Prior authorization
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.
Ambulance prior authorization documentation requirements
Review this checklist to learn about the documentation requirements to ensure an affirmed decision on your prior authorization request (PAR) for repetitive, scheduled, non-emergency transport.
Prior authorization program initiatives
Prior authorization is a process through which coverage is determined prior to providing or billing the service. This process allows the provider to submit documentation prior to providing or billing…