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CMS Identifies Recovery Auditor Findings

James Carroll, for HealthLeaders Media, May 31, 2012


For the first time since it began publishing a quarterly Medicare compliance newsletter, the Centers for Medicare & Medicaid Services has released CERT findings on problematic billing errors.

Unlike all of the preceding releases, the April issue of the Medicare Quarterly Provider Compliance Newsletter, CMS's seventh issue, contains comprehensive error rate testing (CERT) findings in addition to recovery auditor findings.

Find the strengths of your organization and develop a strategic marketing plan that promotes strong service lines to new and existing patients. According to Donna Wilson, RHIA, CCS, CCDS, senior director at Compliance Concepts in Wexford, PA., the inclusion of this new information should prove beneficial to providers.

"Including CERT findings is an added bonus to this priceless resource tool from Medicare," she said. "Providers should consider adding these issues to their internal compliance monitoring. Governmental auditing agencies use CERT, RAC, PEPPER, and OIG studies to detect suspicious billing practices."


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