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.

Access the below information from this page.

CERT Program Basics

• CERT Requests, Response Timeline and Noridian Communication
• Comprehensive Error Rate Testing Program: Reduced Sample Size and Discarded Claims
• Contractors
• Provider Corrective Actions
• Provider Mailing Addresses and Points of Contact for CERT Requests
• Respond to a CERT ADR Letter

Billing and Documentation Help for Identified Errors

• 99211 and Incident To
• Ambulance Services
• CERT Documentation Requests Impacted by a Disaster
• Dear Ordering/Referring Physician Letter [PDF]
• Dual-Chamber Cardiac Pacemaker Insertion Billing
• International Normalized Ratio Home Monitoring
• Laboratory Orders Must be Submitted Within 12 Months of Order
• Laboratory Services: Incorrect Billing Identified
• Major Joint Replacement for Hip and Knee – Documenting Medical Necessity
• Physician Impact on Laboratory Service Providers
• Physician's Orders for Diagnostic Laboratory Tests
• Prevent a No Documentation CERT Finding
• Psychotherapeutic Services and Documentation Requirements
• Records Submission for Specific Patients
• Surgical Pathology Medical Documentation Letter [PDF]
• Teaching Physician Services and Modifier GC

Resources

• CMS Provider Compliance