BILLING NEWS

CERT Denial Reason Finder

CMS calculates the Medicare Fee-for-Service (FFS) improper payment rate through the Comprehensive Error Rate Testing (CERT) program. Each year, CERT evaluates a statistically valid random sample of claims to determine if they were paid properly under Medicare coverage, coding, and billing rules.The CERT Denial Reason Finder tool will indicate the status location and status date of the claim selected by CERT for review. If CERT did not assess an error, the tool will indicate "No" in the Claim Error Field. The CERT Denial Reason Finder tool is located under the Provider Resources tab then Calculators & Tools.


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INDUSTRY NEWS TAGS: National Government Services, MAC J6 Wisconsin, MAC J6 Illinois, MAC J6 Minnesota, MAC JK Maine, MAC JK Massachusetts, MAC JK New Hampshire, MAC JK Rhode Island, MAC JK Vermont, MAC JK Connecticut, MAC JK New York


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