CERT (Comprehensive Error Rate Testing) Resources
Below are just a few of the resources available to assist you with the CERT process. For a quick look at these resources move your mouse over the header/title.
- CMS (Centers for Medicare and
Medicaid Services) website
- CMS CERT Overview which gives you insight into the methodology and
- Reports produced by the Comprehensive Error Rate Testing (CERT) program, including the annual Improper Medicare Fee-for-Service Payment report
- CGS website:
- CERT Newsletters (published quarterly by the CERT Documentation Contractor)
- Sample CERT letters for requesting documentation
- Information about CERT/HIPAA
- Articles covering various topics
- The Review Process
- The Appeal Process
- FAQs
- Tips to help avoid errors
- Error Rates & Provider Benefits
- Submitting documentation
- Web Training
- Contact Information
- Links to other resources
- CGS
Claim Identifier Tool:
- Using the CID (Claim Identifier) number (located in the top left corner of the letter you received requesting documentation) this allows you to search for the results of a CERT review.
- CERT Documentation
Contractor Provider Address website
- Update the CERT Documentation Contractor with the address/contact person best used for obtaining requested medical records in a timely fashion.
Remember you must also submit your updated office address, phone number,
and fax numbers to CGS. CMS allows 90 days for you to submit
these types of changes to us, your Medicare carrier/contractor. These
changes must be done by completing the CMS 855I application (Individual)
or CMS 855B application (Group or Organization) application to change
your information. These forms and instructions can be found on our Web
site on the Part B Forms page
under Provider Enrollment or on the CMS website at www.cms.hhs.gov.
If you have additional questions after reviewing these resources, please
call our Provider Enrollment Department at 866.520.4007 hours 9:00 am
- 3:00 pm (CST).