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Richter ShareSource Blog

Understanding Targeted Probe and Educate – Medicare’s New Medical Review Strategy

In 2015, the Centers for Medicare and Medicaid Services (CMS) introduced the Probe and Educate (PE) strategy, first to hospitals and then to home health care agencies. With this new strategy, five claims were selected from every hospital and home health care provider. If a claim was denied, one-on-one education was offered in an effort to prevent future errors.

Targeted Probe and Educate (TPE) is a result of the positive outcomes that were generated through the PE strategy. Although hospice agencies were not included in the PE strategy, TPE was expanded to all Medicare service providers in October 2017. Unlike other strategies, with TPE, your agency will only receive an Additional Development Request (ADR) if it is shown through data analysis that you may be doing something improperly which could result in an improper Medicare payment.

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Topics: Home Health & Hospice