Kathleen Schaum provided the first of 4 free sessions on “Keeping your Payment after an Audit.” During the first session, she encouraged physicians, qualified healthcare professionals, and hospital-owned outpatient wound/ulcer management provider-based departments to investigate the topics of the Targeted Probe and Educate Audits that are being performed by the Medicare Administrative Contractor (MAC) that processes their claims.
Because I live in Texas and my claims are processed by Novitas Solutions I logged onto the Novitas website, where I found that the list of active Targeted Probe and Educate (TPE) audit topics includes Debridement. Hot links took me to a checklist for debridement documentation, as well as the relevant Local Coverage Determination (LCD) and a checklist for medical documentation in general. It only took 5 minutes to find these materials which helped me understand what my MAC will be looking for if/when I have a pre-payment audit about my debridement services.
Now I know exactly what Novitas Solutions expects me to document to prove medical necessity for debridement. The rest is up to me. After following Kathleen’s advice, I clearly understand that my MAC tells me exactly what to do to pass an audit. The rest is up to me.
Don’t miss the second of four FREE sessions with Kathleen Schaum on Wednesday, October 5th at 5 pm EST. Click here to register.
–Caroline E. Fife, MD
