CERT 'Teaching and Instruction for Providers' Letters

Published 07/25/2023

When the Comprehensive Error Rate Testing (CERT) contractor finds a claim in error based on coverage or billing issues, providers will receive an individual CERT Teaching and Instruction for Providers (TIP) letter for each claim denial.

The CERT TIP Letter was created to:

  • Enhance the provider's knowledge regarding the CERT program
  • Provide education specific to the CERT error
  • Provide suggestions to prevent similar errors from occurring in the future
  • Provide information regarding the appeal process 

The CERT TIP Letter will include the following:

  • Comprehensive article regarding the CERT program
  • Provider's appeal rights for the CERT process
  • Pertinent website and/or reference information regarding the CERT program and coverage issues

If you have any questions regarding the CERT TIP letter or CERT program in general, please email JJ.JM.CERT@palmettogba.com.

Note: TIP letters are to be used for educational purposes only. These letters do not serve as a denial notification for appeals purposes.


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