CERT

Answer
Once you have logged into eServices, locate the eReview tab. If you cannot view this tab, you may not have the necessary permissions. Contact your provider administrator on the account to request access. From the eReview tab, select the eAudit sub-tab. This section currently features CERT contractor claim review and status information that is updated monthly.

Select CERT Claim Review Status from the Audit Type dropdown menu on the eAudit screen. Next you will need to enter your NPI and Contractor ID. Select your audit type (CERT Claim Review Status) and enter CID. To view your CERT Claim Identifier information, you will need to enter required information into both fields. A summary table of your CERT audit data will automatically populate after doing so with results listed by error code category. 

• The claim data table will list the line error code category by claims not in error, claims in error, and claims pending review by the CERT contractor
• The claim data details table will allow users to see the claim line details for that audit error code category noted on the claim data table. There is also a definition of the line error code. Each of the items in the claim data details table can be expanded for extra details.

On our website under topics CERT and Education and Events you can find educational material related to the CERT contractor and frequently reviewed topics to aid in preventing claim denials.

Last Reviewed: 09/23/2024