Last Modified: 8/24/2020
Location: FL, PR, USVI
Business: Part A, Part B
The Centers for Medicare & Medicaid Services (CMS) established the comprehensive error rate testing (CERT) program to calculate a national paid claims error rate for the Medicare fee-for-service program. The CERT program calculates the error rates for all Medicare contractors.
AdvanceMed, the comprehensive error rate testing (CERT) review contactor, also operates the CERT documentation center. All CERT inquiries and medical records should be sent to AdvanceMed. For more information, visit the CERT website
. AdvanceMed is responsible for:
• Reviewing the selected claims and associated medical record documentation; and
• Requesting and receiving the medical record documentation from providers
Providers and suppliers are now able to submit medical records directly to the CERT contractor at CERTmail@nciinc.com
. As a best practice, providers and suppliers are encouraged to password protect their documentation. Passwords should be submitted in a separate email to the CERT contractor.
You may also submit medical records via FAX to: 804-261-8100.
To request additional time for faxing the required medical records/documentation or to contact the CERT contractor, please call:
Requested medical records/documentation may be mailed to:
CERT Documentation Center
Attn CID #: xxxxxx (write the control identification [CID] number indicated in your CERT contractor letter)
1510 East Parham Road
Henrico, VA 23228
Have questions? Reach out to the CERT Contractor at CERTprovider@nciinc.com
. They can assist with questions related to medical records requests, review status, and more.
Note: Please follow the specific instructions for submitting requested medical records/documentation provided with your CERT contractor letter.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.