CERT – Comprehensive Error Rate Testing

We support Comprehensive Error Rate Testing to ensure the documentation for medical necessity, as well as correct coding. It is essential because the CMS developed the Comprehensive Error Rate Testing (CERT) program to calculate the Medicare Fee-for-Service (FFS) program improper payment rate. The CERT program considers any claim that was paid when it should have been denied or paid at another amount (including both overpayments and underpayments) to be an improper payment. The objective of the CERT program is to estimate the accuracy of the Medicare FFS program.