tci Part B Insider - 2018 Issue 2

CMS Spotlights Insufficient Data Issue in CERT Release

Tip: Stay on top of your recertifications, guidance suggests. This year's CERT supplemental data includes a handy breakdown of what it defines as "insufficient data," which accounted for approximately 64 percent of the improper payment rate and $23.2 billion improperly paid out to Medicare providers and suppliers. "In order to provide a more thorough understanding of insufficient documentation errors, CMS examined the root causes of these errors and developed a universal error for the insufficient documentation error," explains the agency in the CERT report. "The root cause of the insufficient documentation error must meet the universal...

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