Articles

For any service or item to be covered by Medicare, it must be eligible for a defined Medicare benefit category, be reasonable...

Learn the difference between fraud and abuse, recognize common warning signs, and understand your role in preventing improper...

Blepharoplasty, blepharoptosis repair and brow lift are surgeries that may be performed to improve function or provided strictly...

Botulinum toxins are potent neuromuscular blocking agents that are useful in treating various focal muscle spastic disorders and...

CMS implemented a prior authorization program for certain hospital outpatient department services for dates of service on or...

Facet joint interventions may be used in pain management for chronic cervical/thoracic and lumbar/sacral pain arising from the...

The following document was developed based on questions and answers posed during our webinars on the prior authorization (PA)...

The MDS is a tool used for implementing standardized assessment and for facilitating care management in skilled nursing homes...

Service-specific reviews

First Coast is tasked with preventing inappropriate Medicare payments. One of the ways this is conducted...

CMS is implementing a five-year demonstration project for the prior authorization of certain services provided in Ambulatory...