Signature guidelines: 20-day timeframe for additional documentation requests
When a medical reviewer contacts the provider requesting to submit an attestation statement or signature log to authenticate a...
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Understanding repetitive scheduled non-emergent ambulance transports
Review these FAQs to learn more about the prior authorization for repetitive scheduled non-emergency ambulance transport.
Targeted probe and educate (TPE) round results: Clinical laboratory services
View targeted probe and educate (TPE) round results for clinical laboratory services.
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.
Checklist: Therapeutic radiation-radiology services documentation
This checklist is intended to provide healthcare providers with a reference for use when responding to medical documentation...
Checklist: Cardiac rehabilitation services
This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for...
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.
CBR Guide - Part B
The Comparative Billing Report (CBR) for Part B providers furnishes a detailed examination of the comparative data that Medicare...
Checklist: Cardiac defibrillator implant w/o cardiac cath
This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for...
Prior authorization program for certain hospital outpatient department services - claim submission guidelines
Claims submitted for a prior authorization request (PAR) that received a provisional affirmation PA decision, including any...