The CERT Public website is design to provide you, Medicare providers and suppliers, with a general information/overview about the Comprehensive Error Rate Testing (CERT) Program.
Pursuant to the Robert T. Stafford Disaster Relief and Emergency Assistance Act, President Trump declared on March 13, 2020 that, as a result of the effects of the Coronavirus Disease 2019 (COVID-19), a national emergency exists nationwide, retroactive to March 1, 2020. On January 31, 2020, Secretary Azar of the Department of Health & Human Services (HHS) declared a nationwide public health emergency, retroactive to January 27, 2020. Accordingly, the Centers for Medicare & Medicaid Services (CMS) is taking the steps below to allow Medicare providers and suppliers to focus their resources on combatting COVID-19.
Effective immediately, CMS is exercising its enforcement discretion to adopt a temporary policy regarding the Medicare Comprehensive Error Rate Testing (CERT) program under which it will not send documentation request letters to or conduct phone calls with providers or suppliers to request medical documentation until further notice.
Additional guidance regarding the administration of the CERT program will be provided in the coming weeks. Please reach out to the CERT Review Contractor at 1-888-779-7477 if you have any questions.
This website contains the following features:
About CERT - This webpage covers a brief description about the CERT program and the functions of the two CERT contractors: The Review Contractor and the Statistical Contractor.
Submit Records to CERT - This webpage provides instructions to providers and suppliers on how to submit medical documentation to the CERT Review Contractor. There are five submission methods.
Letter and Contact Information - This webpage notifies providers and suppliers of the schedule the CERT Review contractor uses to mail out the initial and subsequent Additional Documentation Request (ADR) letters. The timeline includes when providers and suppliers can expect to receive a telephone call.
This webpage also identifies the source of the address the CERT RC will use to mail the initial and subsequent letters. It informs providers that telephone calls will be grouped in order to reduce multiple calls to the same provider. And provides instructions on how providers that have 10 or more PTAN/OSCAR numbers can join the chain address program.
Attestation Letters - This webpage provides a sample of the Disaster Attestation Letter. Providers and suppliers are required to submit this letter when the medical documentation requested to support a claim has been wholly or partially destroyed in a disaster. It also includes a sample of a Signature Attestation Letter that providers and suppliers can use when the signature is illegible/missing.
Sample Request Letters - This webpage includes a sample of the initial and subsequent additional documentation request (ADR) letters that are sent to providers and suppliers. The letters are based on claim type. Both English and Spanish versions are available on this page.
Documentation Request Listings - This webpage includes a sample of the types of documents that the provider and supplier should include when they receive a CERT letter requesting medical records. This page allows the provider to select a specific documentation listing based on service within each claim/billing type.
Psychotherapy Notes - This webpage contains CMS special instructions for providing documentation for psychotherapy claims.
Contractor ID Look-up - This webpage provides a link to an Excel spreadsheet where providers and suppliers can locate the MAC contractor id used in CERT processing and communications.
Contractor ID: The Contractor Identification Number is a 5-character number that identifies the Medicare Administrative Contractor (MAC) workload responsible for processing your claims. Upon CMS instructions, the contractor ids IDs used in the CERT program vary slightly from the MAC specific workload ids IDs used for other reporting within CMS. Follow this link for a spreadsheet to assist you in identifying the appropriate Contractor IDs used for CERT.
FAQs - This webpage contains a word document with the most frequent questions asked about the CERT program.
CMS Links - This webpage has hyperlinks to various CMS topics/resources related to CERT (e.g., CERT power point, Medicare Quarterly Provider Compliance Newsletter, and information on encryption).
Contact Us - This webpage has the CERT Review Contractor’s mailing address, telephone and fax numbers and email address.