CERT Feedback Report Errors and Recommendations for Improvement

Of 200 claims sampled in the August 31, 2009, CERT Feedback Report, 136 errors were identified. Nearly half of errors identified in the August 31, 2009, CERT Feedback were a result of a lack of documentation of medical necessity. In addition, more than 36 percent of errors identified were a result of insufficient documentation. Of that 36 percent, approximately two-thirds of the insufficient documentation errors were due to failure to meet signature requirements.

Recommendations for Improvement

• Ensure your documentation is complete and supports the service provided.
• Code correctly the first time.
• Respond in a timely manner to requests for documentation.
• Submit complete, legible documentation.
• Medicare requires a legible identifier for services ordered and provided.