Hello, my name is Carlette Murray I am the Coordinator here at Empire Medicare Services for the Comprehensive Error Rate Testing Program, also known as CERT.

In August of 2000, the Centers for Medicare & Medicaid Services began a new program to determine a national error rate for the Medicare program and to improve the processing and medical decision making involved with payment to your Medicare claims. An independent contractor was hired by the Centers for Medicare and Medicaid Services to perform this function. Every month this contractor collects a random sample of claim information from Empire and then requests the supporting medical records directly from the billing provider.

Clinical records are then reviewed by this contractors professional staff to determine the correct claim outcome. My role as the CERT coordinator is to act as a liaison between the hired contractor and your office. If your documentation has not been received by the contractor or appears to be incomplete, your office may receive a call from me to follow up with this request.

If it is determined that the claim or service reviewed was denied or the service was reduced to a lower level, I will send you a letter stating the reason for the denial or reduction and request that you refund the monies to us. If your office does receive a request for documentation for the CERT program please be aware that this does not pose any HIPAA vulnerabilities. If your office requires assistance with any CERT related inquiry please feel free to contact me.

Thank you