Annually, CMS monitors the accuracy of Medicare Fee-For-Service (FFS) payments.  CMS contractors use the Comprehensive Error Rate Testing (CERT) program information to determine which services are experiencing high error rates. They then perform comprehensive data analysis to identify specific providers for probe review. In a probe review, a contractor samples a small number of claims from a given provider for a given service and reviews them to determine if the provider is billing in error. When the probe review indicated that corrective action needed to be taken, the contractor took the corrective action they deemed most appropriate.

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Page Last Modified: 03/08/2006 4:01:00 PM
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