CMS-10763.MR-TPE-Survey-Scenarios

CMS-10763.MR-TPE-Survey-Scenarios.docx

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (CMS-10415)

CMS-10763.MR-TPE-Survey-Scenarios

OMB: 0938-1185

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Medical Review / Targeted Probe & Educate preview link

Answer selections and inputs are in bold

Scenario one: Content Caroline (happy with process, short survey)



Please select your Medicare Contract: Jurisdiction J (A/B Providers from AL, GA, TN)

Considering all services provided by Palmetto, overall, how satisfied are you with us: Somewhat satisfied

What best describes you: Staff of a provider of medical services

What is your Medicare enrollment type or the enrollment type of your practice or facility: Physician

What was the service type identified for your Targeted Probe and Educate (TPE) audit: Documentation was not meeting medical necessity

Did our initial notification letter provide a clear understanding of the TPE process: Yes

How professional was our Medical Review staff during your TPE review process: Extremely professional

How knowledgeable was our Medical Review staff during your TPE review process: Very knowledgeable

How useful were our educational materials provided during your TPE review process: Very useful

Did you understand the TPE Results Letter containing the outcome of the completed review without needing additional explanation from Palmetto: Yes

Which round of the TPE process did you just complete for this claim review: First

How satisfied or dissatisfied are you with your overall experience during the TPE process: Extremely satisfied

How can we improve your experience during the TPE review process: No suggestions at this time

Would it be okay if we followed-up with you about your feedback: No

Total questions answered: 14





Scenario two: Average Abigail (some issues, medium survey)



Please select your Medicare Contract: Jurisdiction M (A/B Providers from NC, SC, VA, WV)

Considering all services provided by Palmetto, overall, how satisfied are you with us: Extremely satisfied

What best describes you: Provider of medical services

What is your Medicare enrollment type or the enrollment type of your practice or facility: Clinic/Group Practice

What was the service type identified for your Targeted Probe and Educate (TPE) audit: Signature of certifying physician not included on documents

Did our initial notification letter provide a clear understanding of the TPE process: Yes

How professional was our Medical Review staff during your TPE review process: Somewhat unprofessional

What was unprofessional about our Medical Review staff: I had to send a few follow-up emails that weren’t answered

How knowledgeable was our Medical Review staff during your TPE review process: Moderately knowledgeable

How useful were our educational materials provided during your TPE review process: Slightly useful

Did you understand the TPE Results Letter containing the outcome of the completed review without needing additional explanation from Palmetto: No

What would make our TPE Results Letter easier to understand: The language was vague and I couldn't understand the final result

Which round of the TPE process did you just complete for this claim review: First

How satisfied or dissatisfied are you with your overall experience during the TPE process: Somewhat satisfied

How can we improve your experience during the TPE review process: Better communication from your staff

Would it be okay if we followed-up with you about your feedback: Yes

Name: [leave blank]

Reference/Case number: 1234567890

Work email: Abigail@email.com

Total questions answered: 17



Scenario three: Irate Isabel (upset with process, full survey)



Please select your Medicare Contract: Jurisdiction J (A/B Providers from AL, GA, TN)

Considering all services provided by Palmetto, overall, how satisfied are you with us: Extremely dissatisfied

What best describes you: Staff of a provider of medical services

What is your Medicare enrollment type or the enrollment type of your practice or facility: Physician

What was the service type identified for your Targeted Probe and Educate (TPE) audit: Encounter notes did not support all elements of eligibility

Did our initial notification letter provide a clear understanding of the TPE process: No

What would make our initial notification letter clearer to understand: Write in English! So many acronyms and cryptic Medicare codes I can’t understand what the letter was trying to say.

How professional was our Medical Review staff during your TPE review process: Extremely unprofessional

What was unprofessional about our Medical Review staff: John hung up on me twice and stopped returning my calls.

How knowledgeable was our Medical Review staff during your TPE review process: Not knowledgeable at all

What specifically was our Medical Review staff not knowledgeable about: They couldn’t answer any of my questions and just told me to read the documents they sent but clearly I did and still had questions and they just don’t know what they are talking about!

How useful were our educational materials provided during your TPE review process: Not useful at all

How could we improve these educational materials for you: I don’t have time to sit around and read a 27 page document that barely applies to me. Create shorter more specialized materials!

Did you understand the TPE Results Letter containing the outcome of the completed review without needing additional explanation from Palmetto: No

What would make our TPE Results Letter easier to understand: Stop with the acronyms! Why can’t this just say if I’m done or not?? Everything is so confusing with you!

Which round of the TPE process did you just complete for this claim review: Second

How satisfied or dissatisfied are you with your overall experience during the TPE process: Extremely dissatisfied

How can we improve your experience during the TPE review process: FIX EVERYTHING!

Would it be okay if we followed-up with you about your feedback: Yes

Name: Irate Isabel

Reference/Case number: 0987654321

Work email: Izzy@email.com

Total questions answered: 20

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