Prior authorization

Nasal surgery is any procedure performed on the external or internal structures of the nose, septum or turbinate.

Effective for dates of service July 1, 2020, and after, hospital outpatient department (HOPD) providers will need to obtain prior authorization (PA) for panniculectomy, excision of excess skin and…

Nasal surgery is any procedure performed on the external or internal structures of the nose, septum or turbinate.

Physician certification statements (PCS) are required for patients who are under the direct care of a physician and are required to verify the medical necessity for certain scheduled and unscheduled…

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

Hospital outpatient departments that qualify for an exempt status effective January 1, need to have at least 10 claims submitted and finalized.

Learn how to complete the the prior authorization request (PAR) coversheet for repetitive scheduled non-emergency ambulance transports.

Hospital outpatient departments that qualify for an exempt status effective January 1, need to have at least 10 claims submitted and finalized.

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: 

Repetitive, scheduled non-emergent ambulance transport (RSNAT) has been effective as of April 1, 2022. Through this program, a unique tracking number (UTN) is issued for each medical decision…