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This website provides information and news about the Medicare program for health care professionals only. All communication and issues regarding your Medicare benefits are handled directly by Medicare and not through this website. For the most comprehensive experience, we encourage you to visit Medicare.gov or call 1-800-MEDICARE. In the event your provider fails to submit your Medicare claim, please view these resources for claim assistance.
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CERT resources center

The Comprehensive Error Rate Testing (CERT) CID lookup was developed so providers can obtain a status of their CERT sampled claims. This tool provides information for sampled claims where a decision has been made by the CERT review contractor or is pending review.
The Part A/B MACs joined forces to communicate national issues of concern regarding improper payments to the Medicare program, resulting in the creation of the A/B contractor Comprehensive Error Rate Testing (CERT) task force.
Medical documentation and checklists
For each claim sample selected, the CERT review contractor requests medical records from the provider or supplier that submitted the claim. First Coast has compiled resources and checklists to help guide you when responding to CERT documentation requests.
moreCERT program reference guide -- this guide shows the complete CERT process, including how to respond to medical record requests.
moreCERT checklists -- these checklists provide a reference for use when responding to CERT documentation requests for the selected claim sample.
moreView CERT articles and resources on the First Coast website
moreView articles and resources pertaining to medical documentation on the First Coast website
Courses and interactive tools
moreMedical Documentation Request external link -- This course addresses key components of the documentation request, including timeframes in which to respond to requests, recommended items to include, and acceptable submission methods.
moreEvaluation & Management (E/M) Documentation Part 1 external link and Part 2 external link (Part B) -- Take this course to learn about the documentation guidelines, key components of E/M services, and documenting medical necessity.
FAQs
moreFAQs regarding the CERT program -- review questions and answers pertaining to the CERT program.
CMS resources
moreList of CERT reports external link -- includes the annual Improper Medicare Fee-for-Service Payment report.
more'CERT Signature Requirements' fact sheet external PDF -- covers common denials related to signature requirements and medical documentation.
moreCERT Process for Handling a Provider's Allegation of Medical Record Destruction external PDF -- (SE0547) -- outlines the process Medicare providers should follow when requested medical records are destroyed by disaster.
moreRecommendations regarding the development of a model compliance plan for clinical laboratories the Office of the Inspector General (OIG) and other federal agencies have emphasized the importance of compliance plans.
moreMedicare Learning Network® (MLN) Products Provider Compliance page external link -- find educational products on how to avoid common billing errors and other improper activities.
CERT references
moreOverview of CERT program external link -- this section of CMS' website offers an overview of the CERT program.
moreComprehensive error rate testing contact information -- this document includes information on how to contact the CERT documentation contractor.
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.