CERT awareness month: Steps to take if you get a CERT documentation request
The Part A, Part B, durable medical equipment (DME), home health and hospice, and railroad board MACs are working together to promote the importance of complying with CERT documentation requests. This is the second of four articles in our CERT awareness month to support providers and suppliers.
To be compliant and ensure a timely response to CERT review contractor (RC) documentation requests, take these steps:
Review the CERT RC letter request for these important sections:
- Action: Medical Records Required
- This is the list of records to support claim payment
- When: Date
- This is the deadline to provide medical records to the CERT RC
Prepare the records for submission
- Locate and assemble all records listed on the CERT RC’s letter
- Identify if anything is missing and if so, take action to obtain the needed record(s)
- Make copies and keep the originals
Submit the information by the deadline
- Follow instructions on the CERT RC’s letter
- Place the CERT RC’s bar-coded coversheet in front of your records
Consider follow up to confirm records were received. If sending by fax, verify successful transmission. Failure to respond may result in a recoupment.
Related article
CERT awareness month: CERT documentation deadline
References
- MLN fact sheet: Complying with medical records documentation requirements
- MLN provider minute: The importance of proper documentation
- CERT background
- C3HUB