Long-Term Care

CERT program could test your documentation

Billing Alert for Long-Term Care, July 1, 2009

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SNFs have plenty to worry about when it comes to Medicare compliance. The Recovery Audit Contractor program, Medicare medical reviews, and Medicare Program Safeguard Contractors are some CMS audits that scrutinize providers’ claims.

However, nursing facilities should be concerned about another kind of audit: CMS’ Comprehensive Error Rate Testing (CERT) program. Although the program aims to establish error rates for fiscal intermediaries and Medicare administrative contractors, SNF claims are reviewed in the process, and providers must repay any overpayments discovered. Any underpayments will be returned to providers.

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Billing Alert for Long-Term Care.

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