CERT Denials

If your claim is denied by CERT, you will be notified via Remittance Advice that all or some of the payment is being adjusted to reflect total or partial recoupment (debit/credit). Your Business Office manager or CERT contact person may also receive a letter from NGS regarding the CERT denial and appeal information in detail. Records for claims denied by CERT for insufficient or no documentation may be submitted directly to the CDC via fax at (240) 568-6222. The CERT contractor will determine if the additional documentation is sufficient to reverse the denial. Remember to send the documentation with a copy of the original request letter containing the bar-coded information and CID. If the original letter is unavailable, include the CID on the fax cover sheet.

You may also appeal all CERT denials to the UGS Appeals Department via the regular appeals process.