The Program for Evaluating Payment Patterns Electronic Report (PEPPER) summarizes your hospice’s Medicare claims in target areas that may be at risk for improper Medicare payments, allowing hospices to identify specific areas in need of focused attention.  

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While the PEPPER can be daunting, particularly for those who may be intimated by interpreting the statistics, it provides critical information regarding billing risk areas specific to each hospice.

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The PEPPER currently includes these hospice target areas:

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• Live Discharges Not Terminally Ill

• Live Discharges – Revocations

• Live Discharges LOS 61-179 Days

• Long Length of Stay

• CHC in Assisted Living Facility

• RHC in Assisted Living Facility

• RHC in Nursing Facility

• RHC in Skilled Nursing Facility

• Claims with Single Diagnosis Coded

• Episodes with No GIP or CHC

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Services

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Weatherbee provides three distinct levels of consultation and education services to hospices allowing each client to select the specific services that meet its needs: 

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Level I – PEPPER Education

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PEPPER Education offers live a web-based presentation as a general introductory educational program. This session can be attended by a large group, or viewed by individuals on the management team. Weatherbee’s clinical and statistical consultants will present:

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• Explanations of the PEPPER and its metrics

• Statistical concepts that are used in PEPPER

• Demonstrations of how the PEPPER identifies potential payment risks

• Ways to identify how the report can highlight potential opportunities

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Level II – PEPPER Consulting Services Package

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The PEPPER Consulting Services Package is a focused, hospice-specific service (i.e., per provider identification number). Clients receive the following services, specific to the hospice’s individual PEPPER:

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• Expert analysis, evaluation, and a brief summary report of the hospice’s PEPPER, including risk areas, opportunities and recommendations

• A live web-based meeting with the hospice’s leadership to present the findings, analysis, and evaluation of the PEPPER statistics, answer questions, describe strategies to manage risks, outline opportunities, and provide suggestions for future monitoring of risk areas

• One hour of telephone technical assistance after the live web-based meeting to answer questions related to the PEPPER or recommendations

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Level III – PEPPER Custom Consulting Service

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Weatherbee’s PEPPER Custom Consulting Service is designed to provide ongoing, customized support to your hospice. Custom consulting services may include, but are not necessarily limited to:  

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• Custom presentations specific to the individual hospice’s PEPPER for the C-suite, governing body, and quality and compliance team

• Development of a predictive PEPPER-like report

• Development of a quality dashboard

• Management of audit risk

• Guidance to improve best practices

• Integration of PEPPER data and quality programs   

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Outcomes

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Weatherbee's goal is to assist each hospice in identifying the best strategy to improve areas highlighted in the annual PEPPER.

Dependent upon the Level selected, engaging Weatherbee will result in:

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• Enhancing the ability to understand the PEPPER and its metrics;

• Identifying risk areas based on the specific PEPPER report;

• Developing strategies to manage risk areas;

• Optimizing business opportunities to better serve your community;

• Expanding the quality department’s ability to monitor internal data to predict future risks; and

• Integrating best practices specific to PEPPER risk areas.

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Please contact Weatherbee for additional information regarding PEPPER Services.

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