CERT Inquiry

The Claim Identifier (CID) Status Lookup allows access to inquire on the outcomes of CERT Claims. A CID may be used to find a specific claim, or a listing of all CERT claims can be found by the provider/supplier details.

Inquiry

  • Select Claim Status Inquiry from main menu and then the CERT Inquiry tab.
  • Choose TIN, NPI, PTAN and Program under Provider/Supplier Details
  • A CID may be entered to find a specific claim, but is not required

Response

A listing of the claims that meet the search criteria is displayed.

The results will show the following:

Field Description
CID Unique Claim Identifier Number assigned to each CERT claim
Initial Docs Received Date CERT received first set of documentation
ADR Received DATE CERT received documentation after ADR was sent
CERT Review Date Date CER Contractor reviewed the claim
CERT Review Status Status of claim in the review process
Claim in Error Yes or No - Indicates if the claim has been found to have been initially processed by the MAC
Error Code The category of error on the claim
Error Code Description Description explaining the error category

 

Choose "View Details" to view additional claim information.

Additional details of the claim are provided.

  • Line - The line number as it was listed and billed on the CMS-1500 claim form
  • CPT/HCPCS - The code billed on the claim line of the CMS-1500 claim form
  • Reviewer Comments - CERT Contractor's denial comment for the line under review

 

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