Comprehensive Error Rate Testing (CERT) MAC Outreach & Education Task Forces
The CERT MAC Outreach & Education Task Forces provide Medicare Fee-for-Service (FFS) contractors with consistent communication about reducing error rates. The task forces support CMS‘s efforts to improve the provider experience through the Provider Customer Service Program. The task forces provide a single educational voice to improve knowledge and performance about the Comprehensive Error Rate Testing (CERT) program.
The CERT Part A and Part B (A/B) and Durable Medical Equipment (DME) MAC Outreach & Education Task Forces are independent from the CMS CERT team and CERT contractors, which are responsible for calculation of the Medicare Fee-for-Service improper payment rate.
What is the CERT program?
CMS created the CERT program to measure the error rate of improper FFS payments. The error rate measures payments that didn’t meet Medicare requirements; it doesn’t indicate fraud.
How does the CERT program work?
A CERT contractor reviews a sample of processed claims. If a claim doesn’t meet Medicare’s coverage, coding, and billing rules or the provider fails to submit medical records, it’s counted as a total or partial improper payment. Medicare Administrative Contractors analyze CERT error rates to reduce improper payments by updating their internal processes and educating providers.