Revenue Cycle

CMS identifies CERT, Recovery Auditor findings in latest quarterly compliance newsletter

Recovery Auditor Report, May 31, 2012

Last month CMS released the seventh issue of its Medicare Quarterly Provider Compliance Newsletter. The newsletter contains official guidance on problematic billing errors that it has identified in the past quarter. Unlike all of the preceding releases, this issue contains comprehensive error rate testing (CERT) findings in addition to recovery auditor findings.

According to Donna Wilson, RHIA, CCS, CCDS, senior director at Compliance Concepts, Inc. in Wexford, PA., the inclusion of this new information should prove to be beneficial to providers.

“Including CERT findings is an added bonus to this priceless resource tool from Medicare,” she says. “Providers should consider adding these issues to their internal compliance monitoring. Governmental auditing agencies use CERT, RAC, PEPPER and OIG studies to detect suspicious billing practices.”

As has been the case, these documents are provided in order to propagate information on understanding claims submission problems while also providing guidance on avoiding such errors and improper billing activities moving forward. As auditing bodies continue to grow and evolve, the addition of CERT findings only makes sense.

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