Subscribe to eNews Contact us / IVR

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: 

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

Follow up by accessing the CERT RC C3HUB website. The Claim Status Search feature will confirm if the CERT RC got your records. Failure to submit the requested documentation to the CERT RC may result in payment recoupment.

 

Related article

CERT awareness month: CERT documentation deadline

 

References