Richter ShareSource Blog

For long-term post-acute care (LTPAC) providers, it’s already time to think ahead to the coming year. Specifically, it is budgeting season if your organization has a December fiscal year end. Budgeting is critical for purchasing decisions, and having an accurate budget is necessary when it comes time to analyze financial performance. Instead of just assuming the same performance from year to year, we recommend focusing on the areas below and adjusting your budget projections as necessary. 

In recent blogs, we outlined medical Medicare review strategies; explained probe and educate (PE), as well as Targeted Probe and Educate (TPE), Medicare’s new medical review strategy; we offered strategies for preparing and submitting TPE documentation; we outlined the TPE claims review process; and we highlighted top hospice TPE denial reasons. In this blog, we will share some TPE appeal options and recommendations.

To all of the great BOMs out there in the long-term post-acute care (LTPAC) realm, let me say, thank you! You are valued employees in skilled nursing. When one considers everything that you do, it’s obvious that BOMs wear many hats! You must effectively manage and oversee the bookkeeping function, manage and oversee patient accounts, recruit, select, hire, train, evaluate, counsel and supervise business office staff, manage and operate within budgetary parameters, and exhibit excellent customer service and a positive attitude toward residents and families. 

Employee engagement is not a human resources thing, it is not a CEO thing, and it is not an administrative assistant thing. In a long-term post-acute care (LTPAC) organization, there should be a multitude of individuals that must become the “drivers” of cultivating sustainable change when it comes to employee engagement. 

In recent blogs, we outlined medical Medicare review strategies; explained probe and educate (PE), as well as Targeted Probe and Educate (TPE), Medicare’s new medical review strategy; we offered strategies for preparing and submitting TPE documentation; and we outlined the TPE claims review process. In this blog, we will share some of the top hospice agency TPE denial reasons.

In recent blogs, we outlined medical Medicare review strategies; probe and educate (PE); we explained Targeted Probe and Educate (TPE), Medicare’s new medical review strategy; and we offered strategies for preparing and submitting TPE documentation. In this blog, we will share tips on navigating the TPE claims review process.

In recent blogs, we outlined medical Medicare review strategies, probe and educate (PE), and we explained Targeted Probe and Educate (TPE), Medicare’s new medical review strategy. In this chapter, we will share tips on preparing and submitting your TPE documentation.

In 2015, the Centers for Medicare and Medicaid Services (CMS) introduced the Probe and Educate (PE) strategy, first to hospitals and then to home health care agencies. With this new strategy, five claims were selected from every hospital and home health care provider. If a claim was denied, one-on-one education was offered in an effort to prevent future errors.

Targeted Probe and Educate (TPE) is a result of the positive outcomes that were generated through the PE strategy. Although hospice agencies were not included in the PE strategy, TPE was expanded to all Medicare service providers in October 2017. Unlike other strategies, with TPE, your agency will only receive an Additional Development Request (ADR) if it is shown through data analysis that you may be doing something improperly which could result in an improper Medicare payment.