Meet Medicaid challenges including eligibility and application management, appeals and Adjudication Resolution services.
Richter Healthcare Consultants works with LTPAC providers to implement processes built around Medicaid regulations, and will train staff on the latest billing and reporting requirements. Our team can provide a comprehensive review of claims and documentation to help ensure compliance with the Centers for Medicare and Medicaid Services (CMS) Medicaid Integrity Program.
Richter Healthcare Consultants staff attends industry events to make sure that we maintain the most up-to-date information and training. Our consultants serve on multiple trade association committees and work closely with state and county agencies. From claims resolution to appeals, Richter Healthcare Consultants help LTPAC providers manage Medicaid challenges.
Our Medicaid consulting services include:
- Application and appeals management
- Medicaid program education:
- Eligibility requirements and process
- Medicaid pending case management
- Medicaid managed care
- Adjudication resolution
- Program compliance audits
- Navigating the Targeted Probe and Educate (TPE) Claims ProcessIn recent blogs, we outlined medical Medicare review strategies; probe and educate (PE); we explained Targeted Probe and Educate (TPE), Medicare’s new medical review strategy; and we offered strategies for preparing and submitting TPE documentation. In this blog, we will share tips on navigating the TPE claims review process.
- Preparing and Submitting Documentation for Targeted Probe and Educate, Medicare’s New Medical Review StrategyIn recent blogs, we outlined medical Medicare review strategies, probe and educate (PE), and we explained Targeted Probe and Educate (TPE), Medicare’s new medical review strategy. In this chapter, we will share tips on preparing and submitting your TPE documentation.
- Understanding Targeted Probe and Educate – Medicare’s New Medical Review StrategyIn 2015, the Centers for Medicare and Medicaid Services (CMS) introduced the Probe and Educate (PE) strategy, first to hospitals and then to home health care agencies. With this new strategy, five claims were selected from every hospital and home health care provider. If a claim was denied, one-on-one education was offered in an effort […]