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The Importance of Proper Documentation

The CERT contractor randomly selects claims providers submit to Medicare to determine if the claim was paid properly under Medicare coverage, coding and billing rules by requesting medical records. If the medical records do not support that the rules were met, the claim is counted as either a total or partial improper payment and a CERT error is assigned.

The goal of the CERT A/B MAC Outreach & Education Task Force is to ensure consistent communication and education to reduce the Medicare Part A and Part B error rates. The CERT Task Force creates or recommends certain articles or videos to help prevent CERT errors. Watch the Compliance CERT YouTube Video Provider Minute: The Importance of Proper Documentation to find out how documentation fits in the care of patients, claims payment and helps reduce CERT errors.

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Posted 12/14/2023