Read This Article , Take Survey to Earn Continuing Education Points
CEP
CERT stands for " Comprehensive Error Rate Testing " and is an auditing tool that was established in 1996 . Its purpose was to reduce costs associated with improperly completed and improperly paid Medicare claims . CMS has contracted with Advance Med to oversee the CERT process for Jurisdiction B DME MAC . The CERT contractor randomly requests and audits approximately 2,000 — 3,000 claims per year from Jurisdiction B . It just seems like it is so many more .
The medical review specialists employed by the CERT contractor review each claim and determine the following :
• Does the item / equipment fit a Medicare benefit category ?
• Is the item / equipment statutorily excluded ?
• Is the item / equipment medically reasonable and necessary ?
• Is there documentation to support that the item / equipment was provided ?
• Was the item / equipment coded and billed correctly ?
This determination is made by reviewing the information contained in the claim for services .
Read This Article , Take Survey to Earn Continuing Education Points
The Pedorthic Footcare Association ( PFA ) offers Continuing Education Points ( CEPs ), approved by the American Board for Certification in Orthotics , Prosthetics & Pedorthics , Inc . ( ABC ) and the Board of Certification / Accreditation ( BOC ), via specially designated articles within Current Pedorthics magazine .
To take advantage of the program , thoroughly read the adjacent CEU article and then visit : www . pedorthics . org and click on the Continuing Education Opportunities tab to purchase the 10-question quiz associated with this article . CEP quizzes cost $ 15 for members and $ 25 for non-members . The quizzes are worth 1.0 Scientific or Business CEP , depending on the content . Successful completion of the quiz will result in 1.0 CEP reported directly to ABC and BOC at the end of each quarter .
Look for additional CEP-eligible articles in future issues of the magazine ; previous articles are available in the magazine archive at www . pedorthics . org .
If you have any questions , contact PFA , at ( 229 ) 389-3440 or e-mail : ceu @ pedorthics . org .
Current Pedorthics November / December 2016 45