2020 Jurisdiction M Part B South Carolina Comprehensive Error Rate Testing (CERT)

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.

  • Total claims reviewed: 14
  • Total dollars reviewed: $1,893.59
  • Total paid correctly: $1279.79
  • Total claims paid: 13
  • Total claims denied: 1
  • Total paid incorrectly: $613.80
  • Claim with error code 99 — No Response: 1

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.

Contact Palmetto GBA JM Part B Medicare

Email Part B

Contact a specific JM Part B department

Provider Contact Center: 855-696-0705

TDD: 866-830-3188

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