Betsy Nicoletti

Medical Coding and Compliance Expert, Speaker, Educator, and Auditor

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Analysis of 2018 CERT report: use these findings to educate and audit high risk codes

April 25, 2019

CodingIntel.com

CMS releases a Comprehensive Error Rate Testing (CERT) report annually.  This report, prepared by an independent contractor, measures the error rate for fee-for-service claims. This webinar will analyze errors for Part B payments and identify the types of services with the highest error rates and the reasons identified in the CERT report. The most common type of error is insufficient documentation, followed by incorrect coding.  Some types of procedures, however, were denied for medical necessity.  The report also includes improper payment rates for sampled specialties—see where your specialty ranks. This review will help practices identify potential deficiencies in their documentation. Medical practices can use this information to focus educational efforts and their own audit plans for the coming year.

After the session, participants will be able to:

  • Identify services performed in their practice that have a high error rate in the CERT report
  • Describe the type documentation deficiencies that lead to errors
  • Develop an education and audit plan

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“My organization approached Betsy Nicoletti because we had providers failing coding audits.

Betsy’s name is out there in the coding world as a leader in the field and wanted the best for our providers.

Betsy works with the organization to set up webinars for our new provider on boarding training process (which according to them has been most beneficial), as well as subsequent auditing to ensure provider engagement and understanding.

Betsy’s one on one approach has helped the organization overall by the specialized attention to our specific needs.

I appreciate Betsy’s tactful approach with the providers to lessen their concerns as it relates to proper coding. She is up to date on all of the current changes in coding and maintains the communication whenever warranted.

Overall I have found the experience of working with Betsy as positive and educational. I would not hesitate to recommend Betsy to any organization that needs to improve their coding practices and improve success rates from outside auditing.”

Julie D., LPN
Clinical Performance/Operations Manager

• Develop agenda with Betsy*
• Betsy will customize presentation and prepare learning materials
• 90 minute Zoom, live education session
• 30 days Q&A follow up
• Recording of session to show new hires
• Interactive: everyone hears the same thing and can ask questions

*Betsy’s area of expertise doesn’t include all procedural coding – email to set up a time to discuss your needs