Surviving Hospice and Home Health Targeted Probe and Educate Audits is proudly presented to you by National Association for Home Care & Hospice. Thank you. We hope that you enjoy your course.
Description:
The Centers for Medicare and Medicaid Services (CMS) has implemented the Targeted Probe and Educate (TPE) program to help providers and suppliers reduce claim denials and appeals through one-on-one help. This program helps in identifying and correcting errors, including common errors such as missing physician signatures. However, TPE is a major issue that makes Home Health and Hospice agencies anxious. TPE is the current process that Medicare MACs are using to conduct medical review in the pre-payment model. The TPE process involves receiving a letter explaining the process, with 20-40 claims being pulled for review. Failing a review means your agency has a denial percentage greater than the Medicare MAC's allowed percentage and this process can be repeated with ongoing review for three additional rounds. This is a costly process and it is important than ever to have clinical staff members review charts and document accurately to prevent denials.
Learning Objective 1:
Gain a comprehensive understanding of the Hospice and Home Health Targeted Probe and Educate Audit process.
Learning Objective 2:
Discuss practical aspects of surviving a Hospice and Home Health Targeted Probe and Educate Audit.
Learning Objective 3:
Implement effective quality improvement strategies to ensure compliance with the CMS regulations and guidelines.
Faculty:
Nursing 1.0 Contact Hours awarded.
Nursing Contact Hours for this module will expire on October 15, 2025.