Provider Outreach and Education
Leveraging CMS’s TPE Model to Reduce Improper Payments and Enhance Compliance
We partner with commercial insurance and government-sponsored health plans to offer Provider Outreach and Education services to their provider networks. Utilizing models such as CMS’s Targeted Probe & Educate (TPE), we identify providers with high error rates and deliver individualized education to improve claim accuracy, reduce denials, and ensure regulatory compliance.
Empowering Payors Through Targeted Provider Education
In addition to CMS’s Targeted Probe & Educate (TPE) program—a proactive approach designed to help insurance payors manage provider performance—FHAS offers customized provider education programs to identify providers with high error rates and provide them with targeted education.
This collaboration helps commercial and government-sponsored payors reduce improper payments, minimize administrative burden, and foster a more compliant provider network. With over 30 years of experience, FHAS offers payors a trusted partner in navigating the complexities of healthcare compliance and optimizing provider performance.
Why Choose FHAS for Provider Education
TPE Expertise
Our team’s in-depth knowledge of the CMS TPE model ensures that our services are fully compliant and effective in reducing improper payments for your organization.
Customized Solutions
We develop tailored educational programs that address the specific needs of your provider network, leading to measurable improvements in claim accuracy and compliance.
Proven Results
Payors who partner with us experience significant reductions in claim denials and improper payments, improving their financial performance and regulatory standing.
How Our Service Works for Payors
Our Provider Outreach and Education service follows the structured TPE process outlined by CMS, adapted to meet the needs of insurance payors:
Comprehensive Support Tailored for Payors
Customized Educational Programs
Tailored workshops and training sessions designed to address the specific needs of your provider network, ensuring they stay compliant with the latest regulations.
Expert Consultations
Direct access to our team of experts for one-on-one consultations, helping you navigate complex compliance issues and develop strategies for improvement.
Resource Hub
A centralized library of up-to-date educational materials, including CMS guidelines, best practices, and training modules, to support your compliance efforts.
Performance Analytics
Detailed reports and metrics to track the effectiveness of our interventions, allowing you to measure ROI and identify areas for further optimization.
Key Advantages for Insurance Payors
Reduced Improper Payments
By educating providers on correct billing and documentation practices, we help minimize the number of improper payments, protecting your bottom line.
Enhanced Compliance Oversight
Our service ensures that your provider network maintains high standards of compliance, reducing the risk of regulatory penalties and audits.
Stronger Provider Relationships
By facilitating education and improvement, we help foster better relationships between payors and providers, leading to a more collaborative healthcare ecosystem.
Clients Who Partner with FHAS
Our Provider Outreach and Education service is designed to meet the needs of various insurance payors, including:
Federal Government
Ensuring compliance with CMS regulations and optimizing provider performance within your network.
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