Comprehensive Error Rate Testing Medical Record Requests: Respond Timely

You’re required to respond in a timely manner to Comprehensive Error Rate Testing (CERT) requests for medical records. Without a response, your Medicare Administrative Contractor (MAC) may adjust your CERT sampled claim and recoup the payment. To review the Initial Request Schedule, visit the CERT C3HUB and select Letters and Contact Information. 

If your CERT requests need to go to an address other than what’s in the PECOS Correspondence Address field, contact the CERT C3HUB to discuss your options. You can also contact them for copies of documentation. If you get a CERT error for non-response to a documentation request, find your MAC's website. 

More Information:

• Complying with Medical Record Documentation Requirements (PDF) fact sheet
• Medical Record Maintenance & Access Requirements (PDF) fact sheet
• Medicare Provider Enrollment educational tool
• Section 12.10, Medicare Program Integrity Manual, Chapter 12 (PDF)
• Section 1862(a)(1)(A), Social Security Act