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Comprehensive Error Rate Testing

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Chronic Care Management

Insufficient documentation causes most improper payments. Insufficient documentation means that something was missing from the medical records.  Below is a list of the most common reasons CERT determined there was insufficient documentation that caused improper payments for CCM services: 

    • Missing documentation that support CCM was performed;
    • Missing CCM care plan with documentation that it was provided to the beneficiary or beneficiary’s caregiver;
    • Missing patient agreement or consent for CCM;
    • Missing electronic signature or legible signature of the performing provider

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