CERT Documentation Submission Timeliness Update

December 18, 2013
Rick Gawenda

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.

All material posted on our website is the intellectual property of Gawenda Seminars & Consulting, Inc. and can’t be used, reproduced, or posted as your own material without the prior written approval of Gawenda Seminars & Consulting, Inc.

This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.