Medicare Administrative Contractors Are Audited and Auditing: Learn From the Results
HMP Global February 23, 2023
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I am sure you know that the Medicare Administrative Contractors (MACs)—which process wound/ulcer management claims—conduct pre-payment and post-payment audits, but do you know that all the MACs are audited to determine if they overpaid or underpaid the claims they processed? That audit program is called Comprehensive Error Rate Testing (CERT). Each year, an independent CERT review contractor (NCI Information Systems, Inc.) reviews the documentation in medical records...