Medical review

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Prior authorization (PA) for hospital outpatient department (OPD) services: tips and reminders

The following are tips and reminders that will assist providers in avoiding a delay or dismissal of a prior authorization request.

Medical documentation checklists

Use the links on the left to access checklists to ensure you have met medical documentation requirements based on specific services.

Checklist: Cardiac rehabilitation services

This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for cardiac rehabilitation services.

Checklist: Skilled nursing facility (SNF) documentation

This checklist is an aid to assist skilled nursing facilities with responding to medical record documentation requests.

Checklist: Annual wellness visit (AWV)

This checklist is intended to provide health care providers with a reference for use when responding to medical documentation requests for AWV. Health care providers retain responsibility to submit…

Checklist: Pulmonary rehabilitation services

This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for pulmonary rehabilitation services.

Prior authorization (PA) for hospital outpatient department (OPD) services: tips and reminders

The following are tips and reminders that will assist providers in avoiding a delay or dismissal of a prior authorization request.

Medical documentation checklists

Use the links on the left to access checklists to ensure you have met medical documentation requirements based on specific services.

Checklist: Cardiac rehabilitation services

This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for cardiac rehabilitation services.

Checklist: Annual wellness visit (AWV)

This checklist is intended to provide health care providers with a reference for use when responding to medical documentation requests for AWV. Health care providers retain responsibility to submit…