Medical Record Review Results - JA DME
Medical Record Review Results
Targeted Probe and Education (TPE) Reviews - Noridian reviews used to help improve a supplier's claim payment error rate and reduce the volume of appeals through claim review and education
Service Specific Post-Payment Reviews - Noridian has no current active Post-Payment Reviews
Service Specific Pre-Payment Reviews - Noridian has no current active Service Specific Pre-Payment Reviews
Supplier compliance results for all TPE reviews completed from January 1, 2020 – March 31, 2020, included:
- 10-claim preview - 12% compliance
- Round 1 - 55% compliance
- Round 2 - 38% compliance
- Round 3 - 80% compliance
- CMS referral - 0%
X
| Review Criteria | Current Error Rate | Current Review Results |
|---|---|---|
| Ankle Foot/Knee-Ankle-Foot Orthosis (AFO/KAFO) TPE Reviews | 25% | |
| Diabetic Supplies TPE Reviews | 48% | |
| Hospital Bed TPE Reviews | 46% | |
| Immunosuppressive Drug TPE Reviews | 15% | |
| Knee Orthosis TPE Reviews | 70% | |
| Manual Wheelchair TPE Reviews | 13% | |
| Oral Anticancer Drugs TPE Reviews | 0% | |
| Ostomy TPE Reviews | 9% | |
| Oxygen TPE Reviews | 15% | |
| Positive Airway Pressure (PAP) TPE Reviews | 16% | |
| Respiratory Assist Devices TPE Reviews | 37% | |
| Spinal Orthoses: TLSO and LSO TPE Reviews | 22% | |
| Surgical Dressing TPE Reviews | 72% | |
| Therapeutic Shoe TPE Reviews | 44% | |
| Urological Supplies TPE Reviews | 29% |
Last Updated Mon, 04 May 2020 19:46:12 +0000