Eli's Hospice Insider

Published on Wed Apr 18, 2018 PDF

Don't wait until the round is over to implement improvements.

Seeing the error of your billing ways - and changing them immediately - could get you off punishing Targeted Probe & Educate review, a recent question and answer from Medicare suggests.

Question: "What happens if there are errors in the claims reviewed?" asked one health care provider, according to a recently posted Q&A set from the Centers for Medicare & Medicaid Services.

Answer: "At the conclusion of each round of 20-40 reviews, providers/suppliers will be sent a letter detailing the results of the reviews and offering a 1-on-1 education session," CMS answers in the Q&A set. But Medicare Administrative Contractors "will also educate providers/suppliers throughout the TPE review process, when easily resolved errors are identified, helping the provider to avoid additional similar errors later in the process. CMS' experience has shown that this education process is well received by providers/suppliers and helps to prevent future errors."

Note: See the Q&As at www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/Medical-Review/Downloads/TPE-QAs.pdf.