Events - Home Care & Hospice Resource - Healthcare Provider Solutions

Category: Hospice Documentation

Top Denial Reasons – Hospice Targeted Probe and Educate

By Leslie Heagy / Posted on: September 11, 2018 5 minutes to read

Targeted Probe and Educate (TPE) is underway for Hospice Agencies. HPS is seeing many ADR denials with agencies moving to round 2 and 3 of TPE from both CGS and NGS.

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Targeted Probe and Educate – What We Have Learned So Far

By Melinda Gaboury / Posted on: March 13, 2018 7 minutes to read

Targeted Probe & Educate began on 10/1/17 and is full speed ahead. HPS has discovered nuances with TPE that we did not expect nor have we experienced in past ADR reviews. This review includes targeted medical review and education along with the potential of elevated action toward the agency. This elevated action could take place if the agency is not meeting the standards laid out by the Medicare MAC.

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Preparing for Hospice Targeted Probe and Educate (TPE)

By Katie Wehri / Posted on: October 31, 2017 9 minutes to read

As previously reported, the targeted probe and educate (TPE) process is replacing the medical review process used by Medicare Administrative Contractors (MAC). Each of the three MACs – Palmetto GBA, NGS and CGS – can choose the topics for review under TPE based on existing data analysis procedures.

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Hospice CTI and Election Statement Made Easy

By Katie Wehri / Posted on: October 16, 2017 8 minutes to read

CMS reminded hospices recently about the need to comply with Medicare hospice election statements and certification of terminal illness (CTI) requirements. This reminder comes shortly after CMS’ announcement of the expansion of the targeted probe and educate (TPE) method of medical review to hospices and other provider types. We believe there is a strong possibility that CMS will…

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Targeted Probe and Educate

By Melinda Gaboury / Posted on: September 25, 2017 5 minutes to read

HPS reported recently regarding continued Probe & Educate for Home Health agencies. This is to clarify that the CMS expansion on Probe & Educate is for Home Health and Hospice and will be effective 10/1/2017. This is referred to as Targeted Probe & Educate (TPE). This review will include targeted medical review and education along with an option for potential elevated action, up to and including referral to other Medicare contractors including the Zone Program Integrity Contractor (ZPIC), Unified Program Integrity Contractor (UPIC), Recovery Audit Contractor (RAC), etc.

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Hospice Quality Reporting Program Update – HIS and Hospice Compare

By Katie Wehri / Posted on: June 16, 2017 9 minutes to read

CMS recently released clarification of the response options for HIS item A1400, Payor Information. Many hospices have been asking how to complete this item with questions about the Self Pay option, in particular. In addition to the information in the HIS Manual, CMS provides the following additional information specific to the…

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Attending versus Referring Physician in Hospice

By Katie Wehri / Posted on: June 1, 2017 9 minutes to read

A physician refers a patient to hospice care – what role does this physician play in the care of the patient and in certifying the patient? It depends. Let’s look at the various hospice requirements that involve a physician.

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HIPAA for Home Care | Establishing A Compliant Agency

By Drew Rowley / Posted on: March 3, 2017 5 minutes to read

HIPAA has become an acronym synonymous with healthcare. We see it practiced and preached daily throughout the home care and hospice industry. However, too often breach notifications are at the top of our industry headlines. These breaches are costing our agencies time, money, and patient credibility. If we as agency owners, administrators, and employees understand the severity of a breach then why are breaches still occurring?

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