Free Webinar: Claim Reviews: A Survivor’s Guide; Presented by Alicia Cantinieri

Medicare Claim Audits are on the horizon.
Now’s the time to prepare!

On May 4, CMS issued Pub 100-20 Transmittal 12015 mandating Medicare Area Contractors to conduct a 5-Claim Probe and Educate Review for all SNFs in response to the CERT program’s 15.1% improper 2022 payment rate. After rescinding the first transmittal, CMS released Pub 100-20 Transmittal 12037 on May 15, repeating the SNF 5-Claim Probe Educate Review mandate and stating the identification of improper payment would result in adjustment or denial of claims.

As of June 5, MACs have begun a nationwide prepayment review, starting with the top 20% of providers showing the highest risk profiles. The main reason for claim adjustment or denial is a lack of documentation.

How can you prepare for the coming audits? Join us to learn about:

• The recent CMS memo regarding the SNF 5-Claim Probe and Educate Review
• The most frequent reasons for Medicare Part A claim denial
• Documentation best practices to support your Medicare claims
• Step-by-step procedures to prepare and respond to this or any Medicare audit