tci Medicare Compliance & Reimbursement - 2018 Issue 3

Compliance: Conquer Claims Reviews with These 5 Tips

Be on top of your MAC's TPE guidance as the program evolves in 2018. Now that the MACs are running the show for CMS's Targeted Probe and Educate (TPE) program, ensure you know what's on the to-do list for your jurisdiction. Nuts and bolts: After conducting two rounds of regular Probe & Educate reviews focused on face-to-face requirements, the Centers for Medicare & Medicaid Services instructed all of its MACs to switch their entire medical review operations over to TPE in October (see Medicare Compliance and Reimbursement, Vol. 43, No. 19.). The success of the pilot program led...

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