Process for Requesting Medical Records

Additional Documentation Requests

• INITIAL ADR letters for CERT are sent to the address on file with the NSC for DMEPOS suppliers, or the MAC for the provider/supplier that billed/submitted the claim.

• SUBSEQUENT ADR letters for that claim can be sent to a specific correspondence address designated by the provider. This can be provided to the CERT CSR by calling 888-779-7477 once the provider receives the initial letter.

The above processes are based on each individual CID; providers will need to contact the CERT office as mentioned above for each sampled claim.

For information on updating addresses on file with the NSC or MAC, please see MLN Matters® article SE1617: Timely Reporting of Provider Enrollment Information Changes.

Chain Address Program

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

• Call the CERT office (888-779-7477) or your local MAC CERT coordinator 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 initial 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 a provider has multiple CERT requests with the same phone number, the CERT RC will group all requests together so that a single contact can be made with the provider(s) associated with that phone number to discuss all outstanding requests.

*Important note: This change is only in regards to the CERT program.