tci Medicare Compliance & Reimbursement - 2024 Issue Q2

Reader Questions: Heed This Insight On Documentation Requests For CERT Reviews

Question: Our practice is currently in the middle of a Comprehensive Error Rate Testing (CERT) audit, and we’ve already sent a lot of documentation for specific services rendered to Medicare beneficiaries. Yesterday, we received another request for medical records for a patient, whose records we have already submitted. Should we just ignore the most recent request to avoid confusion since we’ve already forwarded this documentation? Virginia Subscriber Answer: No, you should never ignore a documentation request from a CERT auditor, even if it seems like a repeat request. The CERT auditors may be looking for something specific...

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