Do you realize that your PEPPER report is screaming, “Audit My Building!” Now what do I do?

Event Information
Product Format
Prerecorded Event
Conference Date
Wed, Sep 09, 2015
60 minutes
Product Description

Translate What the PEPPER Report Will Say About Your SNF


The third Skilled Nursing Facility (SNF) “Program for Evaluating Payment Patterns Electronic Report” (PEPPER) was released in April 2015 by CMS. PEPPER data is shared with both Medicare Administrative Contractors (MACs) and the Medicare Recovery Audit Contractors (RACs). This important report details your facility-specific Medicare claims data in certain targeted areas and compares your facility to other SNFs — nationally, by state, and by jurisdiction (Medicare Administrative Contractors/Fiscal Intermediaries).

Join expert speaker Matt McGarvey, MBA in this in-depth interpretation of the elements of the PEPPER. This program will detail how to interpret your PEPPER and discuss the practical application of this critical information to your Skilled Nursing Facility’s compliance program. Learn strategies to develop an action plan to ensure compliance with Medicare regulatory requirements and ensure accurate reimbursement for clinically appropriate care provided.

Key Takeaways

  • PEPPER gives provider-specific Medicare data statistics for services vulnerable to improper payments
  • SNFs whose target percents are at or above the 80th percentile (i.e., in the top 20 percent) are considered at risk for improper Medicare payments with areas at risk for overcoding
  • SNFs whose target percents are at or below the 20th percentile (i.e., in the bottom 20 percent) are considered at risk for improper Medicare payments with areas at risk for undercoding
  • Compliance is the foundation for accurate and appropriate reimbursement

Session Highlights:

  • The three variables contributing to initiation of the PEPPER in the long-term care setting
  • The relevance of PEPPER percentile ranking
  • The calculations leading to PEPPER Target Areas
  • Communicating a summary of their PEPPER data to key staff
  • Identifying their facility-specific risk factors for Medicare reviews
  • Developing a facility-specific action plan in response to PEPPER Data
  • Does your therapy and nursing documentation support skilled coverage criteria?
  • What are the seven elements of compliance?

Who should attend?

CEOs, CFOs, Administrators, Nursing Management, Nursing Staff, Therapy Management, Occupational Therapists, Physical Therapists, Speech Pathologists and Business Office Managers

Ask a question at the Q&A session following the live event and get advice unique to your situation, directly from our expert speaker.

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About Our Speaker

Matthew P McGarvey

Matthew P McGarvey, MBA is the Director of Business Development for Harmony Healthcare International, Inc., an industry leader in Healthcare Consulting. Matt has an MBA, in Health Systems Administration. He is passionate about improving the delivery of healthcare and specializes in the areas of third-party healthcare reimbursement, compliance, long term care, electronic medical record software and managed care. Since SNFs first began receiving PEPPER reports in 2013, Matt has personally reviewed...   More Info
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