What is the role of a CERT contractor?

What is the role of a CERT contractor?

CERT Process The CERT Documentation Contractor is responsible for requesting medical records from health care providers that submitted the claims in the sample via a paper letter.

What is the difference between Mac and RAC?

MAC audits are powerful and intrusive procedures that have the potential to lead to serious federal charges for healthcare entities. A Recovery Audit Contractor (“RAC”) reviews claims and identifies overpayments from Medicare so that CMS and other auditors are able to prevent improper payments in the future.

How do I prepare for a RAC audit?

5 Ways You Can Begin Preparing for a RAC Audit

  1. Perform an Internal Audit. This action will help you to determine the likelihood of coding and billing mistakes within your company.
  2. Identify and Correct Coding/Billing Issues.
  3. Review Problem Areas.
  4. Check Documentation.
  5. Find Assistance.

What is a RAC audit in Medicare?

What does a Recovery Audit Contractor (RAC) do? RAC’s review claims on a post-payment basis. The RAC’s detect and correct past improper payments so that CMS and Carriers, FIs, and MACs can implement actions that will prevent future improper payments.

What does CERT stand for in testing?


Acronym Definition
CERT Certificate
CERT Comprehensive Error Rate Testing (Centers for Medicare and Medicaid Services)
CERT Community Emergency Response Team
CERT Certification

What does CERT stand for in it?

Computer Emergency Response Team
Computer Emergency Response Team (CERT)

What is a CERT 1?

The Certificate I qualification type is to give individuals formal qualifications with basic functional knowledge (and skills) to do work, go in to further learning and or for community involvement.

What is a Mac audit?

Who performs RAC audits?

There are currently three firms that administer RAC audits, according to CMS’ website: Performant Recovery Inc., Cotiviti LLC and HMS Federal Solutions, and the company that comes calling depends on your agency’s geographic region.

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