Eli's Rehab Report

Published on Fri Jul 24, 2009 PDF

The Centers for Medicare & Medicaid Services recently outlined the results of its latest comprehensive error rate testing report, and the outcome could affect your bottom line down the road.

The bad news: The CERT report named OTs in private practice as having the highest error rate -- a whopping 21.2 percent.

In the report, which discusses Medicare coding errors that occurred between Sept. 2006 and Sept. 2007, CMS indicated that it intends to use the CERT results to focus future claim reviews on this report's errors.

"CMS will use the error rate findings described in this report to determine underlying reasons for claim errors and to adjust its action plans to improve compliance in payment, documentation, and provider billing practices," the CERT report noted. "The tracking and reporting of  error rates also helps CMS identify emerging trends and implement corrective actions designed to accurately manage all Medicare FFs contractors' performance."

Beware: RACs look at CERT reports to pinpoint overpayment trends, so OTs in private practice could easily become a RAC target down the road.

To read the complete CERT results, visit www.cms.hhs.gov/apps/er_report/preview_er_report.asp?from=public&which=long&reportID=9&tab=4.