09/18/17
CMS Announces New, More Targeted Medicare Audit Process
The Centers for Medicare and Medicaid (CMS) had initiated a pilot program called Targeted Probe and Educate (TPE) where the Medicare Administrative Contractors focus on specific providers/suppliers within the service rather than all provider/suppliers billing a particular service. TPE involves the review of 20-40 claims per provider, per item or service, per round, for a total of up to three rounds of review. Each round of 20-40 claim reviews is referred to as a probe. After each round, providers are offered individualized education based on the results of their reviews. Providers/suppliers with continued high error rates after three rounds of
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