ADR, TPE & Regulatory Support Services

Service Description

Navigating Medicare audits and regulatory reviews can be complex and time-consuming. CCSC provides expert support for Additional Documentation Requests (ADR), Targeted Probe and Educate (TPE) reviews, Unified Program Integrity Contractor (UPIC) audits, and other payer or regulatory inquiries. Our team works closely with agencies to review records, identify documentation vulnerabilities, prepare audit-ready responses, and develop corrective action plans when needed. We analyze clinical documentation, OASIS assessments, coding, physician orders, and Plans of Care to ensure records accurately support eligibility, homebound status, skilled need, medical necessity, and compliance with Medicare requirements. Whether your agency is responding to an active audit, addressing claim denials, preparing appeal documentation, or seeking proactive risk mitigation, CCSC provides the clinical, coding, and regulatory expertise needed to navigate the process with confidence. Our services may include: ADR and TPE response preparation UPIC audit support and documentation review Medical necessity and homebound justification review Clinical record audits and mock audits Denial analysis and appeal support Corrective action plan development Staff education and remediation training Compliance and risk assessment reviews Survey readiness preparation With decades of combined home health experience, CCSC helps agencies reduce risk, strengthen documentation, and maintain compliance in an increasingly complex regulatory environment.