Audits & ADR/TPE: How to Approach & Successfully Maneuver Through the Process

Date/Time: 11/17/2020, 10:00 am - 4:30 pm

Provider: FHPCA

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10:00 am – 11:30 am HST
11:00 am – 12:30 pm AKT
12:00 pm – 1:30 pm PT
1:00 pm – 2:30 pm MT
2:00 pm – 3:30 pm CT
3:00 pm – 4:30 pm ET

Does your agency have a mechanism for determining whether to appeal a denied government claim? How do you identify areas of risk for oversight? What are the best practices for avoiding increased scrutiny? Deepen your understanding with the answers to these questions and more during this must-attend webinar.


  • Define fraud, abuse, and the different types of government audits
  • Distinguish between payment-related oversight and oversight related to patient safety and quality-of-care issues
  • Explain the Additional Document Request (ADR)/Targeted Probe & Educate (TPE) process and agency responsibilities
  • Identify and decrease risk
  • Define what is required to minimize audits and ADRs/TPE
  • Determine whether to appeal a denied government claim


The healthcare industry is experiencing decreased acute care and increased referrals and CMS expenditures for hospice programs. Increased expenditures bring additional oversight of the post-acute care industry and more ADR/TPE audits. Avoid the scrutiny with industry-standard best practices and identify areas of oversight risk. Defining and reviewing the Additional Document Request and Targeted Probe & Educate process is a good place to start.

This webinar will teach you to identify the different types of government audits and oversight and determine whether to appeal a denied government claim. You’ll study the steps required to effectively submit documentation and win an appeal. Learn which data points are important, what can trigger additional oversight, and common reasons for claim denial. Discover how to implement best practices now to successfully maneuver through the process and avoid future denials.

Attendance certificate provided to self-report CE credits.


This informative session is excellent information for all agency personnel, including administrators, finance staff, clinical managers and supervisors, QAPI team members, medical directors, board members, liaisons, and intake personnel.


  • Medicare Program Integrity Guide
  • Links to:
    • CGS ADR/TPE process handout
    • Fiscal Intermediary Standard System (FISS) Direct Data Entry (DDE) Guide
    • myCGS Medical Review User Manual
    • Hospice documentation audit tool
  • Additional valuable websites and tools

This webinar is available exclusively through the Hospice & Home Care Webinar Network.

PLEASE NOTE: Webinar content is subject to copyright and intended for your individual organization’s use only.

Photo Kathy Ahearn


Ahearn Advisement Partners

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