Fast facts: Appealing a CERT review decision
The Comprehensive Error Rate Testing (CERT) review contractor conducts a medical review of randomly sampled post-payment claims...
The Comprehensive Error Rate Testing (CERT) review contractor conducts a medical review of randomly sampled post-payment claims...
To use the SPOT, you must complete the full new user registration process through the IDM website. If you have your IDM account and attempt to log on to SPOT before the role request has been approved (i.e., no request submitted, request in pending status, or request in denied status), a permission error message will be returned. If your role request was approved and you still receive this error, clear your internet browser’s cache. If you are unsure of the status of your SPOT access request, you may contact the SPOT Help Desk (855-416-4199 option 1).
Read this article for tips on how to prevent reject reason code 31997.
99211 is an established patient office or other outpatient visit that may not require the presence of a physician. To bill incident-to, the incident-to rules must be met. To ensure the services meet those requirements, utilize the incident-to tool on our website. This applies to E/M services prior to 2021 and after.
Reference
Read this article for tips on how to prevent reject reason code 76474.