The CERT Documentation Contractor Needs Help Obtaining Provider Phone
Numbers
The CERT Documentation
Contractor requests and receives medical records from providers whose claims
have been sampled for CERT review.
In an effort to reduce the “No Documentation” error rate, the CERT Documentation Contractor (CDC) is soliciting the help of all the Medicare Contractors (also known as Affiliated Contractors –AC) to provide telephone numbers of Medicare providers. In order for the CDC to be successful in making phone calls to verify address and point of contact information, it is imperative that they have a phone number to make the initial call to the provider.
The CDC sees the relationship between CERT and the ACs as a partnership in meeting the goal of reducing the no-documentation rate. Therefore, the CDC is strongly appealing to the ACs to assist in obtaining telephone numbers and other pertinent information that will help the CDC get the requests for medical records out to providers on the first attempt to contact the provider.
NHIC is urging Medicare providers to verify that their provider information is current with Medicare and that a medical records point-of-contact person be appointed.
Listed below is the information the CDC needs from the providers:
Affiliated Contractor
(AC)
Name: Number :
NHIC NE— ME = 31142
MA = 31143
NH = 31144
VT = 31145
NHIC CA—
So CA = 31146
Provider
Identification Number (all provider ID numbers affiliated with provider’s
office)
Provider Name
Business Name
Address (where the medical records are stored)
Point of Contact (POC-the person who handles requests for medical records)
Direct Phone Number
for the POC
Fax Number (direct Fax number where requests for medical records can be faxed)
E-mail address of the
POC.
There are a number of ways in which this information can be provided to the CDC.
1. Providers
can send the information to the CDC directly by logging on to the provider’s
public website at
www.certprovider.org and sending an e-mail with the new
address or contact information through the link posted on the site. ACs can
also avail themselves of this website to send changes to the CDC.
The provider may call the
Hours are:
8am
to 6pm Eastern Standard Time.
5am
to 3pm Pacific Standard Time.
2. The
provider may also call the AC CERT Point of Contact:
·
NHIC CA: Alina
Jimenez (213) 593-6820
·
NHIC NE: Susan
Kecskemety (781)
741-3050
3. For those providers with large group practices, it would be extremely helpful if this information is provided electronically in a Microsoft Excel spreadsheet or Access Database format. Attached, for your convenience, is an Excel spreadsheet that may be used to provide the needed information.
4. Lastly, ACs can provide the CDC with regular updated provider address information in a Microsoft Excel or Access file.
Revised 5/24/2007
Updated 10/06/05
Posted 8/18/05