CMS will expand the Targeted Probe and Educate (TPE) program to all MAC Jurisdictions later this year. CMS launched the first TPE pilot project in 2016 with Part A and B providers in Jurisdiction F. Due to the success of the pilot, all Jurisdictions will now take part in CMS's latest audit initiative. The TPE process begins with providers who have high error rates for a specific item. Selected providers will be audited on a sample of claims and then individually educated based on the results. This review and education process can repeat up to three times until a desirable error rate is achieved or the contractors deem it necessary to escalate and engage other tools in their arsenal.
As more resources shift to the TPE program, providers can expect closure of many ongoing, widespread DME MAC audits. MiraVista expects this innovation to be welcomed by providers and ultimately lessen the number and duration of audited claims at the NPI level. We will share more details of this new program and answer your questions during A Power Hour with Andrea Stark event on October 19.
As more resources shift to the TPE program, providers can expect closure of many ongoing, widespread DME MAC audits. MiraVista expects this innovation to be welcomed by providers and ultimately lessen the number and duration of audited claims at the NPI level. We will share more details of this new program and answer your questions during A Power Hour with Andrea Stark event on October 19.
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