Part B Insider (Multispecialty) Coding Alert
CERT Program Not Consistent, OIG Says
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If the Comprehensive Error Rate Testing auditor didn't do a good job of following up with you about its documentation requests, then you're not alone.
CERT contractor AdvanceMed didn't always follow up via phone in many cases if you failed to send in medical records after the first request, complains the HHS Office of Inspector General. But AdvanceMed did a better job of completing quality assurance reviews properly than it did the last time the OIG looked at it.
The Centers for Medicare & Medicaid Services could be doing a better job of making sure that the CERT program is consistent, the OIG adds in its report on the program (A-03-05-00006). The OIG recommended that CMS centralize the management of the CERT program and make sure the sampling periods for CERT audits are the same every time.
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