Targeted probe and educate (TPE) round results: Rehabilitation services outpatient
View these round results for rehabilitation services outpatient.
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Targeted probe and educate (TPE) round results: End stage renal disease (ESRD) (CPT 90999)
Review the top denial / partial denial reasons and high-level results listed below from each round of JN ESRD TPE reviews.
Checklist: Evaluation and management (E/M) services documentation
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation...
Ambulance physician certification statement
Physician certification statements (PCS) are required for patients who are under the direct care of a physician and are required...
Prior authorization program initiatives
Prior authorization is a process through which coverage is determined prior to providing or billing the service. This process...
Paperwork (PWK)
Learn how PWK, the paperwork segment of the X12N version 5010, allows providers to submit medical documentation with their...
Understanding the prior authorization (PA) demonstration for ambulatory surgical center (ASC) services
This document was developed based on questions and answers posed during our webinars on the PA demonstration for ASC services.
Prior authorization (PA) program for certain hospital outpatient department (OPD) services - submitting the prior authorization request (PAR)
View these submission guidelines when submitting prior authorization requests for certain hospital outpatient department...
Tools & forms: Compliance / Review
Access tools and forms related to the prior authorization program, CERT, and provider audit.
Submit medical review documentation electronically
Are you sending hardcopy mail to submit your requests to First Coast? Did you know there are faster and easier ways to send your...