CERT audits can trigger Medicare scrutiny

03/5/2013 | O&P Almanac (Adobe Flash required)

Comprehensive Error Rate Testing audits are intended to control Medicare fraud and abuse, but unlike others, CERT audits are designed to measure the performance of claims contractors rather than providers. Nevertheless, the results can trigger increased scrutiny and prepayment audits, explains AOPA’s Director of Coding and Reimbursement Services Joseph McTernan, so O&P providers should be sure they understand applicable medical policies, boost communications with their referral sources and perform internal audits on a regular basis.

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