Medical review
Targeted probe and educate (TPE) round results: Rehabilitation services outpatient
View these round results for rehabilitation services outpatient.
Targeted probe and educate (TPE) round results: Evaluation and management services - outpatient office visits
View TPE round results for evaluation and management services - outpatient office visits.
Targeted probe and educate (TPE) round results: Rehabilitation services outpatient
View these round results for rehabilitation services outpatient.
Submit prior authorization requests electronically
Are you using regular mail for submissions to First Coast? We have several electronic options that are easier and faster for you to use. Additionally, submitting documentation electronically:
Submit prior authorization requests electronically
Are you using regular mail for submissions to First Coast? We have several electronic options that are easier and faster for you to use. Additionally, submitting documentation electronically:
Hospital outpatient department (OPD) prior authorization exemption process
On August 1, exempt OPDs will receive an additional documentation request (ADR) for a 10-claim post-pay sample on finalized claims with dates of service on or after January 1, through June 30. Review…
Prior authorization (PA) demonstration for certain ambulatory surgical center (ASC) services
CMS is implementing a five-year demonstration project for the prior authorization of certain services provided in Ambulatory Surgical Centers (ASCs) and will be implementing the demonstration in two…
Targeted probe and educate (TPE) round results: Wound debridement (CPT 11042-11045)
Review the top denial/partial denial reasons and high-level results of wound debridement (CPT 11042-11045) TPE round results for December 2022 - May 2023.
Targeted probe and educate (TPE) round results: Inpatient rehabilitation facilities (IRF)
Review the targeted probe and educate (TPE) round results for inpatient rehabilitation facility (IRF).
Targeted probe and educate (TPE) round results: Inpatient rehabilitation facilities (IRF)
Review the targeted probe and educate (TPE) round results for inpatient rehabilitation facility (IRF).