Comprehensive Error Rate Testing (CERT) Question and Answer Fact Sheet
When submitting medical records in response to CERT's request, use the barcoded cover sheet provided. Please note that the requested documentation is not all-inclusive; the provider should respond with all documentation necessary to support the medical necessity of the services billed and to support the billed services were provided. If applicable, an authenticated or intent to order the billed services should also be submitted with the documentation. A sample of the request letters can be viewed on the C3HUB portal under the section titled “Sample Request Letters.”
- Via U.S. Mail
CERT Documentation Center
8701 Park Central Drive, Suite 400-A
Richmond, VA 23227
- Via Fax to (804) 261–8100
- Use the barcoded cover sheet as the only coversheet; do not add your own cover sheet
- Send a separate fax transmission for each individual claim
- Via Electronic Submission of Medical Documentation (esMD)
- Include a CID# or claim number and the barcoded cover sheet in your file transmission
- Information on esMD can be found at www.cms.gov/esMD
- Via CD
- Must contain only images in TIFF or PDF format
- The images should be encrypted per HIPAA security rules. Once encrypted, the password and CID# must be provided via email to CertMail@empower.ai or via fax to (804) 261–8100.
- Via Email Attachment
- Must contain only attachments in TIFF or PDF format
- The email attachment(s) should be encrypted per HIPAA ecurity rules. Once encrypted, the password and CID# must be provided via phone to 888–779–7477 or via fax to (804) 261–8100.
- Jurisdiction J (JJ): 877–567–7271
- Jurisdiction M (JM): 855–696–0705
- Railroad Medicare: 888–355–9165
Providers can now access the CERT C3HUB to obtain claim review status under the claim status search feature. The C3HUB is operated by the CERT Contractor and updated daily. Providers may contact the POC listed for more information about the CERT review. Please do not contact CERT directly. Refer to the Medicare Program Integrity Manual, Publication 100-08, Chapter 12 (PDF) for more information about how CERT information is disseminated.
- Visit CMS website to obtain the CMS-855A form or the CMS-855B form to update your information. An original signature is required, so the form must be printed, signed and mailed and cannot be sent electronically.
- The Provider Contact Center can assist you with address changes.
- Jurisdiction J (JJ): 877–567–7271
- Jurisdiction M (JM): 855–696–0705
- Railroad Medicare: 888–355–9165
- For information on updating addresses with PECOS, please see MLN Matters® Article SE1617 (PDF).
- After the initial request letter is sent on a specific CID, providers can designate a point of contact, address and/or phone number for future CERT correspondence related to that CID by contacting the CERT customer service center at 888–779–7477, or sending an email to CertProvider@empower.ai
- Providers with at least five PTANs (Provider Transaction Numbers) or OSCAR (Transaction Access Number and NPI), such as a hospital chain with multiple PTANs, or billing practice with multiple NPIs, who would like to elect a single point of contact can enroll in the “chain address” program. Providers should contact CERT at the above number and/or email address. Please see the CERT contractor's letter and contact information on the CERT C3Hub for additional information and guidance concerning this.