Prior authorization fax coversheet

Now available: Prior Authorization Request (PAR) coversheet 

The CMS implemented a prior authorization program for certain hospital outpatient department (OPD) services for dates of service on or after July 1, 2020. The hospital OPD provider must submit the PAR to First Coast before the service is provided to the beneficiary and before the claim is submitted for processing. The PAR must include all documentation necessary to show that the service meets applicable Medicare coverage, coding, and payment rules. 

Providers may access the PAR coversheet  and submit the form via the Secure Provider Online Tool (SPOT), fax, or mail.

First Coast has a Prior Authorization webpage that provides more information and links relating to this new program.