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Comprehensive Error Rate Testing (CERT) Information for Providers

Guidance for the CERT program will resume sending documentation request letters to and conducting phone calls with providers or suppliers to request medical documentation for claims in Reporting Year (RY) 2021 (claims submitted 7/1/2019 through 6/30/2020) and RY 2022 (claims submitted 7/1/2020 through 6/30/2021).

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: August 11, 2020

The current CERT Contractors are:
CERT Review Contractor – Empower AI, Inc. (formerly known as NCI Information Systems, Inc.)
CERT Statistical Contractor – The Lewin Group, Inc.

CERT medical records are to be sent to:

              CERT Documentation Center
              8701 Park Central Drive, Suite 400-A
              Richmond, VA 23227
              Fax: 804-261-8100
              Phone:  1-888-779-7477

Should a provider or supplier have questions on the documentation request or prefer the request to be made in a format other than a postal mailing, the CERT Documentation Center Customer Service may be contacted via:

             Phone: 1-888-779-7477
             Email: CertProvider@empower.ai

For medical records submissions or password assistance: CertMail@empower.ai

The CERT C3HUB Public website can be accessed through the link in the Related Links section at the bottom of this page.  This website is designed to provide Medicare providers, suppliers, and contractors with information about the CERT program including how to submit medical records, samples of additional documentation requests, a claims status search feature, a frequently asked questions document, and other helpful CMS links.

 

HHS is committed to making its websites and documents accessible to the widest possible audience, including individuals with disabilities. We are in the process of retroactively making some documents accessible. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov.

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.