Understand CERT Findings and What Your Organization Should Be Monitoring

Pam Joslin, MM, CMC, CMIS, CMOM, CMCO, CEMA, CMCA-E/M, consultant with Innovative Healthcare Consulting and over 20 years of medical practice management, billing and coding, reimbursement, auditing and compliance experience, returns to First Healthcare Compliance to lead this webinar. Since 1996, Centers for Medicare and Medicaid Services (CMS) implemented several initiatives to prevent improper payments. CMS’ goal is to reduce payment errors by identifying and addressing billing errors concerning coverage and coding. The Medicare FFS Improper payment rate for 2017 was estimated at 36.2 billion dollars.

1. Introduction to CERT Process: This webinar will educate you on the CERT process and how your organization can be proactive in identifying your improper payment categories to maintain compliance. The improper payment rates are categorized by type, specialty and geographical location. This is a great opportunity to see how your practice measures up to these national stats and information on how to respond if you receive a medical record request.

2. Review improper payment categories by specialties and geographical area

3. Review improper payment categories; how to respond to CERT medical record requests; and recognize the CERT timelines for documentation submission.