Prior authorization

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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: 

RSNAT (repetitive scheduled non-emergent ambulance transportation) glossary tool

The following article provides a list of common terms used by the medical review department for prior authorization requests.

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…

Repetitive scheduled non-emergency ambulance transport prior authorization claims submission guidelines

Follow this instructions to learn how to file a claim once you received the unique tracking number (UTN) related to the prior authorization of repetitive, scheduled non-emergency ambulance transports…

Prior authorization for ambulance transports is for repetitive transports

A repetitive service is defined as medically necessary ambulance transportation that is furnished three or more times during a 10-day period OR at least once per week for at least three weeks.…

Prior authorization for ambulance transports is for repetitive transports

A repetitive service is defined as medically necessary ambulance transportation that is furnished three or more times during a 10-day period OR at least once per week for at least three weeks.…

Botulinum toxin injections

Botulinum toxins are potent neuromuscular blocking agents that are useful in treating various focal muscle spastic disorders and excessive muscle contractions, such as dystonia, spasms, and twitches.

Botulinum toxin injections

Botulinum toxins are potent neuromuscular blocking agents that are useful in treating various focal muscle spastic disorders and excessive muscle contractions, such as dystonia, spasms, and twitches.