Comprehensive Error Rate Testing
CERT Documentation Contractor
The Centers for Medicare & Medicaid Services (CMS) are modifying the process for the Comprehensive Error Rate Testing (CERT) medical record requests. Although this transition is expected to be seamless, you may notice a few changes if you have had claims reviewed as part of a CERT sample in the past.
Previously, AdvanceMed, the CERT Review Contractor (CRC) in Richmond, Virginia, has been responsible for both requesting and reviewing medical records for CERT sampled claims. However, the task of requesting the medical records is being transitioned to a new CERT Documentation Contractor (CDC) located in Annapolis Junction, Maryland.
The timeframes for complying with the documentation requests will remain the same. However, the new contractor will be taking additional steps in an effort to improve overall communication and expedite response times.
Prior to sending out the initial request for documentation, the CDC will attempt to make a telephone contact to your office in order to obtain a Point of Contact (POC). If this contact is successful, the CDC will fax (preferred method) or mail the medical record request directly to the POC. This contact information is retained by the CDC to insure that future CERT correspondence is directed to the appropriate staff and reaches your facility in a timely manner.
Please note that until this transition is complete, you may receive letters from both AdvanceMed and the CRC. We ask that you please respond to these requests by sending the documentation to the address or fax number indicated on the letter corresponding to the specific claim.
If you have been notified that you were part of a CERT sample, but the record requests did not reach your practice, or were delayed or misrouted, you may change the address of where your CERT requests are mailed, or add a fax number or POC for your facility.
Effective July 18, 2005 the CERT Documentation Contractor made available the following website for providers to review address information that is currently in the CMS database: www.certprovider.org. This is a "read only" website with an e-mail link: byron@certcdc.com to send updates to the CERT Documentation Contractor. Providers may also call a Customer Service Representative at (301) 957-2380 to update information. Verification of the information will be done via a return phone call to the provider's office to ensure authenticity.
Please review the information. In particular, the CERT Documentation Contractor needs the address where the medical records are stored and the point of contact name, direct phone number, and fax number. If updates or corrections are required, you may click on the E-mail link or call a CSR to update provider contact information.
Items to include:
- Affiliated Contractor Name and Number
- Provider Number
- Name of Provider
- Address of Provider (where medical records are stored)
- Point of Contact (POC) for obtaining medical records
- Direct Phone Number of POC
- Fax Number of POC
Providing updated contact information and timely responses to CERT requests for documentation directly contributes to the reduction of the CERT error rate. For more information on the CERT program, please visit our Website by clicking here, or submit your questions using our 'Contact Us' form.
