Medicare Administrative Contractor Palmetto GBA has posted Q&As from its recent teleconference on targeted probe-and-educate (TPE) reviews.
Among other things, Palmetto leaders addressed when it will reach out to providers with questions.
Palmetto encouraged agencies to include the name of their designated contact person when responding to additional documentation requests (ADRs).
“Not all providers will receive a call during the review process,” Palmetto officials note. “The medical reviewer will only reach out during the review process if there is an easily curable issue identified. If a complete package is initially submitted, Palmetto GBA would not reach out until all of the reviews have been completed. Then a post-protocol call will be scheduled.”
Within the Q&As, one agency asked if reviewers will call agencies if the agency’s package is missing a page — “Sometimes this occurs with a fax machine or uploading through eServices and we receive a denial without an intra-call.”
According to Palmetto officials, “Reviewers have been trying to reach out to the provider when there is a missing piece of documentation that would support payment.”