Title: The Comprehensive Error Rate Testing (CERT) Program

Presenter: Betty A. Hovey, BSHAM, CPC, COC, CPC-I, CPC-P, CPMA, CEMC, CCS-P, CDIP, Senior Consultant and Owner of Compliant Health Care Solutions

Time: 51.31 minutes

Description:

The CERT program is valuable to practices, and practices should have a plan on how to respond to a CERT records request. Betty A. Hovey shares how to follow a CERT request, respond within the given timeframe, and get external assistance if necessary to maintain compliance with the program.

Objectives:

• Describe the CERT program.

• Identify how the CERT program works.

• Recognize why the CERT program is important.

• Understand how to address a CERT records request.

• Be aware of how to use the CERT report in the practice.

Key Topics:

What is the CERT Program?
•  Definition
•  History
•  Goal

How Does the Program Work?
•  5 Specific Types of Billing and Medical Necessity Errors
•  5 Major Error Categories
•  Error Rate Breakdown
•  Appendices A-J

Why is the CERT Program Important?
•  After the Report
•  MACs Can…

Addressing a CERT Records Request
•  Contact a Healthcare Attorney
•  Protocols
•  Steps to Take
•  Timeframes

Use of CERT Reports in the Practice
•  Internal Review
•  Additional Education
•  Monitor Compliance

Final Thoughts
•  Key Points
•  Resources

Compliant Health Care Solutions

Betty is a nationally recognized health care consultant and speaker. She is an expert auditor and loves to help practices stay compliant and profitable. Betty's philosophy is, "Physicians work hard for their patients and they should be paid properly for what they do."

Betty brings over thirty years of healthcare experience. She has worked for practices both large and small with the same intensity and attention. She has spent years on the "front lines" for practices handling medical billing, coding, claims, and denials.  She has also managed practices and directed health care system departments. Her areas of specialization include Evaluation and Management, Primary Care, Dermatology, Plastic Surgery, Cardiology, Cardiothoracic Surgery, General Surgery, GI, E/M and procedural auditing, and ICD-10-CM.

Compliant Health Care Solutions is a consulting firm that provides compliant solutions to issues for all types of health care entities: solo practices, physician groups, physician offices, health care systems, care facilities, and payors.

https://chcs.consulting/