Medicare Program Integrity Manual (Pub. 100-08), Ch. 3 § 3.6.2
Verifying Errors
3.6.2 - Verifying Errors
(Rev. 10365; Issued: 10-02-20; Effective: 08-27-20; Implementation: 08-27-20)
This section applies to MACs, CERT, and UPICs, as indicated.
Understanding the characteristics of the service area of the provider is a key element of
claim data analysis. The areas selected for review by the contractor (e.g., providers,
services) must be deemed high priority and contractors must be able to document the
rationale for selection.