With PDPM now live, providers need to be prepared to implement the Triple Check process under the new model, ensuring that key items are verified to ensure accurately and timely billing.

The purpose of holding a triple check meeting is to ensure that Medicare is billed accurately and in a timely manner. The process requires claims to be reviewed for accuracy by the clinical team, therapy, and the business office prior to transmission. Many providers grew used to a triple check meeting where PPS items were reviewed at one meeting on a monthly basis. Under PDPM, the interdisciplinary discussions that occur throughout the patients stay should include discussions of key components that traditionally were reviewed at Triple Check monthly. By discussing and validating these key items on a more regular basis, it will allow for the Triple Check meeting to be more efficient and seamless.

Be ready for Triple Check by incorporating the following process and interactive forms within your facility operation.

How to prepare your facility for Triple Check under PDPM

Procedure & Process

The facility is responsible for implementing an effective monthly triple-check process to

verify claims are accurate prior to submission to the Fiscal Intermediary. The facility will verify each Medicare (Part A and B) claim prior to submission.

Recommended Individuals to Attend

· Administrator


· MDS Coordinator

· Therapy Program Manager