Understanding the Targeted Probe and Educate Process Module
The Centers for Medicare & Medicaid Services (CMS) Targeted Probe and Educate (TPE) program is designed to help providers and suppliers reduce claim denials and appeals by identifying provider errors, helping correct them and prevent future errors. Medicare Administrative Contractors (MACs) have been tasked by CMS to identify high denial rates or unusual billing practices and work one-on-one with those providers to reduce claim errors and payment denials; MACs are also expected to review items and services that have high national error rates and are at a financial risk to the Medicare program. This module focuses on TPE and responding timely and correctly to Additional Documentation Requests (ADRs).
To view this module, please select one of the links below.
