Home Health & Hospice Week

A little staff education is likely in order.

With calls for using CERT to target high-risk home health agencies in the air, now may be a good time to shore up your Comprehensive Error Rate Testing record.

The HHS Office of Inspector General recently urged the Centers for Medicare & Medicaid Services to use data gathered from the CERT program to identify high-risk HHAs for advanced review and other fraud-fighting tactics (see Eli’s HCW, Vol. XXVIII, No. 32). Although CMS seems resistant to the general idea, don’t be surprised to see at least some pieces of the recommendations show up down the road.

That may make Medicare Administrative Contractor National Government Services’ recent advice on avoiding CERT areas timely. NGS “has experienced an increasing number of CERT errors due to ‘no documentation’ received,” the MAC says in an email to providers.

Do this: “Providers should periodically verify if the address information in PECOS is correct and update, if necessary,” NGS advises. That’s because the CERT contractor sends the initial letter to the PECOS address on file for the provider.

And this: Show staff who manage the mail a sample of the CERT envelope and letter, available at https://certprovider.admedcorp.com/Home/SampleRequestLetters. “This will help the staff route the CERT requests to the appropriate area,” NGS says.

And this: “Providers having at least ten PTAN/OSCAR numbers who would like to elect a single point of contact can participate in the ‘chain address’ program implemented by CERT,” which established one point of contact for CERT, NGS explains.