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Critical Access Hospitals: Bill Correctly  

The CERT contractor randomly selects claims providers submit to Medicare to determine if the claim was paid properly under Medicare coverage, coding and billing rules by requesting medical records. If the medical records do not support that the rules were met, the claim is counted as either a total or partial improper payment and a CERT error is assigned.

The goal of the CERT A/B MAC Outreach and Education Task Force is to ensure consistent communication and education to reduce the Medicare Part A and Part B error rates. The CERT Task Force creates or recommends certain articles or videos to help prevent CERT errors.  

Critical access hospitals read this compliance fast fact article Critical Access Hospitals: Bill Correctly! to understand how to properly document and bill for services to Medicare to prevent CERT errors.

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Posted 11/29/2023