Attention All Providers! CERT Program Has New Processes

The Comprehensive Error Rate Testing (CERT) Program has implemented several new processes that providers need to be aware of in order to remain compliant.

Documentation Requests

All FIRST Additional Documentation Request (ADR) letters for CERT are sent to the address on file with the National Supplier Clearinghouse (NSC) for Durable Medical Equipment Prosthetics, Orthotics and Supplies (DMEPOS) suppliers, or the Medicare Administrative Contractor (MAC) for the provider/supplier that billed/submitted the claim.

All SUBSEQUENT ADR letters can be sent to a specific correspondence address. This can be provided to the CERT Customer Service Representative (CSR) by calling 888-779-7477.  The above processes are based on each individual CID (Claim ID); providers will need to contact the CERT office as mentioned above for each sampled claim.

Chain Address Program

Providers who have at least ten (10) PTAN/OSCAR numbers who would like to elect a single point of contact (POC) can participate in the “chain address” program recently implemented by CERT. This program is as follows:

  • Call the CERT office (888-779-7477) or Cahaba’s CERT Coordinator (Ashley Carroll-205-220-1698) with a list of PTAN/OSCAR numbers and the designated point of contact information.
  • To assure you supply the information to CERT within the 45 days, CERT will email/call the point of contact with a list of outstanding CID numbers.
    • NOTE: Due to the FIRST letter being sent to the provider address on file, these may be requests the point of contact has not yet received.
    • When requested, the CERT CSR will forward a copy of the letters not yet received.

Group Calls

In order to reduce provider burden, when multiple calls are due to the same phone number, the CERT RC groups the calls so that a single contact can be made with the provider (providers) associated with that phone number to discuss all outstanding requests.

*****IMPORTANT NOTE: This change is ONLY in regards to the CERT program

For information on updating addresses with the NSC or MAC, please see MLN Matters® Article SE1617.

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