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This edition includes information on a new model to target wasteful, inappropriate services in Original Medicare, CY 2026 proposed rules for ESRD and home health, revalidation deadline for skilled nursing facilities, and more.
Read this article to learn more about the CERT awareness month campaign focusing on responding to CERT documentation requests.
Get the latest news regarding provider audit and reimbursement, along with forms for interim rate and periodic interim payment requests as well as statistical and reimbursement report fax sheets.
Details on submitting the credit balance report, submission deadlines, and a tool to check credit balance status.
This edition includes information on hospital price transparency, providers accepting CHAMPVA, a Medicare fraud alert, and more.
Review the top denial / partial denial reasons and high-level results listed below from each round of JN ESRD TPE reviews.
View targeted probe and educate (TPE) round results for end stage renal disease (ESRD).
DHHS authorizes an extension of Medicare fee-for-service (FFS) response to hurricane Helene for the state of Georgia.
View this updated listing of targeted probe and educate (TPE) review topics.
Review the top denial / partial denial reasons and high-level results of evaluation and management services – emergency department visits TPE round results.