Comprehensive Error Rate Testing (CERT) - JE Part B

Since 1996, CMS implemented several initiatives to prevent improper payments. CMS' goal is to reduce payment errors by identifying and addressing billing errors concerning coverage and coding. The CERT program is one of the programs created by CMS to assist in eliminating improper payments.

The CERT Review Contractor (CERT RC) completes audits on randomly selected claims submitted to Noridian. When a claim has been selected for an audit, the CERT RC sends a supplier a Medical Record Request Letter asking that all supporting claim documentation be pulled for the audit.

CERT Program Basics

CERT Articles and Resources - Learn more about common CERT errors and answers to common CERT questions.

CERT Review Process - View the process for receiving and responding to CERT requests.

CERT Documentation Requests Impacted by a Disaster - This article is for providers that have claims under CERT review and are affected by a natural or man-made disaster.

Resources

• CMS Provider Compliance