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Tag: TPE

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Home Oxygen Company earns another reprieve from audits

May 10, 2019HME News Staff

MODESTO, Calif. - Home Oxygen Company has earned another reprieve from audits for oxygen, due its success ratio of more than 90% in recent audits, the company says. Noridian Healthcare Solutions has notified Home Oxygen Company that it has successfully completed Round 1 of the Targeted Probe & Educate program and will not be required to complete subsequent rounds. As a result, the company says its audit file has been “closed.” “This is a collaborative effort between intake and A/R...

Audits, Oxygen, TPE

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CMS tweaks TPE program

January 8, 2019HME News Staff

WASHINGTON - CMS on Dec. 31 implemented the “TPE 10-Claim Preview Pilot” to help reduce the burden for compliant DME providers, AAHomecare reports.Per the pilot, the MACs may select 10 claims for review under Round 1, and if a provider is found to be compliant for a service/item, the NPI associated with those 10 claims will be exempt from reviews for about one year for that service/item. If errors are detected, a provider will go through the usual TPE process.AAHomecare says information...

Audits, TPE

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Is TPE really as easy as 1,2,3?

September 24, 2018Guest Commentary

As you are likely well aware by now, Medicare has transitioned away from widespread prepayment review and is now full speed ahead on their Targeted Probe and Educate (TPE) audit program. The key word here being “targeted.” The widespread medical review audits were previously focused on procedure codes and not necessarily on providers. Anyone submitting claims for codes under review were subject to prepayment audits. Now, they pick specific suppliers to focus their audit efforts on based...

Targeted Probe and Educate, TPE, Wayne van Halem

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Don't gamble on your claims, van Halem Group says

April 23, 2018Theresa Flaherty, Managing Editor

LAS VEGAS - Although Medicare is attempting to reduce claim denials and appeals with a “friendlier” process, HME providers still need to take that process seriously.Originally launched as a pilot program in one MAC jurisdiction in 2016, the Targeted Probe and Educate program was expanded to all jurisdictions in October 2017.“Reducing the provider burden is great—who doesn't want to reduce burdens,” said Wayne van Halem, president of The van Halem Group, during his Medtrade...

The van Halem Group, TPE, Wayne van Halem

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