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Speaker(s): Melinda A. Gaboury, CEO
About the Speaker(s)
Melinda A. Gaboury, with more than 30 years in home care, has over 22 years of executive speaking and educating experience, including extensive day to day interaction with home care and hospice professionals. She routinely conducts Home Care and Hospice Reimbursement Workshops and speaks at state association meetings throughout the country. Melinda has profound experience in Medicare PDGM training, billing, collections, case-mix calculations, chart reviews and due diligence. UPIC, RA, ADR & TPE appeals with all Medicare MACs have become the forefront of Melinda’s current impact on the industry. She is currently serving as the Chair of the NAHC/HHFMA Advisory Board and Work Group and is currently serving on the Board of Directors for both the Home Care Association of Florida & Tennessee Association for Home Care. Melinda is also the author of the Home Health OASIS Guide to OASIS-E and Home Health Billing Answers, 2023.
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About the Event
Thursday, May 9:
Speaker: Melinda A. Gaboury, CEO
Session Details:
Targeted Probe & Educate has been in place since 2017 – paused in 2020 and resumed in late 2021. This program has evolved and situations such as an agency being subject to two simultaneous TPE reviews has propelled to the forefront of concern. This session will provide both home health and hospice agencies with insight into the program and how things have continued to evolve. A review of the top denials from NGS – Medicare MAC will also be included in this update. This session will also review submission guidelines for submitting data to the MAC for review. It is imperative that agencies are prepared to successfully weather the storm of TPE that can hit your agency at any time.
AFTER THIS SESSION YOU’LL BE ABLE TO:
- Detail the process of Targeted Probe & Educate (TPE)
- Outline the triggers for agencies to be targeted under TPE.
- List significant issues identified in reviews that cause denials.
- Detail the top denial reasons for agencies under TPE