Fast facts: Checking the status of your CERT review

The Comprehensive Error Rate Testing (CERT) review contractor conducts a medical review of randomly sampled claims.  If a claim is sampled, there are resources available to check the status of a CERT review. Each resource requires the 7-digit claim identifier (CID) number. The CID number can be found on the additional documentation request sent by CERT. 

Here are three ways to get the status of a CERT claim review:

  • C3HUB
    • Check the status of a CERT review by utilizing the “Claim Status Search” tool.  To obtain the status of a review, enter the CID number into the claim status search bar and press enter.  One of the following status indicators will be given:
      • Review status: No error (Claim was billed and paid properly)
      • Review status: Error (Contact your MAC)
      • Review status: Started on “mm/dd/yyyy” (Review still in progress)
  • First Coast’s CERT CID lookup tool
    • This tool provides information for sampled claims where a decision has been made by the CERT review contractor; if a claim is pending review with the CERT review contractor, the file will indicate status of the review. To obtain the status of a review, enter the 7-digit CID number into the search bar and press enter.
  • Email QuestCERT2@fcso.com
    • Send an email requesting a claim review status update. Please do not include any protected health information (PHI) or personally identifiable information (PII), only the 7-digit CID number is needed.