The 2019 Comprehensive Error Rate Testing (CERT) report was published last week. The report provides detailed information regarding fee-for-service payment errors made under both Part A and Part B. The findings reflect payment errors of $28.9 billion for fiscal year 2019. The volume and types of errors noted suggest providers continue to struggle with appropriate documentation and accurate coding to support coverage and reimbursement in the outpatient and inpatient setting. The HBE team has prepared a summary of the key findings you need to know.
We recommend reviewing the complete report in detail. If you routinely provide and bill for the types of services identified within the CERT report, we recommend you incorporate them into your compliance auditing and monitoring program work plan. The HBE team is available to assist you with identifying the risks unique to your organization as well as providing assistance with conducting documentation, coding, medical necessity and coverage audits. We also offer customized education and training for your physicians, coders and executive leadership.
The complete CERT report is available at: https://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/CERT/CERT-Reports