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Estes Park Health scores win with Medicare review

When Medicare claims are submitted accurately, everyone benefits. That is the philosophy behind the Targeted Probe and Educate (TPE) program. The review is designed to help providers and suppliers reduce claim denials and appeals through one-on-one help. Estes Park Health’s wonderful Patient Financial Services department had a big win recently! Estes Park Health was selected for prepayment review on […] ....

Patient Financial Services Department , Centers For Medicare , Estes Park Health , Patient Financial Services , Targeted Probe , Park Health , Information Management ,

The Gift That Keeps On Giving: TPE Insights and Strategies | Husch Blackwell LLP

While not new, the number and scope of Targeted Probe and Educate (TPE) reviews have soared to new heights. At the same time, more hospices are facing the uncomfortable position of. ....

Husch Blackwell Meg Pekarske , Bryan Nowicki , Targeted Probe , Husch Blackwell , Meg Pekarske ,

CMS 5-claim audits so far a 'debacle' - McKnight's Long-Term Care News

A new federal review process designed to lessen improper government payments is sending provider staffs scurrying to justify their coding. ....

United States , Jessie Mcgill , Eleisha Wilkes , Human Services , Us Department Of Health , Medicare Medicaid Services , Patient Health , Resource Utilization Group , Curriculum Development Specialist , Long Term Care News , Skilled Nursing Facility , Claim Probe , Medicaid Services , Medicare Part , Medicare Administrative Contractors , American Association , Post Acute Care Nursing , Long Term Care , Patient Driven Payment Model , Targeted Probe , Proactive Consulting , Brief Interview , Mental Status ,

CMS Announces New "SNF 5-Claim Probe & Educate Review" | Maynard Nexsen

On June 8, 2023, the Centers for Medicare & Medicaid Services (CMS) announced a new nationwide audit of all skilled nursing facilities (SNF) and Hospital swing bed providers that submit. ....

Maynard Nexsen , Resource Utilization Group , Centers For Medicare Medicaid Services , Medicaid Services , Claim Probe , Medicare Administrative Contractor , Comprehensive Error Rate Testing , Payment Driven Model , Educate Review , Targeted Probe , Medicare Fee For Service , Patient Driven Payment Model ,

Medicare Administrative Appeals Process Explained for Providers

The Medicare appeals process starts well before the first level listed above when a provider receives a medical records request, also known as an additional records request. These requests can come from different Medicare contractors, for example, a MAC or a UPIC. ....

Program Integrity Contractor , District Court , Medicare Appeals , Federal District , Medicare Administrative Contractor , Unified Program Integrity Contractor , Initial Request , Reconsideration Decision , Targeted Probe , Supplemental Medical Review , Recovery Audit Contractor , Medicare Administrative Contractor , Unified Program Integrity Contractor , Medicare Appeals Process ,