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 facility. 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 to verify or make changes to this information.

Comprehensive Error Rate Testing (CERT) Articles

CERT Error: Medical Necessity Not Met for Home Health ProvidersDenials for Incorrect Billing of “Attending/Other” Physician Names and NPIsComprehensive Error Rate Testing (CERT) Error: Medical Necessity Not Met for Hospice ProvidersProvider Minute: Physician Orders/Intent to Order Laboratory Services and Other Diagnostic ServicesCERT Provider Sample LettersCERT Error: Incorrect CodingMedicare Providers: What You Need to Know About Signatures & DocumentationCERT Documentation Request ListingsFace to Face Documentation for Home Health Certification: Important Information for Certifying Physicians and Non-physician Practitioners (NPPs)CERT Error: Insufficient DocumentationWhat is a Comparative Billing Report?CERT Contractor Email AddressesVerify Your CERT Contact InformationCMS Contractors Verify ComplianceCERT Follow-up Record RequestsAsk Questions, Be InformedCERT Decisions May be AppealedHome Health Tip: Document Complication FactorsHospice Tip: Incorrect CodingHome Health Tip: Orders Must be in the Proper FormatHospice Tip: Certification of Terminal IllnessHospice Tip: Benefit PeriodHome Health Tip: Comprehensive Error Rate Testing (CERT) Error - Medical Necessity Not MetHospice Tip: Date(s) of ServiceHome Health Tip: Insulin AdministrationHome Health Tip: Plan of Care Certification is RequiredHome Health Tip: Frequency and Duration Requirements for TherapyHospice Tip: Certification/RecertificationHome Health Tip: Documentation to Support HIPPS CodeHome Health Tip: Sufficient Documentation RequiredHospice Tip: Signatures for Face-to-Face EncountersHome Health Tip: Therapy ServicesHospice Tip: DocumentationHome Health Tip: DiagnosisHospice Tip: AssessmentsHospice Tip: Election InformationHome Health Tip: Home Health Services EligibilityHome Health Tip: Acute Change in Patient's ConditionHospice Tip: Palliative Care Acknowledgement in the Hospice Election StatementHospice Tip: What documentation is needed to support terminal illness?Home Health Tip: Date of Face-to-Face EncounterHospice Tip: CERT Medical Record ReviewHospice Tip: Correctly Code ClaimsHospice Tip: Comprehensive Error Rate Testing (CERT) Error: Medical Necessity Not MetHospice Tip: Complete DocumentationHome Health Tip: Nursing DocumentationHome Health Denials for Incorrect Billing of 'Attending/Other' Names and NPIsComplying with Medicare Signature RequirementsComplying with Medicare Signature RequirementsOutpatient Rehabilitation Therapy Services: Complying with Documentation RequirementsComplying With Medical Record Documentation RequirementsCMS Provider Minute: The Importance of Proper Documentation VideoCMS Provider Minute: The Importance of Proper Documentation VideoProvider Minute: Utilizing Your MACEntries in Medical Records: Amendments, Corrections and AddendaTop CERT ErrorsCMS MLN Fact Sheet: Medical Record Maintenance and Access RequirementsCaring for Medicare Patients is a PartnershipPhysician Signatures Missing on Medical Records: CERT TipRequested CERT Documentation Located at Another FacilityLack of Documentation Affects Provider ReimbursementA Legible Medical Record and Authentication MattersDocumenting Specific Services Is Critical!The Purpose of the CERT ContractorSignatures, Credentials and Dates Are ImportantDo you know if the CERT Contractor differs from the Medicare Administrative Contractor?Be Sure to Keep the CERT Contractor's Website UpdatedComprehensive Error Rate Testing (CERT) Question and Answer Fact SheetCERT A/B MAC Outreach and Education Task Force: Emphasis on Outreach and Education to Reduce ErrorsHome Health Tip: Face-to-Face Encounter