TPE

[lacey15890]

Anyone else going through the TPE process? If so what all information did you guys send in On top of the required information?

 

[NomadicMedic]

Thermoplastic Elastomer?

Telework Partnership with Employers?

Total Power Exchange?

 

[akflightmedic]

Toilet Paper Extravaganza!

 

[Summit]

Therapeutic Plasma Exchange?
Threshold PhotoElectron spectroscopy?
Telomere Position Effect?

 

[Aprz]

I've never heard of TPE before.

 

[RocketMedic]

Triple Penetrated Entrails?

 

[NomadicMedic]

Triple Penetrated Entrails?

Ow.

 

[Flying]

https://www.cms.gov/Research-Statis...cal-Review/Targeted-Probe-and-EducateTPE.html

Never heard of it. Seems to be that if you know what it stands for, your company is probably in (big?) trouble.

 

[lacey15890]

It's a new review process that has been put into place by Medicare . A Targeted Probe & Educate process that is extremely less invasive than an audit but is similar. It is a 3-tier review process examining 30-40 claims for medical necessity and requiring all documentation on the claim and patient. At my last ABC 360 conference it was announced that they would be happening and would become quite common sometimes happening to a company more than one time a year. This is our first one and we are in tier one hoping to pass with flying colors. I was just wondering if anyone else was going though the same process.

 

[Aprz]

Whelp, I learned something new today. I don't know if my company would get field crews involved with that, but I guess if they have us do CMS/compliance training every year, I don't see why they wouldn't communicate with us about this too?

 

[Carlos Danger]

Whelp, I learned something new today. I don't know if my company would get field crews involved with that, but I guess if they have us do CMS/compliance training every year, I don't see why they wouldn't communicate with us about this too?

Places generally like to keep it on the DL, and don't necessarily want it to be common knowledge that they're being audited by CMS.

 

[lacey15890]

Places generally like to keep it on the DL, and don't necessarily want it to be common knowledge that they're being audited by CMS.

I would say it's not quite an audit. I have my basic but I also have my CAC and am the billing and AR manager. When I went to the billing class this past summer it was explained by PWW that this would become a very common thing for most agencies and is more of a learning/teaching process that would help with compliance across the board. We rarely get denials and have never had any compliance issues but we are mostly just a NonE transport company. So i'm guessing that was the reason for us getting chosen. Im oddly a little excited to see the outcome. We have outstanding EMTs that have amazing documentation skills after all of the InServices we have had. And our QI process is pretty strong. I believe we should have no problems passing with flying colors. But now that I see not many people know about this process maybe it should be more put out there!

 

[Carlos Danger]

I would say it's not quite an audit. I have my basic but I also have my CAC and am the billing and AR manager. When I went to the billing class this past summer it was explained by PWW that this would become a very common thing for most agencies and is more of a learning/teaching process that would help with compliance across the board. We rarely get denials and have never had any compliance issues but we are mostly just a NonE transport company. So i'm guessing that was the reason for us getting chosen. Im oddly a little excited to see the outcome. We have outstanding EMTs that have amazing documentation skills after all of the InServices we have had. And our QI process is pretty strong. I believe we should have no problems passing with flying colors. But now that I see not many people know about this process maybe it should be more put out there!

When a federal agency comes to examine your operation to make sure you are in compliance, it's an audit. They can call it whatever they want….just because it's gentler and starting to happen more frequently doesn't make it any less of an audit.

 

[akflightmedic]

...have my CAC

CAC? Common Access Card also known as ID? You are military?

....was explained by PWW

People Went Whack?

Just FYI, you use a lot of acronyms which are job, employer or region specific...

 

[NomadicMedic]

CAC is Certified ambulance coder. PWW is Page Wolfberg and Wirth, an EMS law firm that does a lot of compliance work.