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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.
Prior authorization is a process through which coverage is determined prior to providing or billing the service. This process allows the provider to submit documentation prior to providing or billing the service. The contractor will then al…
Access tools and forms related to the prior authorization program, CERT, and provider audit.
Use these checklists to ensure you have met medical documentation requirements based on specific services.
View these round results for rehabilitation services outpatient.
View targeted probe and educate (TPE) round results for clinical laboratory services.
Review the top denial / partial denial reasons and high-level results listed for DRG 885.
Review the targeted probe and educate (TPE) round results for inpatient rehabilitation facility (IRF).
When a medical reviewer contacts the provider requesting to submit an attestation statement or signature log to authenticate a medical record, the provider must submit the attestation statement or signature log within 20-calendar days.