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Identify the top issue for the following claim types: Part B, DMEPOS, Part A excluding Inpatient Hospital PPS and Part A Inpatient Hospital PPS. For each claim type, identify the top issue (

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Identify the top issue for the following claim types: Part B, DMEPOS, Part A excluding Inpatient Hospital PPS and Part A Inpatient Hospital PPS. For each claim type, identify the top issue ( Part 2 – Improper Payment Review Analysis (8pts) Visit the Medicare CERT homepage (link below). Locate the most recent CERT annual report. Locate the section titled: Projected Improper Payments and Type of Error by Type of Service for Each Claim Type. Make , Word document, cite references. Identify the top issue for the following claim types: Part B, DMEPOS, Part A excluding Inpatient Hospital PPS and Part A Inpatient Hospital PPS. For each claim type, identify the top issue (for Part A Inpatient Hospital PPS identify the top clinical area). For each top issue identify the payment implication, the error rate, and the most significant error type. After reviewing the statistics, discuss what providers and facilities should do to improve their performance. Additionally, use the CERT annual report to define the five major error categories and explain each and what can be done to resolve these. 2.1 – No Documentation 2.2 – Insufficient Documentation 2.3 – Medical Necessity 2.4 – Incorrect Coding 2.5 – Other The CERT homepage can be found at: https://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/CERT/index.html?redirect=/certLinks to an external site. Directions on the CMS cite: The link takes you to CMS, next in the left menu click on CERT Reports. Next click on the 2019 Medicare Fee for Service Supplemental Improper Payments Data and download that report. In the report, go to page 4 and see Appendix D. Click to open it and use each table in Appendix D that applies to an answer for the questions above.

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