Comprehensive Error Rate Testing (CERT)

Centers for Medicare & Medicaid Services (CMS) established the Comprehensive Error Rate Testing (CERT) program to monitor and report the accuracy of Medicare fee-for-service (FFS) payments. The CERT program measures the error rate for claims submitted to Medicare contractors. Palmetto GBA uses CERT reports to identify areas of focus for our Provider Outreach and Education efforts. One of the major outcomes of these CERT reports is the paid claims error rate (percentage of dollars paid incorrectly).

For More Information About CERT

Providers may designate a specific point of contact (POC) to receive CERT information in your billing or medical records office. We strongly encourage you to assure your designated CERT POC is up to date. This is important in ensuring that the CERT request is received as soon as possible by the correct person and to avoid being routed to various departments within your facility. During the review process CERT and Palmetto GBA may need to call you concerning documentation request. You can reach the CERT office at 888–779–7477.

Comprehensive Error Rate Testing (CERT) Articles

Provider Minute: Physician Orders/Intent to Order Laboratory Services and Other Diagnostic ServicesCERT Provider Sample LettersCERT: Part A ChecklistPatient Discharge Status Codes MatterComprehensive Error Rate Testing (CERT) Teaching and Instruction for Providers (TIP) Letters from Medical ReviewOutpatient Therapy and Rehabilitation Services Documentation ChecklistDRG 460 - Spinal FusionInpatient Rehab Facilities (IRFs) Common CERT Error CodesMedicare Part A Payments for End-Stage Renal Disease Dialysis Services and Comprehensive Error Rate Testing (CERT)DRG 453, 454 and 455 - Combined Anterior/Posterior Spinal FusionDRG 056 - Degenerative Nervous System Disorders with MCC and DRG 057 - Degenerative Nervous System Disorders without MCCDo You Know What Your Comprehensive Error Rate Testing (CERT) Contractor Is Looking For?DRG 884 (Psychoses) and DRG 885 (Organic Disturbances and Mental Retardation)Comprehensive Error Rate Testing (CERT) Identified Errors for TelehealthDRG 627 - Thyroid, Parathyroid and Thyroglossal procedureMedicare Providers: What You Need to Know About Signatures & DocumentationHEAT Provider Compliance Training VideosDRG 560 - Aftercare, Musculoskeletal System and Connective Tissue with Complication or Comorbidity (CC)CERT Decisions May be AppealedCERT Follow-up Record RequestsComplying with Medicare Signature RequirementsComplying with Documentation Requirements for Laboratory ServicesOutpatient Rehabilitation Therapy Services: Complying with Documentation RequirementsCMS Provider Minute: The Importance of Proper Documentation VideoProvider Minute: Utilizing Your MACComplying With Medical Record Documentation RequirementsCMS Provider Minute: The Importance of Proper Documentation VideoIntroduction to CERT Web Based TrainingCMS MLN Fact Sheet: Medical Record Maintenance and Access RequirementsCaring for Medicare Patients is a PartnershipThe Purpose of the CERT ContractorA Legible Medical Record and Authentication MattersRequested CERT Documentation Located at Another FacilityPhysician Signatures Missing on Medical Records: CERT TipDocumenting Specific Services Is Critical!Signatures, Credentials and Dates Are ImportantDo you know if the CERT Contractor differs from the Medicare Administrative Contractor?How to Avoid Denials for Inpatient Transcatheter Aortic Valve Replacement (TAVR) ServicesHow to Avoid Denials for Inpatient Transcatheter Aortic Valve Replacement (TAVR) ServicesBe Sure to Keep the CERT Contractor's Website UpdatedCERT A/B MAC Outreach and Education Task Force: Emphasis on Outreach and Education to Reduce ErrorsComprehensive Error Rate Testing (CERT): Inpatient Admission Documentation ChecklistDRG 266 and DRG 267: Endovascular Cardiac Valve ReplacementAftercare, Musculoskeletal System and Connective Tissue Diagnosis Related Groups (DRGs)Responding to CERT Documentation RequestCERT: Inpatient Psychiatric Facility ChecklistAppeal Errors Identified by the Comprehensive Error Rate Testing (CERT) ProgramCERT Appeals: Providing DocumentationCERT Contractor Email AddressesCERT Error: Insufficient DocumentationComprehensive Error Rate Testing (CERT) Question and Answer Fact SheetAsk Questions, Be InformedCERT Error: Incorrect CodingDRG 226 and 227 Cardiac Defibrillator Implant without Cardiac Catheterization with/without MCCEntries in Medical Records: Amendments, Corrections and AddendaCMS Contractors Verify ComplianceLack of Documentation Affects Provider ReimbursementCERT Holiday Announcement: Martin Luther King Day

Last Updated: 01/01/2020