Part B Insider (Multispecialty) Coding Alert
Respond To CERT Requests Or Face Claims Denials
Published on Sat Oct 30, 2004 
PDF
PDF
Last year's 8 percent non-response rate to Comprehensive Error Rate Testing (CERT) record requests dropped to only 1 percent in 2004, thanks to strong-arm tactics from the Centers for Medicare & Medicaid Services. Now if you don't reply, you risk being sent to the HHS Office of Inspector General - and your claim risks denial.
CERT contractor AdvanceMed chooses about 28,000 claims per year for review to see whether providers are billing (and Medicare contractors are paying) correctly, explained Wayne Steiner, CERT coordinator for Part B carrier HGSAdministrators.
Other Articles in this issue of
Part B Insider (Multispecialty) Coding Alert
- NEW MEDICATIONS:
Denied For Unlisted Drugs? List Other Therapies You Tried First
Don't forget crucial information when billing for new MDS drug
A new [...] - APPEALS:
Say Goodbye To FHOs And Hello To A New Voice On Your Appeals
But will the new QICs provide an easier process?
Many providers believed Fair Hearing Officers weren't [...] - Fee To Be You And Me
GAO backs providers gasping over cuts to inhalation
If you've been worried about sharp cuts [...] - DRUG REIMBURSEMENT:
Good News: You Soon Can Use 14 New Anti-Cancer Drug Codes
Bad news: New payments replace just 1/5 of what you're losing
The Centers for Medicare and [...] - Respond To CERT Requests Or Face Claims Denials
Last year's 8 percent non-response rate to Comprehensive Error Rate Testing (CERT) record requests dropped [...] - COMPLIANCE:
Better A Flat Fee Than A Round Target On Your Back
Can you see the danger signs in your Medical billing company contracts?
[...] - New And Revised Drug Codes
- FRAUD & ABUSE:
Are Your Billing Staff Presenting Place Of Service Accurately?
You could be reaping thousands you're not entitled to
Warning: If you're [...] - Part B Coding Coach:
Turn your Physician's Time Into Money With This Coding Catch
Proper documentation of time spent on counseling can increase your level of service
- PHYSICIAN NOTES:
Let Doctors Help With Flu Shot Crisis, Association Calls
Doctors should be in the loop on the government's plans to distribute scarce flu vaccine, [...]
View All