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Guide to CERT Request Letters
CERT Response Time Change
Beginning with initial letters dated November 1, 2006, and after, providers will be required to supply records in 75 days.
Key Points
- Palmetto GBA may have processed your Part B claim, but two other contractors handle functions associated with the actual claims sampling and review. They are known as the CERT Documentation Contractor (CDC) and the CERT Review Contractor (CRC).
- These are postpay audits of Medicare Part B claims and records. This means that because your services were submitted to Medicare for payment consideration, and the Centers for Medicare & Medicaid Services (CMS), by law, has the authority to exam your records for the presence of valid and corroborating documentation.
Please open on files below to see CERT letter examples. These examples include explanations and page-by-page references for CERT sample letters.