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Printed Date: 9/22/2015
The Comprehensive Error Rate Testing (CERT) program looks for improper payments on Medicare claims. Based on the 2020 annual report, here is the Jurisdiction M Part B CERT for South Carolina.
CERT Reviewer Error: 99 — No Response
The claim was denied for provider non-response to four or more requests for medical records. The CERT process is a federally mandated program and non-submission of medical records results in a denial of all services.
Compliance with the CERT process benefits the provider by ensuring the appropriate reimbursement of their claims, preventing unnecessary denials and appeals, and reflecting a positive impression on the provider industry by having a low payment error rate. Compliance with the CERT process may also prevent additional medical review of providers and the provider industry.
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Last Updated: 02/14/2020