On the CERT Contractor Call, providers were notified of CMS’ intent to change the response time for CERT requests for Initial Documentation to 60 days, down from 75 days. It is important that providers respond to any CERT Initial Documentation requests on or after January 1, 2014, within 60 days.
Make a note that the follow-up call and letter time frame from CERT will change as well:
- Day 0: Contact and/or send letter 1 via fax or mail
- Day 30: Contact and/or send letter 2 via fax or mail
- Day 45: Contact and/or send letter 3 via fax or mail
- Day 60: If no records were received, full claim denial
Also note, the response time for Additional Documentation requests remains 15 days.
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