Comprehensive Error Rate Testing (CERT) - JF Part A

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

• Admission Date and Statement Covers Period Billing
• CERT Documentation Requests Impacted by a Disaster
• Dear Ordering/Referring Physician Letter
• Dual-Chamber Cardiac Pacemaker Insertion Billing
• Laboratory Orders Must be Submitted Within 12 Months of Order
• Laboratory Services: Incorrect Billing Identified
• Physician Handwritten Signature Documentation Requirements
• Prevent a No Documentation CERT Finding
• Spinal Fusions: Anterior vs. Posterior
• Surgical Pathology Medical Documentation Letter

Resources

• CMS Provider Compliance