What does CERT stand for in healthcare finance?

In healthcare finance, CERT stands for Comprehensive Error Rate Testing. This program is primarily conducted by the Centers for Medicare & Medicaid Services (CMS) to measure the accuracy of payments made to healthcare providers and identify improper payments due to errors. The goal of the CERT program is to ensure compliance and reduce the amount of erroneous payments that may lead to financial losses for the Medicare program.

Comprehensive Error Rate Testing involves reviewing a sample of claims to determine whether they were paid correctly according to the regulations. By doing so, it helps in creating a feedback loop for providers, allowing them to improve their billing practices and compliance with healthcare regulations. Understanding this concept is essential for professionals in the healthcare finance sector, as it directly impacts revenue cycle management and compliance efforts.