Targeted probe and educate (TPE)
TPE is one process that a MAC can utilize when providers are selected by medical review.
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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.
Paperwork (PWK)
Learn how PWK, the paperwork segment of the X12N version 5010, allows providers to submit medical documentation with their...
Medical necessity requirements for skilled nursing facility (SNF) admissions
This questionnaire is intended to provide health care providers with a reference for use when screening a new patient for a SNF...
Checklist: Drugs and Biologicals
This checklist is intended to provide health care providers with a reference for use when responding to medical documentation...
Checklist: Skin lesion removal
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation...
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: Community mental health centers (CMHC) or partial hospitalization program (PHP)
This checklist is an aid to assist providers when responding to medical record documentation requests pertaining to community...
Checklist: Skilled nursing facility (SNF) documentation
This checklist is an aid to assist skilled nursing facilities with responding to medical record documentation requests.
Targeted probe and educate (TPE) round results: Evaluation and management services - outpatient established office visits
View TPE round results for evaluation and management services - outpatient established office visits.