Summary of CERT Errors
To improve provider awareness and education about CERT errors, CGS encourages providers to review the recent errors identified by CERT. This proactive step allows providers the opportunity to review and develop internal processes within their own organization to prevent experiencing a similar CERT error.
During the most recent reporting period, the majority of CERT errors are related to the home health face-to-face encounter documentation. As a reminder, errors related to the FTF encounter are considered a full-denial, and results in a full recoupment of Medicare payment. Errors include:
- Insufficient FTF documentation from the physician to support the patient's homebound status; and
- Insufficient FTF documentation from the physician to support the need for skilled services.
For detailed information about the home health FTF requirements, refer to the following resources:
- Home Health Face-To-Face (FTF) Encounter Webpage
- Home Health Denial Fact Sheet: Denial Reason 5FFTF: Missing/Incomplete/Untimely Face-to-Face Encounter
- Face-To-Face (FTF) Encounters for Home Health Certification quick resource tool
Updated: 11.13.15