Targeted probe and educate (TPE) topics and schedule of review
View this updated listing of targeted probe and educate (TPE) review topics.
Articles
Article Type
Category
Targeted probe and educate (TPE) round results: Evaluation and management services – initial inpatient care visits and subsequent inpatient care visits
Review the top denial / partial denial reasons and high-level results of evaluation and management services - initial inpatient...
Breakdown of Common Minimum Data Set (MDS) errors
The MDS is a tool used for implementing standardized assessment and for facilitating care management in skilled nursing homes...
Medical necessity requirements for skilled nursing facility (SNF) admissions
This questionnaire is intended to provide health care providers with a reference for use when screening a new patient for a SNF...
CBR Guide - Part B
The Comparative Billing Report (CBR) for Part B providers furnishes a detailed examination of the comparative data that Medicare...
Hospital outpatient department (OPD) prior authorization (PA) exemption process reminders
Hospital outpatient departments that qualify for an exempt status effective January 1, need to have at least 10 claims submitted...
Checklist: Transitional Care Management services documentation
This checklist is intended to provide health care providers with a reference for use when responding to medical documentation...
Targeted probe and educate (TPE) round results: Endovascular cardiac valve replacement and supplement procedure (DRG 266 & 267)
Review the top denial/partial denial reasons and high-level results from each round of DRG 226 and 267 TPE.
Understanding repetitive scheduled non-emergent ambulance transports
Review these FAQs to learn more about the prior authorization for repetitive scheduled non-emergency ambulance transport.
Prior authorization (PA) for hospital outpatient department (OPD) services: tips and reminders
The following are tips and reminders that will assist providers in avoiding a delay or dismissal of a prior authorization...