This free web-based application from Novitas Solutions allows users to view and print electronic remittances via a secure website. PortalPortal is designed to help service providers, billing services, and clearinghouses by offering them a free service.
On Novitasphere, users can obtain information about their appeals, including their outcomes. In addition, users can get account receivable details, such as recoupment, adjustment, and collection amounts.
CERT (Comprehensive Error Rate Testing) Program
The Centers for Medicare and Medicaid Services (CMS) created this federally mandated program integrity activity to ensure Medicare claims are billed and paid accurately. The following error rates have been calculated using this program:
- National
- Contractor specific
- Contractor type
- Provider type
- Service type
CMS and its Medicare Administrative Contractors (MACs) can extract data and produce rates to identify the sources of billing, payment, and processing errors. CERT error rates are also used by CMS as a measure of progress toward its performance goals.
A law known as the Improper Payments Elimination and Recovery Improvement Act of 2012 regulates CERT. The law states that “the heads of federal agencies, including HHS, are required to review programs that they administer annually to improve efforts to reduce and recover improper payments.” “CMS and Contractors analyze improper payment rates and develop plans to help reduce improper payments.” Stated otherwise, the objective of the CERT program is to reduce improper payments through education and thereby reduce the CERT error rate.
CERT Process
To ensure the health integrity of Medicare claims, AdvanceMed, the CERT Review Contractor, chooses random samples from each Medicare claim to give to the process contractors. In the process of the CERT Review Contractor, each request for medical records is accompanied by a follow-up request to the provider or supplier who submitted the claim (different follow-up requests may be made depending on the response or non-response).
The client receiving the service or item may request additional documentation. To ensure that claims are properly coded and billed under Medicare regulations, CERT evaluates a statistically valid sample of claims based on medical record documentation. A claim error is the result of incorrect billing, payment, or claims processing.