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Medicare Compliance & Reimbursement

Reader Questions:

Know the Facts on Error Percentages and TPE Review

Published on Wed Jul 05, 2023

Question: Is there a specific denial percentage for a service that Medicare looks for when determining whether a provider will be part of a Targeted Probe and Educate (TPE) review? Iowa Subscriber Answer: No, not exactly. Though you might think that outlier behavior alone would alert your Medicare Administrative Contractor (MAC) to claims issues, it’s more complicated than that, according [...]
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