What does CERT stand for?

What does CERT stand for?

• A. Comprehensive Error Rate Testing
• B. Corporate Integrity Agreement
• C. Certificate of Waiver
• D. Compliance Program Guidance

Answer: (A)

Comprehensive Error Rate Testing is the expansion behind CERT. This CMS program uses a sample of Medicare and Medicaid claims and the corresponding medical records to determine how often payment claims are incorrect. The goal is to estimate the overall improper payment rate and help target improvements in billing and claims processing. The other terms refer to different concepts in healthcare compliance—Corporate Integrity Agreement relates to settlements with the OIG, Certificate of Waiver is a CLIA designation for certain lab tests, and Compliance Program Guidance refers to guidance for implementing compliance programs. None of those describe what CERT stands for in the context of auditing and improper payments.

Comprehensive Error Rate Testing is the expansion behind CERT. This CMS program uses a sample of Medicare and Medicaid claims and the corresponding medical records to determine how often payment claims are incorrect. The goal is to estimate the overall improper payment rate and help target improvements in billing and claims processing. The other terms refer to different concepts in healthcare compliance—Corporate Integrity Agreement relates to settlements with the OIG, Certificate of Waiver is a CLIA designation for certain lab tests, and Compliance Program Guidance refers to guidance for implementing compliance programs. None of those describe what CERT stands for in the context of auditing and improper payments.