Riverbend

CERT

The Center for Medicare and Medicaid Services (CMS) established the Comprehensive Error Rate Testing (CERT) program to monitor and report the accuracy of Medicare fee for services payments.  The provider compliance error rate measures how well providers prepare Medicare claims for submission.  The Program uses independent reviewers to review representative random samples of Medicare claims. The CERT methodology includes:

• Randomly selecting a sample of approximately 120, 000 claims submitted.
• Request medical records from providers who submitted the claims
• Reviewing medical records for compliance with coverage, coding and billing

For more information visit the CMS CERT Web page