Comprehensive Error Rate Testing (CERT)

CERT Home Page
Who Performs CERT?
Responding to Documentation Requests
- Documentation Checklist
HIPAA Compliance
Samples of CERT Request Letters
CERT Denials
What If My Records Were Destroyed?
Update Provider Contact Information
Contact Information
CERT Findings
CERT References
CERT Newsletters
Other Links
CERT Quiz

Who Performs CERT?

CERT activities are performed by two contractors: the CERT Documentation Contractor (CDC) and the CERT Review Contractor (CRC).

The CDC, located in Maryland, is responsible for requesting and obtaining the documentation to support the payments for the selected claims. The CDC attempts initial telephone contact with the provider to explain the program and follow up with a faxed or mailed medical record request letter.

The CRC, located in Virginia, reviews the documentation obtained by the CDC to determine if Medicare payment was supported. Services that are paid incorrectly are considered errors, whether overpaid or underpaid. The CRC then notifies the Medicare Contractor to adjust the claim accordingly.

A Joint Operating Agreement (JOA) exists between the CDC and the CRC to guide both contractors in working efficiently together to accomplish the CERT program activities.