Friday, November 1, 2013

CERT Documentation Submission Update

Effective for all initial documentation request letters sent on or after January 1, 2014, providers and suppliers will have 60 days to submit medical documentation in response to initial documentation request for claims selected by the Comprehensive Error Rate Testing (CERT) program.  If no documentation is received by the 60th day, the claim will be considered a “no documentation” error and recoupment will be pursued.  This information was sent by CGS a Medicare Administrative Contractor.

We have always recommended that you submit your documentation as soon as possible and send it by certified mail return receipt.  We also recommend you send each patient separately and identify on the green return receipt card a patient number.  Do not use patient names or Medicare numbers.  This proves that the record for that medical record number was indeed received.  There have been many cases when documentation was sent timely, but not properly credited as received.

For more information please use the following link:

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