CMS Calls Providers to Follow Up on CERT Program

If you get a call from the Centers for Medicare & Medicaid Services (CMS), don’t be alarmed. In an effort to calculate a more accurate Medicare fee-for-service error rate and reduce improper payments, CMS is following up on letters and phone calls you may have already received from Comprehensive Error Rate Testing (CERT) contractors.

CMS staff may ask you for all necessary medical record documentation for claims your practice submitted to a Medicare administrative contractor (MAC) that were reviewed under the CERT program. According to CMS, these additional efforts may change your claims’ status from “improper payment” to “proper payment.”

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