CERT Audit

A CERT Audit Is Serious – Don’t Take These Medicare Reviews Lightly

Medicare, Medicaid & Private Payor Updates /

(November 23, 2011): The “Comprehensive Error Rate Testing” (CERT) program was implemented as a mechanism for the Centers for Medicare and Medicaid Services (CMS) to assess whether their Medicare Administrative Contractors (MACs) are properly paying claims. In other words, is a particular MAC failing to identify and deny improper claims? Alternatively, is the MAC denying […]

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CERT Postpayment Audits: An Overview of the Audit Process

Medicare, Medicaid & Private Payor Updates /

(March 12, 2011): Health care providers around the country are finding their practices and clinics subjected to Medicare post-payment audits by Zone Program Integrity Contractors (ZPICs), Program Safeguard Contractors (PSCs) and Comprehensive Error Rate Testing (CERT) Contractors. While all post-payment audits should be taken seriously, there are real differences between both the contractors and the

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