tci Part B Insider - 2017 Issue 11

Medical Review: Fix Claims Issues to Prevent TPE Scrutiny

Targeted Probe and Educate audits are now in full swing. If Medicare Part B forms and documentation are a hassle for your practice, CMS assures clinicians that new policies will help cut down on the administrative burden. But for those providers whose claims are frequently found in error, the paperwork may be the least of your concerns. Background: CMS decided over the summer to update its successful Probe and Educate medical review program, originally initiated in 2014. This past June, the agency upped its strategies, using first one of its Medicare Administrative Contractors (MACs) as a "pilot" for a...

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