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PC-ACE upgrade and installation instructions
PC-ACE version 6.9 is now available. Follow these instructions to complete the required quarterly upgrades or the full...
Hospital outpatient department (OPD) prior authorization exemption process
Hospital outpatient departments (OPDs) who demonstrate compliance with Medicare coverage, coding, and payment rules related to...
Prior authorization program for repetitive, scheduled non-emergent ambulance transports (RSNAT)
CMS has implemented the prior authorization program for certain repetitive, scheduled non-emergent ambulance transports in...
Ambulance Prior Authorization Documentation Requirements
Review this checklist to learn about the documentation requirements to ensure an affirmed decision on your prior authorization...
Fast facts: CERT vaccine and roster billed claims
Read this article to learn more about CERT reviews for vaccine and roster billed claims.
Limited systems availability Friday, April 3 through Sunday, April 5
There will be Common Working File (CWF) "dark days" Friday, April 3, through Sunday, April 5, affecting the IVR.
Appeal status requests must be obtained through SPOT
To enhance efficiency and ensure the secure handling of appeal information, effective May 1, 2026, all providers will be...
Prior authorization (PA) demonstration for certain ambulatory surgical center (ASC) services
CMS is implementing a five-year demonstration project for the prior authorization of certain services provided in Ambulatory...
Blepharoplasty, eyelid surgery, brow lift, and related services
Blepharoplasty, blepharoptosis repair and brow lift are surgeries that may be performed to improve function or provided strictly...