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).

From this web page, you may view CERT error rates by code group and provider type (specialty), articles about specific areas of concern as a result of CERT review findings, and newsletters from the CERT documentation contractor (CERT DC).

More Information About CERT

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 InformationComprehensive Error Rate Testing (CERT) Question and Answer Fact SheetCMS Contractors Verify ComplianceStamped Signatures Not Acceptable!Physician Signatures Missing on Medical Records: CERT TipSubmitting Complete and Legible Medical Records is Key!Additional Guidance on Electronic Signatures Is AvailableDocumenting Is Critical!Create a Signature LogCERT Follow-up Record RequestsDiagnostic Test Order Needed to Support a Service for the Interpretation of a Diagnostic TestDocumenting the Patient's Progress in the Medical RecordMedicare Does Not Accept Retroactive OrdersDo you know if the CERT Contractor differs from the Medicare Administrative Contractor?Respond to All CERT RequestsDocumenting Specific Services in the Medical RecordBe Sure to Keep the CERT Contractor's Website UpdatedOrders for Tests Must Be SignedWhat Can You Expect to Receive from the CERT Contractor?Lack of Documentation Affects Provider ReimbursementRequested CERT Documentation Located at Another FacilityAsk Questions, Be InformedCERT Decisions May be AppealedSignatures, Credentials and Dates: They Are ImportantLack of Signature Could Affect Provider ReimbursementA Legible Medical Record MattersKnow the Purpose of the CERT ContractorHome 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 MetHome Health Tip: Face-to-Face EncounterHospice 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 DocumentationAuthentication Matters!Home Health Denials for Incorrect Billing of 'Attending/Other' Names and NPIsFrom the Desk of the MAC Medical Directors: Caring for Medicare Patients is a PartnershipComplying with Medicare Signature RequirementsCaring for Medicare Patients is a PartnershipComplying with Medicare Signature RequirementsCaring for Medicare Patients is a PartnershipOutpatient Rehabilitation Therapy Services: Complying with Documentation RequirementsComplying With Medical Record Documentation RequirementsCERT A/B MAC Outreach & Education Task Force: Emphasis on Outreach & Education to Reduce ErrorsCMS 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 Errors