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 the service. The contractor will then al…
To avoid claim denials and future appeals due to incorrect claim submissions, we’re providing guidance on how to properly submit a claim when applying modifier 57.
This edition includes information on proposed payment rules for fiscal year 2027, events, guidance on new requirements for hospital price transparency, and more.
Review this checklist to learn about the documentation requirements for medical professionals related to the repetitive, scheduled, non-emergency prior authorization program.
Learn about First Coast’s online and instructor-led training opportunities; get involved with the Provider Outreach and Education Advisory Group (POE-AG); and find links to the educational resources available on the Centers for Medicare