Repetitive scheduled non-emergency ambulance transport prior authorization claims submission guidelines
Follow this instructions to learn how to file a claim once you received the unique tracking number (UTN) related to the prior...
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Targeted probe and educate (TPE) round results: Endovascular cardiac valve replacement and supplement procedure (DRG 266 & 267)
Review the top denial/partial denial reasons and high-level results from each round of DRG 226 and 267 TPE.
Targeted probe and educate (TPE) round results: End stage renal disease (ESRD) (CPT 90960)
View targeted probe and educate (TPE) round results for end stage renal disease (ESRD).
Skilled nursing facility (SNF) 5-claim probe and educate (P&E) review
View this article for information concerning requirements of change request 13164.
Checklist: Psychotherapy services
This checklist is an aid to assist providers with documentation pertaining to psychotherapy services.
Targeted probe and educate (TPE) round results: Skilled nursing facility (SNF)
Review the top denial / partial denial reasons and high-level results of SNF TPE round results.
Targeted probe and educate (TPE) round results: Diagnostic-related group (DRG) 885 - psychosis
Review the top denial / partial denial reasons and high-level results listed for DRG 885.
Prior authorization of ambulance claims requires UTN in proper field
Repetitive, scheduled non-emergent ambulance transport (RSNAT) has been effective as of April 1, 2022. Through this program, a...
YouTube video: Answers to your prior authorization exemption questions
Are you participating in prior authorization and want to know how to maintain exemption within this program? Do you have...
Prior authorization for hospital outpatient department services: Don’t wait too long to submit your prior authorization requests
When submitting prior authorization requests, be aware of response timeframes and documentation guidelines.