Health Information Management

OIG examines CMS' CERT improper payment error rate estimations

HIM-HIPAA Insider, March 27, 2012

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On March 9, the OIG published the report, “Review of CERT Errors Overturned Through the Appeals Process for Fiscal Years 2009 and 2010.” Findings suggest that CMS could improve the accuracy of its error rate estimations if it took into account the denials that were overturned on appeal.

“If these overturned CERT claim payment denials had been included in the initial error-rate calculations, the estimated value of reported errors for FYs 2009 and 2010 would have decreased by approximately $2 billion each year,” according to the report.
 
Click here to view the report.



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