoder.com\/coding-newsletters\/my-homecare-week-alert\/reimbursement-take-these-steps-to-combat-tpe-159498-article\">Source- SuperCoder<\/a><\/em><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Don\u2019t forget about appeals. Home health agencies affected by Targeted Probe and Educate review, or those just wanting to stay off the TPE radar, should focus on the program\u2019s top &hellip; <a class=\"readmore\" href=\"https:\/\/advantagehcconsulting.com\/blog\/2018\/12\/13\/take-these-steps-to-combat-tpe\/\">Continue Reading &rarr;<\/a><\/p>\n","protected":false},"author":1,"featured_media":579,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8,15,19],"tags":[24,23,31],"class_list":["post-578","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-compliance","category-home-health","category-regulation","tag-homecare","tag-homehealth","tag-tpe"],"_links":{"self":[{"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/posts\/578","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/comments?post=578"}],"version-history":[{"count":1,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/posts\/578\/revisions"}],"predecessor-version":[{"id":580,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/posts\/578\/revisions\/580"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/media\/579"}],"wp:attachment":[{"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/media?parent=578"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/categories?post=578"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/tags?post=578"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}