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ABCs of the Comprehensive Error Rate Testing (CERT) Program Questions and Answers

The following Questions and Answers (Q&A) are cumulative from the web-based training(s). Some questions have been edited for clarity and answers may have been expanded to provide further details. Similar questions were combined to eliminate redundancies. Updated March 2015.

Q1. When the documentation is not legible and does not meet signature requirements, are we able to get an extension in order to transcribe the notes?
A1. You would need to check with the CERT contractor to verify if they would grant an extension beyond the 75 days you have to return documents. You can also use a signature log or signature attestation if the signature is illegible.

Q2. When signing an order or writing a note, how critical is it for the physician to date his/her own signature?
A2. This is very important for a reviewer and for the documentation. Dates and times are reviewed to support the order time versus the completion of the service.

Q3. We received a CERT request dated back to May 2013 but have not received a determination in the form of a letter. How can we find out about the results?
A3. If you have a specific CERT request question, contact the CERT Coordinator for assistance.           

Q4. Why does it take 6-8 months to receive a determination after submitting the MR to the CERT contractor?
A4. The CERT review contractor must complete their reviews prior to the next reporting period. If your request is submitted early in that timeframe, it can take that entire time to get a result. You can get an update on the status from the CERT coordinator.

Q5. Is the reporting period quarterly?
A5. The reporting period spans 6-9 months. The last report was sent out November 2014.

Q6. Does a physician certification on the hospital transfer orders, signed by the hospital physician, suffice for the SNF initial certification requirement?
A6. Yes, per the CMS Internet Only Manual (IOM), Publication 100-02, Chapter 8, Section 40, a certification statement can be included in forms, notes, or other records that would normally be signed in caring for a patient, or on a separate form; however, note that the section also states: "the routine admission order established by a physician is not a certification of the necessity for post-hospital extended care services for purposes of the program. There must be a separate signed statement indicating that the patient will require on a daily basis SNF covered care."

Last Updated Oct 07, 2016