Comprehensive Error Rate Testing (CERT)

Comprehensive Error Rate Testing

The Government Performance and Results Act of 1993 established performance measurement standards for federal agencies. To achieve the goals of this Act, the Centers for Medicare & Medicaid Services (CMS) established the Comprehensive Error Rate Testing (CERT) program in November 2003. The purpose of the CERT program is to measure and improve the quality and accuracy of Medicare claims submission, processing, and payment. The results of these reviews are used to characterize and quantify local, regional, and national error rate patterns. CMS uses this information to address the error rate through appropriate educational and interventional programs.

The CERT DC has noted that from time to time they receive calls from providers that do not have access to long distance. When this occurs, the provider incurs costs that can be a financial burden especially on small providers. To assist those providers, the CERT DC is now offering a toll-free telephone number. This number is for voice only and NOT for faxes. The new number is 888-779-7477. Providers can also continue to use the long distance number 301-957-2380.

DME MAC A CERT Contact Information

Contact Alina Jimenez, the DME MAC A CERT Coordinator! Alina can help you tackle various CERT-related questions and/or concerns, such as:

General CERT information
Detailed review results of a CERT claim
Explanation of a CERT-related overpayment
How to have a CERT overpayment re-reviewed
Clarification of the type of documentation CERT is requesting
Why you may still be receiving request letters for medical records when you have already submitted the documentation

You may contact Alina at: 213-593-6020 or alina.jimenez@hp.com

Have your claim information ready before you call.

Changes or Updates to Supplier Addresses

DME MAC suppliers, please note the following in regards to an article within the January 2005 CERT newsletter: Any changes or updates to supplier addresses, telephone numbers (including area code changes), or tax information must be reported in writing to the National Supplier Clearinghouse (NSC) within 30 days after such changes have taken place. Visit the NSC Web site (http://www.palmettogba.com/nsc ), call the toll-free telephone number (866-238-9652), or write to the NSC (at the address below) for instructions.

National Supplier Clearinghouse (NSC)
NSC, AG-495
P.O. Box 100142
Columbia, SC 29202-3142