PEPPER Resources Portal

Please complete the following fields to access your PEPPER. A provider’s PEPPER is only available to
that individual provider’s Chief Executive Officer, President, Administrator or Compliance Officer.
TMF Health Quality Institute is committed to ensuring and maintaining the confidentiality of each provider’s PEPPER.
Likewise, all recipients of PEPPER are expected to maintain and safeguard the confidentiality of privileged data or information.

I certify that I am the
of this health care provider and further certify that I have the actual authority to receive PEPPER and all other confidential information concerning this health care provider. If a provider does not have a management position with any of these titles, the person who has the authority to make decisions on behalf of the organization should check the box for the title that best describes their position.

   
    
  

  

Enter either a Patient Control Number *or* a Medical Record Number (found at form locators 03a or 03b on the UB04 claim form) from a claim of a traditional fee-for-service Medicare beneficiary who received services during the specified time period (“from” or “through” date between July 1-Sep. 30, 2016 for providers except HHAs and PHPs; between Oct. 1-Dec. 31, 2016 for HHAs and PHPs).