Developing a Winning Hospice Targeted Probe and Educate Medical Review Strategy is proudly presented to you by National Association for Home Care & Hospice. Thank you. We hope that you enjoy your course.
With CMS' increased focus on fraud, abuse and waste, Targeted Probe and Educate (TPE) reviews have now extended to Hospice agencies. TPE is part of CMS’s attempts to prevent improper payments in a manner that does not increase the administrative burden on providers, and reduce the number of appeals. TPE targets selected providers of a service rather than all who deliver that service. Specifically, data analysis is used to identify statistical outliers in the historical claims billing data to identify specific providers. Hospice providers must fully understand the areas within the hospice benefit which could be at risk for improper Medicare payment and therefore, are areas for potential TPE review. ♦ Commercial support provided by Axxess
Learning Outcomes:
- Raise awareness of Targeted Probe and Educate Medical Reviews.
- Develop a proactive strategy of clinical and compliance review prior to claim submission.
- Identify tips and procedural concepts for responding to documentation requests and initiating appeals.
Faculty:
Yolanda Riley