Question:
How do MACs use data in the TPE program?
Answer:
The Targeted Probe and Educate (TPE) program tries to raise accuracy in specialized areas regarding claims and billing practices. According to the Centers for Medicare & Medicaid Services (CMS), Medicare Administrative Contractors (MACs) use data analysis to identify:
- Providers and suppliers who have high claim error rates or unusual billing practices, and
- Items and services that have high national error rates and are a financial risk to Medicare.