April 17, 2008
Comprehensive Error Rate Testing (CERT)
Faxing Documentation to the CERT Documentation Contractor (CDC)
The Comprehensive Error Rate Testing program (CERT) is a federally mandated program to monitor and improve the accuracy of Medicare payments to physicians and other providers.
The process begins when the CERT Review Contractor requests records for review for each sampled claim. A few helpful tips for faxing documentation to the CERT Documentation Contractor are listed below:
- Be sure you are using the correct fax number – (240) 568-6222
- Documents containing small fonts, the recommended mode of resolution for faxing should be “fine” (The resolution modes on most fax machines can easily be changed at the time of faxing by a button usually labeled “resolution” that is easily accessible near the other buttons at the top of the machine. Note that on most fax machines, the button will not function or change resolutions unless the document to be faxed has first been inserted. Should you not see this at the top of your machine, check your fax machine’s instruction manual for the location of the “resolution” button)
- Documents containing either light colored or light grey text or text embedded within background in shades of gray or color should be faxed using a resolution mode of “photo”, alternatively referred to as “gray scale”. This mode is available via the same “resolution” button mentioned above. This mode may not be available on all fax machines. Check your fax machine’s instruction manual for availability of this mode
- The CERT Contractor tracks their requests for records using the Claim Identifier (CID) which is located at the top of the barcoded cover sheet sent with the request for records. When faxing information back to the CERT office include the barcoded cover sheet first, followed by the records you are faxing. If the barcoded cover sheet is missing you should write the Claim Identifier (CID) number on each page of the fax. This will help the CERT office make sure your records reach the appropriate person.
- The CERT Documentation Contractor’s fax modems are set to respond after two rings; be sure your fax machine does not hang up after two rings or the fax will not be received.
- Confirmation
letters are sent from the CERT office acknowledging receipt of faxes whenever
possible. This confirmation however, does not attest to the quality or
legibility of the record nor does it guarantee completeness of the documentation.
A fax confirmation will be sent only after the CERT Documentation Contractor
Quality Assurance staff reviews the documentation received. If the documentation
is incomplete or illegible, the CERT Documentation Contractor will contact
you in an effort to obtain complete and/or legible documentation. The CERT
Documentation Contractor is not able to fax a confirmation in the following
situations:
- If you have a block on your fax number
- The fax number is not a direct line and has an extension. In that case, the confirmation may go back to the main number.
- Line noise or bad connections
- Fax machines must be set to receive
Should you have any problems providing the documentation requested, you may call the CERT Documentation Contractor at (888) 779-7477. Please have the CID of the claim in question available when you call.
