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CMS Improper Payment Probe May Impact Timely Reimbursement for Nursing Homes.

Posted by Admin Posted on Sept 21 2023

Probe & Education Review Letters

Skilled Nursing Facilities are beginning to receive letters from CMS/CGS regarding the Probe and Educate review process. CMS will have its auditors conduct reviews of five claims per SNF – providers with an error rate of 20% or less will receive education of some kind, while those with an error rate greater than 20% will receive one-on-one education with a Medicare Area Contractor (MAC). MACs were directed to start with providers that show the highest risk. See articles below.

Click here to view the CMS Manual System.

Click here to view the updated Memo from CMS.

Do you have questions? You may call us at (270) 726-4033 or email us at:

Leah Shoulders, Director of Revenue Management



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