Comprehensive Error Rate Testing
CERT Documentation Updates
Failure to respond to CERT requests for documentation and submitting insufficient documentation to support the services billed to Medicare continue to have a significant impact on our CERT Error Rate as a carrier. Providers can significantly impact these error rates by sending complete and accurate documentation in response to CERT requests, and by supplying WPS with updated and accurate address information.
CERT Documentation Reminders
- If you are part of a CERT review and the requested records are located at a hospital or other facility, it is your responsibility to retrieve the records and forward them to the CERT contractor.
- When providing records for multiple billed services, prior to sending, please verify that the documentation supports ALL services on the billed claim.
- Please be sure to include documentation for laboratory and radiology services in addition to any evaluation and management services billed on the claim.
Address Changes
It is imperative that providers respond to CERT Documentation Contractor's (CDC) requests for documentation. Failure to respond to these requests may result in an overpayment request and/or additional data analysis on the subsequent CERT-identified errors.
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/misrouted, you may change the address where the CERT requests are mailed by faxing an address update request to WPS at (608) 301-2625, ATTN: CERT Address Change. Please include your Medicare provider number and a contact name and telephone number so that we can contact you to confirm that your request was received.
Note: We can only accept address information for providers that have been identified within a CERT sample, and this change will only affect correspondence sent to you by the CERT Documentation Contractor (CDC). All other Medicare correspondence will continue to be mailed to the address on file with our Medicare Provider Enrollment Unit.
If you need to make changes/updates to your Medicare address with our Provider Enrollment Unit you may contact us at:
Telephone:
877-908-8476 (WI, IL, MI)
866-564-0315 (MN)
The form(s) may also be downloaded from the CMS website at
http://www.cms.hhs.gov/MedicareProviderSupEnroll/, and mailed to WPS at the appropriate address below:
Illinois/Michigan/Wisconsin
Wisconsin Physicians Service
Medicare B Provider Enrollment Unit
P.O. Box 8248
Madison, WI 53708-8248
Minnesota
Wisconsin Physicians Service
Medicare B Provider Enrollment Unit
8120 Penn Avenue South #200
Bloomington, MN 55431-1394
If you need assistance in completing the form or have any questions, please contact Provider Enrollment at your respective number above.
(Dated 04/07/05)
