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Medicare Administrative Contractors use data analysis to identify specific areas of compliance: (1) providers and suppliers who have high claim error rates or unusual billing practices, and (2) items and services that have high national error rates and are a financial risk to Medicare. Providers whose claims are compliant with Medicare policy won't be chosen for TPE.

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CMS Targeted Probe and Educate Program

Dec 10, 2019

The CMS Targeted Probe and Educate program provides one-on-one assistance to reduce claims denials and appeals.